Medications Aide-mémoire

PAIN / FEVER

Paracetamol BFP

Tablet
Suspension
Rectal

10-15 mg/kg 6 hourly
Max dose: 1000 mg / dose; 75 mg/kg / day; ( up to 4000 mg / day )

1000 mg QDS

No age limit

Ibuprofen

Tablet / Capsule
Syrup

5-10 mg/kg 6-8 hourly
Max dose: 400 mg / dose; 40 mg/kg / day; ( up to 2400 mg / day )

200-400 mg TDS to 4 hourly

6 months and above

Diclofenac

Tablet
SR Tablet
IM
Rectal

0.5-1 mg/kg 8-12 hourly
Max dose: 3 mg/kg / day

50-100 mg BD-TDS
SR Tablet: 75 mg = 2 tabs OD; 100 mg = 1 tab OD
IM: 75 mg OD-BD
Max dose: 100 mg / dose; 200 mg / day

1 year and above

Naproxen

Tablet
Suspension

Juvenile RA: 10 mg/kg/day, divided BD; More than 50 kg = adult dose

275-550 mg BD-QDS
Max dose: 825 mg / dose; 1375 mg / day

Juvenile RA: 5 years and above
Others: 16 years and above

Mefenamic acid

Tablet / Capsule
Suspension

250-500 mg TDS-QDS
Max dose: 500 mg / dose; 1500 mg / day

14 years and above

Celecoxib

Capsule

100-200 mg OD-BD
Max dose: 400 mg / day

18 years and above

Etoricoxib

Tablet

OA: 60 mg / day
RA / AS: 90 mg / day
Others: 120 mg / day

16 years and above

Tramadol

Tablet / Capsule
IM / IV

50-100 mg TDS
Max dose: 400 mg / day

12 years and above

18 years and above for post-operative pain following tonsillectomy / adenoidectomy

URTI

Cetirizine

Tablet
Syrup

6 months to <1 year: 2.5 mg OD
1 to <2 years: 2.5 mg OD - BD
2 to 5 years: 2.5 mg BD / 5 mg OD
6 years and above: 5 mg BD; -

10 mg OD

Max: 10 mg BD

6 months and above

Levocetirizine

Tablet

6 years and above: 5 mg OD; -

5 mg OD

Max: 5 mg BD

6 years and above

Loratadine

Tablet
Syrup

-: -; -

10 mg OD

Max: 10 mg BD

2 years and above

Desloratadine

Tablet
Syrup

1 to <6 years: 1.25 mg (2.5 ml) OD
6 to <12 years: 2.5 mg (5 ml) OD
12 years and above: Follow adult dosing; -

5 mg OD

1 year and above

Fexofenadine

Tablet
Suspension

6 months to <2 years: 15 mg (2.5 ml) BD
2 to <12 years: 30 mg (5 ml) BD
12 years and above: Follow adult dosing; -

120 - 180 mg OD

6 months and above

Chlorpheniramine

Tablet
Syrup
IM/ IV / SC

1 to <2 years: 1 mg (1.25 ml) BD
2 to <6 years: 1 mg (1.25 ml) TDS
6 to <12 years: 2 mg (2.5 ml) TDS
12 years and above: Follow adult dosing; -

Usual: 4 mg TDS

Max: 24 mg / day

1 year and above

Racecadotril (Hidrasec)

Granules

Less than 9 kg: 10 mg TDS
9 kg to < 13 kg: 20 mg TDS
13 kg to 27 kg: 30 mg TDS
More than 27 kg: 60 mg TDS; ( 1.5 mg/kg TDS ); The duration of treatment in the clinical trials with children was 5 days.

No trials in infants < 3 months old

Smecta

Powder

1 satchet BD-TDS

1 satchet TDS

2 years and above

Ondansetron

Tablet
IM / IV

IM / IV (1 month and above): 0.15 - 0.3 mg/kg ONCE
Oral (6 months and above): 8-15 kg = 2 mg ONCE; 15-30 kg = 4 mg ONCE; >30 kg = 6-8 mg ONCE
Max dose: 16 mg / dose

4-8 mg ONCE

Repeat 4-8 mg 4-8 hourly as needed

1 month and above

Domperidone

Tablet
Suspension
Rectal

< 12 years OR < 35 kg: Oral = 0.25 mg/kg TDS; Rectal = 0.75 mg/kg BD
≥ 12 years AND ≥ 35 kg: Oral = 10 mg TDS; Rectal = 30 mg BD

10 mg TDS

1 month and above
Contraindicated:: Raised QTc; Significant electrolyte disturbances; Underlying cardiac disease
Caution:: > 60 years

ANTIVIRALS

Valacyclovir

Tablet

Varicella: 20 mg/kg/dose (max 1000 mg) TDS x 5 days
Children who need treatment: > 12 years old; Secondary cases in household contacts; Chronic cutaneous or pulmonary disease; On oral or inhaled steroids

Varicella: 1000 mg TDS x 1 week
Zoster: 1000 mg TDS x 1 week
Ramsay Hunt: 1000 mg TDS x 7-10 days; + prednisolone 1 mg/kg x 5 days, no taper
Bell's palsy: For severe cases (HB grade IV or higher) = 1000 mg TDS x 1week
Genital herpes: First episode = 1000 mg BD x 7-10 days; Recurrence = 500 mg BD x 3 days OR 1000 mg OD x 5 days
Oral herpes: First episode = 1000 mg BD x 7-10 days; Recurrence = 2000 mg BD x 1 day

Start within 72 hours of onset

Oseltamivir

Capsule

Influenza treatment: Less than 1 year old:; 3 mg/kg/dose BD; 1 year and above:; Less than 15 kg = 30 mg BD; 15 to 22 kg = 45 mg BD; 23 to 39 kg = 60 mg BD; 40 kg and above = 75 mg BD
Influenza prophylaxis: Same dose, just OD instead of BD; Not recommended for < 3 months old

Influenza treatment: 75 mg BD x 5 days
Influenza prophylaxis: 75 mg OM
Duration of prophylaxis: Used as adjunct to influenza vaccination; Taken throughout duration of exposure; Continue for 1 week after last exposure; Minimum duration of treatment is 2 weeks (time taken for antibody development after vaccination)

Benefit is greatest if started within 48 hours

ANTIBIOTICS

Augmentin

Tablet
Suspension

4:1 formulation: 20 - 40 mg/kg/day divided TDS; Max dose = 1500 mg / day
7:1 formulation: 25 - 45 mg/kg/day divided BD; Max dose = 1750 mg / day

500 mg BD to TDS

875 mg BD

Dose according to amoxicillin content

Formulations generally fall into ratios of 2:1, 4:1, or 7:1 (of amoxicillin to clavulanate)

Ceftriaxone

IM / IV

Neonates (up to 14 days): 20-50 mg/kg OD
Up to 12 years: 20-80 mg/kg OD; ≥50 kg = adult dosing
Gonorrhoea: <45 kg OR < 12 years; 25-50 mg/kg ONCE; (max 250 mg IM); ≥45 kg AND ≥ 12 years; Follow adult dosing

Usual: 1 - 2 g OD
Gonorrhoea: 500 mg ONCE; (+ anti-chlamydial treatment)

Dilution (IM): 500 mg = 2 ml of lignocaine 1%; 1 g = 3.5 ml of lignocaine 1%
Dilution (IV injection): 500 mg = 5 ml of water; 1 g = 10 ml of water
Dilution (IV infusion): 2 g = 40 ml of calcium-free infusion solution

Doxycycline

Capsule

Malaria prophylaxis: 2.2 mg/kg OD; ( Max: 100 mg OD ); Start 2 days before travel; Continue for 4 weeks after return

Malaria prophylaxis: 100 mg OD; Start 2 days before travel; Continue for 4 weeks after return
Acne: 100 mg OD; Min 6 weeks for effect; Limit to 3-4 months

8 years and above
ADR: GI upset; Esophagitis; Photosensitivity

ANTIFUNGALS

Itraconazole

Capsule
Solution

Tinea / pityriasis versicolor: 200 mg OD x 7 days
Dermatomycosis: Regular skin = 200 mg OD x 7 days OR 100 mg OD x 15 days; Highly keratinised skin (e.g. palms, soles) = 200 mg OD x 7 days OR 100 mg OD x 30 days
Onychomycosis: Continuous treatment = 200 mg OD x 3 months; Pulsed treatment = 200 mg BD x 1 weeks THEN Break x 3 weeks; Fingernails = 2 pulses, Toenails = 3 pulses
Vulvovaginal candidiasis: 200 mg BD x 1 day OR 200 mg OD x 3 days

Nystatin

Suspension
Vaginal tablet

Premature infants: 1 ml QDS
Infants: 2 ml QDS; (1 ml to each side of mouth)
1 year and above: Follow adult dose

Oropharyngeal candidiasis: 5 ml QDS
Vulvovaginal candidiasis: 1 vaginal tablet ON

No age limit
Infants: Paint onto recesses of mouth mucosa
Children / adults: Swish in mouth for few minutes, then swallow
Duration of treatment: 1-2 weeks

INHALERS

Budesonide / Formoterol (Symbicort)

Rapihaler (MDI)
Turbuhaler (DPI)

6 to 11 years: Maintenance; 80/2.25 = 2 puffs BD; 160/4.5 = not recommended; SMART / PRN Reliever; Not recommended
12 years and above: Follow adult dose

Maintenance: 80/2.25 = 2-4 puffs BD; (can step up to max 8 puffs BD); 160/4.5 = 2 puffs BD; (can step up to max 4 puffs BD)
SMART: 80/2.25 = 2-4 puffs BD + 2 puffs PRN; (max 24 puffs per day); 160/4.5 = 1-2 puffs BD + 1 puff PRN; (max 12 puffs per day)
PRN Reliever: 80/2.25 = 2 puffs PRN; (max 24 puffs per day); 160/4.5 = 1 puffs PRN; (max 12 puffs per day)

Maintenance therapy: 6 years and above
PRN Reliever: 12 years and above
Maintenance + Reliever (SMART): 12 years and above

Fluticasone propionate / Salmeterol (Seretide)

Evohaler (MDI)
Accuhaler (DPI)

4 to 11 years: 50/25 = 2 puffs BD; 100/50 = 1 puff BD; Other strengths = not recommended
12 years and above: Follow adult dose

Evohaler = 2 puffs BD

(can step up to ___)

Accuhaler = 1 puff BD

(can step up to ___)

4 years and above

Fluticasone furoate / Vilanterol (Relvar)

Ellipta (DPI)

12 years and above: Follow adult dose

Asthma: Either strength = 1 puff BD
COPD: 100/25 = 1 puff BD; 200/25 = not recommended

12 years and above

NASAL SPRAYS

Fluticasone furoate (Avamys)

Nasal spray

2 to 11 years: Start: 1 spray to each nostril OD; Max: 2 sprays to each nostril OD

12 years and above: Start: 2 sprays to each nostril OD; Maintenance: 1 spray to each nostril OD

2 years and above

Mometasone furoate (Nasonex)

Nasal spray

2 to 11 years: 1 spray to each nostril OD

12 years and above: Start: 2 sprays to each nostril OD; Max: 4 sprays to each nostril OD; Maintenance: 1 spray to each nostril OD

AR: 2 years and above
Acute rhinosinusitis: 12 years and above
Nasal polyposis: 18 years and above

Fluticasone propionate / Azelastine hydrochloride (Dymista)

Nasal spray

6 years and above: Follow adult dose

1 spray to each nostril BD

6 years and above

Mometasone furoate / Olopatadine hydrochloride (Ryaltris)

Nasal spray

12 years and above: Follow adult dose

2 sprays to each nostril BD

12 years and above

ANGIOTENSION CONVERTING ENZYME INHIBITORS

Captopril

Tablet

Initial: 6.25 - 25 mg BD - TDS

Max: 50 mg TDS

Enalapril

Tablet

Initial: 2.5 - 10 mg OD - BD

Max: 20 mg BD

Lisinopril

Tablet

Initial: 2.5 - 10 mg OD

Max: 40 mg OD

6 years and above

Perindopril arginine

Tablet

Initial: 2.5 - 5 mg OD

Max: 10 mg OD

18 years and above

Perindopril erbumine

Tablet

Initial: 4 mg OD

Max: 8 - 16 mg OD

18 years and above

Max for CrCl 30-80: 8 mg OD

ANGIOTENSION II RECEPTOR BLOCKERS

Candesartan

Tablet

4 - 32 mg OD

18 years and above

Irbesartan

Tablet

75 - 300 mg OD

Losartan

Tablet

25 - 100 mg OD

Olmesartan

Tablet

20 - 40 mg OD

Telmisartan

Tablet

20 - 160 mg OD

18 years and above

Valsartan

Tablet

Hypertension: 80 - 320 mg OD
Heart failure: 40 - 160 mg BD
Post-MI: 20 - 160 mg BD

18 years and above

CALCIUM CHANNEL BLOCKERS

Amlodipine

Tablet

2.5 - 10 mg OD

Nifedipine LA

Tablet

20 - 160 mg OD

(ACG Max: 120 mg OD)

18 years and above

BETA BLOCKERS

Atenolol

Tablet

Initial: 25 mg OD - BD

Max: 100 mg / day

Bisoprolol

Tablet

Initial: 2.5 - 5 mg OD

Max: 10 mg OD (ACG: 20 mg OD)

Carvedilol

Tablet

Initial: 12.5 mg for first 2 days, then 25 mg OD

Max: 50 mg OD (PI: 50 mg BD)

18 years and above

Labetalol

Tablet
IV

Initial: 100 mg BD

Max: 800 - 2400 mg / day in divided doses

Metoprolol tartrate

Tablet

Initial: 50 mg BD

Max: 400 mg / day in divided doses

Nebivolol

Tablet

Initial: 2.5 - 5 mg OD

Max: 40 mg OD (PI: 10 mg OD)

18 years and above

Propranolol

Tablet

Initial: 80 mg / day in 1-4 divided doses

Max: 160 mg / day

DIURETICS

Hydrochlorothiazide

Tablet

Initial: 12.5 - 25 mg OD

Max: 50 - 100 mg OD

Indapamide

IR Tablet
SR Tablet

IR tablet: Initial: 1.25 mg OD; Max: 2.5 mg OD
SR tablet: Single dose: 1.5 mg OD

Doses above maximum does not appreciably reduce BP, but causes more diuretic ADR

Frusemide

Tablet
IV / (IM)

Oral: 2 mg / kg; Max: 40 mg / day
IV: 1 mg / kg; Max: 20 mg / day

Oral: Initial: 20 - 40 mg OD; Max: 160 mg / day, divided BD
IV: 1 mg / kg; Max: 20 mg / day

OTHERS

Acetazolamide

Tablet

Altitude sickness: 125 mg BD (prevention); 250 mg BD (treatment); Start 2 days (48 hours) before beginning ascent; Continue throughout ascent; Take for 2 days after reaching highest altitude

Contraindications: Adrenal disease; Hyponatremia; Hypokalemia; eGFR < 10

EMERGENCY CONTRACEPTION

Ulipristal (Ella)

Tablet

1 tablet STAT

Effectiveness: Up to 5 days (120 hours); ~ 95%; Reduced effectiveness if used concurrently with OCP; Start OCP on 6th day after taking ulipristal

Levonorgestrel (Postinor 2)

Tablet

1 tablet STAT, then 1 tablet 12 hours later

Effectiveness: Up to 3 days (72 hours); ~ 80%; No interaction with OCP

OBESITY

Phentermine (Duromine)

Capsule

Initial: 30 mg OM

Maintenance: 15 - 30 mg OM

Use for up to 6-12 months (MOH CPG 2016)

ADR: Insomnia, restlessness, tremors; Dry mouth, nausea, constipation; Can raise BP and HR
Contraindications: Poorly controlled hypertension; Atherosclerotic diseases (IHD, CVA); Valvular heart disease / arrhythmiaa; Psychiatric illness or history of drug abuse; Concomitant MAO inhibitors (stop for at least 14 days)