ALOE-BERRY-NECTAR 90.3027 LIQUID

Indications

• Skin burns and wounds
• Sunburn
• Acne
• Psoriasis
• Digestive disorders
• Constipation

Dosage

Children: For topical use, apply Aloe vera gel as needed on the affected area. For oral formulations, consult product-specific dosing recommendations tailored to children's needs.

Adults: For topical use, apply Aloe vera gel directly to the affected area as needed. For oral consumption, refer to specific product guidelines, as formulations vary widely.

Mechanism of action

The primary mechanism of action of Aloe vera involves its anti-inflammatory and immunomodulatory properties. The polysaccharides, such as acemannan, enhance immune function and promote wound healing. Aloe also exhibits antimicrobial activity, which can help in preventing infections in wounds. In the gastrointestinal tract, Aloe may exert a laxative effect by stimulating intestinal peristalsis and enhancing mucosal secretions.

Pharmacodynamics

Aloe vera gel has demonstrable effects on skin hydration, wound healing, and anti-inflammatory responses. Its polysaccharide content is responsible for its ability to retain moisture and promote cell proliferation and migration, essential processes in tissue repair. Additionally, Aloe has shown potential in modulating inflammatory cytokines, which may contribute to its soothing effects when applied topically.

Pharmacokinetics

Aloe vera is typically administered topically or orally. When applied to the skin, it is absorbed locally, facilitating its effects on the epidermis and dermis. Oral consumption of Aloe products leads to absorption of its active compounds in the gastrointestinal tract, where they may exert systemic effects. The half-life and metabolism of Aloe components can vary depending on the formulation and route of administration, with the laxative effects usually occurring within a few hours after oral intake.

Adverse effects

• Abdominal cramps
• Diarrhea
• Electrolyte imbalance
• Dehydration
• Allergic reactions

Interactions

• May interact with diuretics, increasing the risk of electrolyte imbalance
• May affect the absorption of other medications due to its laxative effects

Precautions

• Use with caution in individuals with gastrointestinal disorders
• Not recommended for long-term use due to potential for dependence
• Avoid in cases of known allergy to aloe or its components

Pregnancy

Aloe is not recommended during pregnancy due to potential uterine stimulation and risks of miscarriage.

Breast-feeding

Aloe should be avoided during breastfeeding as safety has not been established.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Aloe vera gel
• Aloe vera juice
• Aloe extracts in capsules or tablets

Indications

• Preservation of vaccines
• Stabilisation of protein drugs
• Enhancement of topical formulations
• Improvement of shelf life for liquid medications
• Maintaining efficacy in biological products

Dosage

Children: Dosage for children should also be determined based on specific product guidelines and formulations. Refer to established paediatric dosages for the relevant products.

Adults: Dosage varies widely based on the specific application and formulation. Refer to specific product guidelines for detailed dosage information.

Mechanism of action

Stabilising agents work through various mechanisms depending on their chemical nature and application. They may function by preventing oxidation, maintaining pH levels, or enhancing solubility and dispersion of active ingredients. For instance, antioxidants prevent oxidative degradation, while surfactants help in the uniform distribution of substances in solutions.

Pharmacodynamics

The pharmacodynamics of stabilisers can vary significantly. Generally, they do not exert a direct therapeutic effect but instead enhance the pharmacological profile of the primary active ingredient by improving its stability and bioavailability. This results in prolonged shelf life and consistent therapeutic action when administered.

Pharmacokinetics

The pharmacokinetics of stabilisers is largely dependent on their chemical structure and the formulation in which they are used. Many stabilising agents do not have defined pharmacokinetic profiles as they are not absorbed significantly into systemic circulation. Instead, they act locally within the formulation to maintain stability and efficacy.

Pregnancy

Stabilized forms are generally considered safe during pregnancy, but clinical judgment should be exercised.

Breast-feeding

Use with caution while breastfeeding, as the effects on the infant are not well studied.

Storage

Store in a cool, dry place, away from direct sunlight and moisture.

Indications

• Hypertension
• Angina pectoris
• Supraventricular tachycardia
• Atrial fibrillation
• Atrial flutter

Dosage

Children: Refer to the BNF for Children for appropriate dosing information based on age and weight.

Adults: Refer to the BNF for specific dosing guidelines based on the condition being treated and patient characteristics.

Mechanism of action

Verapamil works by selectively blocking L-type calcium channels, which are essential for the influx of calcium ions during depolarization in cardiac and vascular smooth muscle cells. This blockade decreases intracellular calcium levels, resulting in reduced cardiac contractility (negative inotropic effect), decreased heart rate (negative chronotropic effect), and vasodilation, which collectively help in managing conditions like hypertension and angina.

Pharmacodynamics

Verapamil exhibits dose-dependent effects on cardiac conduction and vascular tone. It slows conduction through the atrioventricular (AV) node, which is beneficial in treating certain types of supraventricular tachycardias. Its vasodilatory effects lead to a reduction in peripheral vascular resistance, contributing to its antihypertensive properties. The onset of action occurs within 1 hour after oral administration, with effects lasting for several hours.

Pharmacokinetics

Verapamil is well absorbed from the gastrointestinal tract but undergoes extensive first-pass metabolism in the liver, leading to variable bioavailability (usually 20-35%). It is highly protein-bound (90-95%), primarily to albumin. The elimination half-life ranges from 3 to 7 hours, with metabolites also exhibiting pharmacological activity. Renal excretion accounts for the elimination of both unchanged drug and metabolites, necessitating caution in patients with renal impairment.

Contra-indications

• Severe hypotension
• Cardiogenic shock
• Severe left ventricular dysfunction
• Second- or third-degree AV block (unless a functioning pacemaker is present)

Adverse effects

• Hypotension
• Bradycardia
• Heart block
• Peripheral edema
• Constipation
• Headache
• Dizziness
• Fatigue

Interactions

• amiodarone+verapamil: Severe (increases risk of cardiodepression)
• verapamil+betablockers, non-selective: Severe (increases risk of cardiovascular adverse effects)
• intravenous dantrolene+verapamil: Severe (increases risk of acute hyperkalaemia and cardiovascular collapse)
• grapefruit juice+verapamil: Severe (increases exposure)
• miconazole+verapamil: Moderate (increases exposure)
• verapamil+bictegravir: Moderate (increases exposure)
• verapamil+panobinostat: Moderate (increases exposure)
• verapamil+thrombin inhibitors: Moderate (increases exposure)
• verapamil+dabigatran: Moderate (increases exposure)
• enzalutamide+verapamil: Unknown (decreases exposure)

Precautions

• Use with caution in patients with hepatic impairment
• Monitor heart rate and blood pressure regularly
• Caution in patients with a history of heart failure

Pregnancy

Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult local guidelines.

Breast-feeding

Verapamil is excreted in breast milk, caution is advised when used during breastfeeding.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Tablets
• Sustained-release tablets
• Injection