Cortimax24 mg

Cortimax 24 mg is indicated in- Anaphylaxis, asthma, severe hypersensitivity reactions Rheumatoid arthritis, juvenile chronic arthritis, polymyalgia rheumatica Systemic lupus erythematosus, dermatomyositis, mixed connective tissue disease (other than systemic sclerosis), polyartritis nodosa, sarcoidosis ... Read moreCortimax 24 mg is indicated in- Anaphylaxis, asthma, severe hypersensitivity reactions Rheumatoid arthritis, juvenile chronic arthritis, polymyalgia rheumatica Systemic lupus erythematosus, dermatomyositis, mixed connective tissue disease (other than systemic sclerosis), polyartritis nodosa, sarcoidosis Pemphigus,bullous pemphigoid, pyoderma gangrenosum Minimal change nephrotic syndrome, acute interstitial nephritis Rheumatic carditis Ulcerative colitis, Crohn's disease Uveitis, optic neuritis Autoimmune haemolytic anaemia, idiopathic thrombocytopenic purpura Acute and lymphatic leukaemia, malignant lymphoma, multiple myeloma Immune suppression in transplantation

Glucocorticoids

Cortimax 24 mg provides anti-inflammatory action by inhibiting Phospholipase A2 enzyme which is responsible for prostaglandin synthesis. Besides Cortimax 24 mg decreases the release of certain chemicals that are important in the immune system. By decreasing the release of these chemicals Cortimax 24 mg provides immunosuppressive action.

Adults: For acute disorders: up to 120 mg/day Cortimax 24 mg may need to be given initially. Maintenance doses in most conditions are within the range 3-18 mg/day. Rheumatoid arthritis: The maintenance dose is usually within the range 3-18 mg/day. The smallest effective dose should be used and increased if necessary. Bronchial asthma: In the treatment of an acute attack, high doses of 48-72 mg/day may be needed depending on severity and gradually reduced once the attack has been controlled. For maintenance in chronic asthma, doses should be titrated to the lowest dose that controls symptoms. Other conditions: The dose of Cortimax 24 mg depends on clinical need titrated to the lowest effective dose for maintenance. Starting doses may be estimated on the basis of ratio of 5 mg prednisone or prednisolone to 6 mg Cortimax 24 mg. Children: Alternate day administration may be appropriate.  Doses of Cortimax 24 mg usually lie in the range 0.25-1.5 mg/kg/day. The following ranges provide general guidance: Juvenile chronic arthritis: The usual maintenance dose is between 0.25 to 1.0 mg/kg/day. Nephrotic syndrome: Initial dose of usually 1.5 mg/kg/day followed by down titration according to clinical need. Bronchial asthma: The initial dose should be between 0.25 - 1.0 mg/kg on alternate days. Cortimax 24 mg withdrawal: In patients who have received more than physiological doses of systemic corticosteroids (approximately 9 mg per day or equivalent) for greater than 3 weeks, withdrawal should not be abrupt. How dose reduction should be carried out depends largely on whether the disease is likely to relapse as the dose of systemic corticosteroids is reduced.

Adults- For acute disorders: Up to 120 mg/day Cortimax 24 mg may need to be given initially. Maintenance doses in most conditions are within the range of 3-18 mg/day. Rheumatoid arthritis: The maintenance dose is usually within the range of 3-18 mg/day. The smallest effective dose should be used and increased if necessary. Bronchial asthma: In the treatment of an acute attack, high doses of 48-72 mg/day may be needed depending on severity and gradually reduced once the attack has been controlled. For maintenance in chronic asthma, doses should be titrated to the lowest dose that controls symptoms. Other conditions: The dose of Cortimax 24 mg depends on clinical need titrated to the lowest effective dose for maintenance. Starting doses may be estimated on the basis of ratio of 5 mg prednisone or prednisolone to 6 mg. Children: There has been limited exposure of children to Cortimax 24 mg in clinical trials. In children, the indications for glucocorticoids arethe same as for adults, but it is important that the lowest effective dosage is used. Alternate day administration may be appropriate. Doses of Cortimax 24 mg usually lie in the range 0.25-1.5 mg/kg/day. The following ranges provide general guidance: Juvenile chronic arthritis: The usual maintenance dose is between 0.25-1.0 mg/kg/day. Nephrotic syndrome: Initial dose of usually 1.5 mg/kg/day followed by down titration according to clinical need. Bronchial asthma: On the basis of the potency ratio, the initial dose should be between 0.25-1.0 mg/kg on alternate days. Cortimax 24 mg withdrawal: In patients who have received more than physiological doses of systemic corticosteroids (approximately 9 mg per day or equivalent) for greater than 3 weeks, withdrawal should not be abrupt. How dose reduction should be carried out depends largely on whether the disease is likely to relapse as the dose of systemic corticosteroids is reduced.

Cortimax 24 mg is metabolized in the liver. It is recommended to increase the maintenance dose of Cortimax 24 mg if drugs which are liver enzyme inducers are co-administered, e.g. rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone and aminoglutethimide. For drugs which inhibit liver enzymes, (e.g. ketoconazole) it may be possible to reduce the maintenance dose of Cortimax 24 mg.

Hypersensitivity to or any of the ingredients. Patients receiving live virus immunization.

GI disturbances, musculoskeletal, endocrine, neuropsychiatric, ophthalmic, fluid and electrolyte disturbances; susceptible to infection, impaired healing, hypersensitivity, skin atrophy, striae, telangiectasia, acne, myocardial rupture following recent Ml, thromboembolism.

Use in pregnancy: Cortimax 24 mg does cross the placenta. When administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intra-uterine growth retardation. As with all drugs, corticosteroids should only be prescribed when the benefits to the mother and child outweigh the risks.Use in lactation: Corticosteroids are excreted in breast milk. Doses up to 50 mg daily of Cortimax 24 mg are unlikely to cause systemic effects in the infant.

The following clinical conditions require special caution and frequent patient monitoring is necessary- Cardiac disease or congestive heart failure (except in the presence of active rheumatic carditis), hypertension, thromboembolic disorders. Glucocorticoids can cause salt and water retention and increased excretion of potassium. Dietary salt restriction and potassium supplementation may be necessary. Gastritis or oesophagitis, diverticulitis, ulcerative colitis if there is the probability of impending perforation, abscess or pyogenic infections, fresh intestinal anastomosis, active or latent peptic ulcer. Diabetes mellitus or family history, osteoporosis, myasthenia gravis, renal insufficiency. Emotional instability or psychotic tendency, epilepsy. Previous corticosteroid-induced myopathy. Liver failure. Hypothyroidism and cirrhosis, which may increase the glucocorticoid effect. Ocular herpes simplex because of possible corneal perforation.

In patients who have received more than physiological doses of systemic corticosteroids (approximately 9mg per day or equivalent) for greater than 3 weeks, withdrawal should not be abrupt. How dose reduction should becarried out depends largely on whether the disease is likely to relapse as the dose of systemic corticosteroids is reduced.

Store in a cool (below 25°C) and dry place, protected from light & moisture. Keep out of the reach of children.

Elderly: In elderly patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary.Hepatic impairment: In patients with hepatic impairment, blood levels of Cortimax 24 mg may be increased. Therefore the dose of Cortimax 24 mg should be carefully monitored and adjusted to the minimum effective dose.Renal impairment: In renal impaired patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary.

Glucocorticoids

Cortimax 24 mg provides anti-inflammatory action by inhibiting Phospholipase A2 enzyme which is responsible for prostaglandin synthesis. Besides Cortimax 24 mg decreases the release of certain chemicals that are important in the immune system. By decreasing the release of these chemicals Cortimax 24 mg provides immunosuppressive action.

Pregnancy: Cortimax 24 mg does cross the placenta. However, when administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intrauterine growth retardation. As with all drugs, corticosteroids should only be prescribed when the benefits to the mother and child outweigh the risks.Nursing Mother: Corticosteroids are excreted in breast milk, although no data are available for Cortimax 24 mg. Doses of up to 50 mg daily of Cortimax 24 mg are unlikely to cause systemic effects in the infant. Infants of mothers taking higher doses than this may have a degree of adrenal suppression but the benefits of breastfeeding are likely to outweigh any theoretical risk.

Hepatic Impairment: In patients with hepatic impairment, blood levels of may be increased. Therefore the dose of Cortimax 24 mg should be carefully monitored and adjusted to the minimum effective dose.Renal Impairment: In renally impaired patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary.Elderly: In elderly patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary. The common adverse effects of systemic corticosteroids may be associated with more serious consequences in old age.