Forhef Tablets SpecificationRequires Prescription (YES/NO)YesGenericsSacubitril , ValsartanUsed ForHeart FailureHow it worksSacubitril + valsartan inhibits neprilysin (neutral endopeptidase; NEP) , the active metabolite of the prodrug sacubitril and blocks the angiotensin II type-1 (AT1) receptor via valsartan. The cardiovascular and renal effects of sacubitril + valsartan in heart failure patients are attributed to the increased levels of peptides that are degraded by neprilysin, such as natriuretic peptides (NPs) and the simultaneous inhibition of the effects of angiotensin II by valsartan. NPs exert their effects by activating membrane bound guanylyl cyclase coupled receptors, resulting in increased concentrations of the second messenger cyclic guanosine monophosphate (cGMP), which could result in vasodilation, natriuresis and diuresis, increased glomerular filtration rate and renal blood flow, inhibition of renin and aldosterone release, reduction ofsympathetic activity and antihypertrophic and antifibrotic effects. Valsartan inhibits the effects of angiotensin II by selectively blocking the AT1 receptor and also inhibits angiotensin II-dependent aldosterone release. This prevents sustained activation of the renin-angiotensin-aldosterone system that would result in vasoconstriction, renal sodium and fluid retention, activation of cellular growth and proliferation and subsequent maladaptive cardiovascular remodeling.Forhef Tablets Usage And SafetyDosageSacubitril , ValsartanSide EffectsVery Common : Hyperkalemia, hypotension and renal impairment.Common : Anemia, hypokalemia, hypoglycemia, dizziness, headache, syncope, vertigo, orthostatic hypotension, cough, diarrhea, nausea, gastritis, renal failure (renal failure, acute renal failure), fatigue and asthenia.Uncommon : Hypersensitivity, dizziness postural, pruritus, rash and angioedema.Drug InteractionsAngiotensin Receptor Blockers , OATP1B1 and OATP1B3 substrates, e.g. statins , PDE5 inhibitors including sildenafil , potassium-sparing diuretics (triamterene, amiloride), mineralocorticoid antagonists (e.g. spironolactone, eplerenone), potassium supplements, salt substitutes containing potassium or other agents (such as heparin) , Non-steroidal anti-inflammatory agents (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors , Lithium , OATP1B1, OATP1B3, OAT3 (e.g. rifampicin, ciclosporin), OAT1 (e.g. tenofovir, cidofovir) or MRP2 (e.g. ritonavir) , Metformin HCl.IndicationSacubitril + Valsartan is indicated in adult patients for treatment of symptomatic chronic heart failure with reduced ejection fraction. Sacubitril + Valsartan is usually administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other ARB.When not to UseSacubitril + Valsartan is contraindicated in patients with:? Hypersensitivity to the active substance, sacubitril, valsartan or to any of the excipient of the product.? Concomitant use with ACE inhibitors. Sacubitril + Valsartan must not be administered until 36 hours after discontinuing ACE inhibitor therapy.? Known history of angioedema related to previous ACE inhibitor or ARB therapy.? Hereditary or idiopathic angioedema.? Concomitant use with aliskiren-containing medicinal products in patients with diabetes mellitus or in patients with renal impairment (eGFR <60 ml/min/1.73 m2 ).? Severe hepatic impairment, biliary cirrhosis and cholestasis.? Second and third trimester of pregnancyForhef Tablets PrecautionsPrecautionSacubitril + valsartan may cause angioedema. If angioedema occurs, discontinue sacubitril + valsartan immediately, provide appropriate therapy and monitor for airway compromise. Sacubitril + valsartan should not be used in patients with a known history of angioedema related to previous ACE inhibitor or ARB therapy.Forhef Tablets WarningsWarning 1Sacubitril + valsartan lowers blood pressure and may cause symptomatic hypotension. Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. Correct volume or salt depletion prior to administration of sacubitril + valsartan or start at a lower dose. If hypotension occurs, consider dose adjustment of diuretics, concomitant antihypertensive drugs and treatment of other causes of hypotension (e.g., hypovolemia). If hypotension persists despite such measures, reduce the dosage or temporarily discontinue sacubitril + valsartan.Warning 2Through its actions on the RAAS, hyperkalemia may occur with sacubitril + valsartan. Monitor serum potassium periodically and treat appropriately, especially in patients with risk factors for hyperkalemia such as severe renal impairment, diabetes, hypoaldosteronism or a high potassium diet. Dosage reduction or interruption of sacubitril + valsartan may be required.Warning 3Caution should be exercised when initiating sacubitril + valsartan in patients with NYHA functional classification IV due to limited clinical experience in this population.Forhef Tablets Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.
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Forhans Lion DescriptionDescription : Forhan?s Lion Balm Muscle Rub is a special Herbal formulation for the relief of muscle aches, joint aches and stiffness associated with rheumatic conditions (a type of condition that affects your joints tendons, ligaments, bones, and muscles e.g. Arthritis). It is a high quality and effective Pain Relief Balm that has special ingredients to help quickly penetrate deep into sore, tired muscles and melt away muscular pain and discomfort of joints. With the natural healing powers of turmeric, Forhan?s Lion Balm Muscle Rub immediately provides relief from any muscle or joint pain. Massaged on the affected area, it gently warms and stimulates blood circulation and helps soothe down the discomfort. How to use ? Apply directly to shoulders, knees, elbows, back or any part of the body that feels painful. Wash your hands thoroughly after use.Warnings ! For external use only. Read the package insert and follow directions carefully. If there is an insert, save it to refer to later. Never apply them to wounds or damaged skin. Do not use them along with a heating pad, because it could cause burns. Do not use under a tight bandage . Wash your hands well after using them or wear gloves. Avoid touching your eyes with the product on your hands . If you are allergic to aspirin or are taking blood thinners, check with your doctor before using topical medications that contain salicylates. Do not use on wounds or open damaged skin. Not for children under 5 years of age. Avoid contact with eyes. Seek medical attention if pain symptoms persist. Keep out of reach of young children. Benefits : ? Helps relieve muscle stiffness of patients with Arthritis or any other joint conditions ? Provides immediate relief for any muscle or joint pain ? Regulated blood circulation in the affected area ? Detangles any overlapped muscles ? Contains natural healing powers of turmeric ? Helps soothe down the discomfort ? Quickly penetrates deep into sore muscles .
Forhef Tablets SpecificationRequires Prescription (YES/NO)YesGenericsSacubitril , ValsartanUsed ForHeart FailureHow it worksSacubitril + valsartan inhibits neprilysin (neutral endopeptidase; NEP) , the active metabolite of the prodrug sacubitril and blocks the angiotensin II type-1 (AT1) receptor via valsartan. The cardiovascular and renal effects of sacubitril + valsartan in heart failure patients are attributed to the increased levels of peptides that are degraded by neprilysin, such as natriuretic peptides (NPs) and the simultaneous inhibition of the effects of angiotensin II by valsartan. NPs exert their effects by activating membrane bound guanylyl cyclase coupled receptors, resulting in increased concentrations of the second messenger cyclic guanosine monophosphate (cGMP), which could result in vasodilation, natriuresis and diuresis, increased glomerular filtration rate and renal blood flow, inhibition of renin and aldosterone release, reduction ofsympathetic activity and antihypertrophic and antifibrotic effects. Valsartan inhibits the effects of angiotensin II by selectively blocking the AT1 receptor and also inhibits angiotensin II-dependent aldosterone release. This prevents sustained activation of the renin-angiotensin-aldosterone system that would result in vasoconstriction, renal sodium and fluid retention, activation of cellular growth and proliferation and subsequent maladaptive cardiovascular remodeling.Forhef Tablets Usage And SafetyDosageSacubitril , ValsartanSide EffectsVery Common : Hyperkalemia, hypotension and renal impairment.Common : Anemia, hypokalemia, hypoglycemia, dizziness, headache, syncope, vertigo, orthostatic hypotension, cough, diarrhea, nausea, gastritis, renal failure (renal failure, acute renal failure), fatigue and asthenia.Uncommon : Hypersensitivity, dizziness postural, pruritus, rash and angioedema.Drug InteractionsAngiotensin Receptor Blockers , OATP1B1 and OATP1B3 substrates, e.g. statins , PDE5 inhibitors including sildenafil , potassium-sparing diuretics (triamterene, amiloride), mineralocorticoid antagonists (e.g. spironolactone, eplerenone), potassium supplements, salt substitutes containing potassium or other agents (such as heparin) , Non-steroidal anti-inflammatory agents (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors , Lithium , OATP1B1, OATP1B3, OAT3 (e.g. rifampicin, ciclosporin), OAT1 (e.g. tenofovir, cidofovir) or MRP2 (e.g. ritonavir) , Metformin HCl.IndicationSacubitril + Valsartan is indicated in adult patients for treatment of symptomatic chronic heart failure with reduced ejection fraction. Sacubitril + Valsartan is usually administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other ARB.When not to UseSacubitril + Valsartan is contraindicated in patients with:? Hypersensitivity to the active substance, sacubitril, valsartan or to any of the excipient of the product.? Concomitant use with ACE inhibitors. Sacubitril + Valsartan must not be administered until 36 hours after discontinuing ACE inhibitor therapy.? Known history of angioedema related to previous ACE inhibitor or ARB therapy.? Hereditary or idiopathic angioedema.? Concomitant use with aliskiren-containing medicinal products in patients with diabetes mellitus or in patients with renal impairment (eGFR <60 ml/min/1.73 m2 ).? Severe hepatic impairment, biliary cirrhosis and cholestasis.? Second and third trimester of pregnancyForhef Tablets PrecautionsPrecautionSacubitril + valsartan may cause angioedema. If angioedema occurs, discontinue sacubitril + valsartan immediately, provide appropriate therapy and monitor for airway compromise. Sacubitril + valsartan should not be used in patients with a known history of angioedema related to previous ACE inhibitor or ARB therapy.Forhef Tablets WarningsWarning 1Sacubitril + valsartan lowers blood pressure and may cause symptomatic hypotension. Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. Correct volume or salt depletion prior to administration of sacubitril + valsartan or start at a lower dose. If hypotension occurs, consider dose adjustment of diuretics, concomitant antihypertensive drugs and treatment of other causes of hypotension (e.g., hypovolemia). If hypotension persists despite such measures, reduce the dosage or temporarily discontinue sacubitril + valsartan.Warning 2Through its actions on the RAAS, hyperkalemia may occur with sacubitril + valsartan. Monitor serum potassium periodically and treat appropriately, especially in patients with risk factors for hyperkalemia such as severe renal impairment, diabetes, hypoaldosteronism or a high potassium diet. Dosage reduction or interruption of sacubitril + valsartan may be required.Warning 3Caution should be exercised when initiating sacubitril + valsartan in patients with NYHA functional classification IV due to limited clinical experience in this population.Forhef Tablets Additional InformationPregnancy categoryAlways consult your physician before using any medicine.Storage (YES/NO)Store this medicine at room temperature, away from direct light and heat.
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