Abbreviated Prl'scribing Int<>rmatioYSPECIAL REPORTING TO CSM REQCIRED
,_l'
Presl'ntation: Losee cap:-.ule:-. C(nltaining 20mg tlmeprazt1le. Indications: Healing t1f enJsin.•
reflux ocs(1phagitb. Symptt >m relief i" rapid. :md the majority of paticm" arc healed :1fter
-f week ..... Treatment of patient" with benign peptK ulcer. . unrc,...,pon . . . in· to an adequ:1tc dt>se and
duration tlf O>IWemitmal therap~ Ztlllinger-Eili.~tlll,...,Ylldn>mc. Dosage: and Administration:
.\duh:-. ( indw..ling elderly). Ftlr cro,...,iw reflux tlC:-tlphagitb 10mg Lt>,...,cc tlllce daily for-! week.....
If not fully he:! led. he:iling u .... ually occur" during a funher -f week,..,· tn.::ument. Lo.,ec has abo
been u . . cd in a dtN~ of -!Omg t>nce daily in patient.... with reflux oe:-.t1ph:1gitb refracttJry ttl
other therapy. Healing u:-.u:lily occurn:d wid1in H weeks. For duodenal ulcer 20mg Losee ont..-e
daily for-! week:-. For ga-;trk ulcer 20mg Lo. . .ec t mce daily for H week..... In severe ca:-.e"
innea:-.e to -!Omg Lo. . .ec on~..·e daily Long-term maintenance treatmem with Losee i" not
recommended. Zullinger-EI!ison.~l'lldrome The recommended initial do:-.age b bOmg Lo. . .ec
once t..bily Adjust indi\'idually and continue a:-. long a:-. cliniclily indicated. Patient:- arc u . . . u:illy
cffecti,·ely comrolled on dose:-. of 20-120mg daily. \X'ith do:-.c:-. above HOmg daily, the do. . .e
.-;hould be di\'ided and gi\'ell twice daily. Children: There b no experience of the usc ofLtJscc
in children.lmfxlired renal orbepaticjimc.:tion Adjusunent i"not n.:quired. Patit'nt:o. with
~ewre lh·er di.sea. . . e . . .hould not require mort..' than 20mg Losee daily Contra-indications.
w·arnings, t'tc: :\tl klltlWll et>mr:t-illllicatitlll.'! ttl the u . . .e tlfl.o:-.ec. \X 'hen ga:-.tric ulcer i,...,
suspected. the possibility of m:1lignancy "hould he cxcluded before tre:nment wid1 Lo:-.cr i:-.
in,titutt...'ll. a.-. treatment ma~ alle\·iate :-ymptt lllb and dclay diagnt l."i". :\\'<lid in pn:gn:mc~
unle,...,,..., tlll.:rt...' b nu .-.afer ahcrnatin.~ Brea:-.t feeding . . . IHJuld be di.'!ctmtinued if the use t 1f Lt>:o.cc
b con:-.it..it...'rcd e. . scntial. I.o,...,cc i" wdl tolt...'r:ttnl. Nau:-.et. hcadarhc. diarrhoea. con . . . tipation and
tbtuleLK't...' h:t,·e been reponed hut are r~1re. Skm ra,...,he" h:t\'e uccurrcd in a fcw pauent:-.. The . . .e
e,·cnt.-. ha\'1.: u . . . u~i\1~ been mild and tr:m . . . ient and thcrc ha" hecn no con:-.i:-tent rebtion:-.hLp
\\itll treatment. Lt>:o...:c c:u1 dl..'b~· the l..'liminati<m tlf diazej)~\Lll. pllell~1tliLl :u1d warfarin
\h mitt 1ring <>f patient" recei\·ing warf:!rin t 1r phen~1oin h rcn JLmncndcd and a reducth 1n of
\\~1rfari11 t>r plletl~ttJiLl dt>:-.1..' ma~ hc Llecc:-.. . ar~· whc11 tlmeprat.ule i" addl..'d ttl rrcatml.:llt :\11
t'\'idence of :Ill inwr:Ktion with thcophylline. propranolol or :mt:Kids. A.nimallUxicu/o}!
Gastric ECL-cdl hyperpla,...,ia and carcinoid:-.. localised to the oxymic muco. . a, haw been
ob. . .cn:cd in life-long :-.tlldie:-. in rats. Thc"e change,.., ha,·c hel..'ll relatcd to ... ustained
h~pcrg:L'itrinaemia. :\o tre:nmem rcbted mucosal ch:mge" haw been ob.-;er..-cd in patient..,
treated Ctllltinuou . . . ly for period:-. up to-! ye:u-.. . . Pharmaceutical Precautions: { ·,...,e within onc
mo1lth of opening. RL'pial..'l..' cap finn!~· after use. Dispe11,...,e in t>riginal comaint'r ...... Legal
Catt'gory: PO.\ I. Package Quantities and Ba..o;ic ~HS Cost: Bonk·,.., of.:; c:tp,...,ulc:-. .•(6.-!9; B< mle..,
of 2H ctpsules. £.36..16 Product Licence Number: PL001-'(l231H. Product Un·ncc Holder:
.\..,tra Pharm:~eeutic:tb Ltd .. Home Park Estate. Kings Langley, Hens \'1:1)-f HDH
References
1. \X'allmark Bet :1llSl .-\tla"' of Science: Pharmaculo~· 19H-: 1: l')H-61 2. .Sandmark S ct al
Scand_l Gaslroenreroll9H8,25 62')-51. -~· Zcitoun Pet a! Lancet 19H-J 1:621-1. -f. Bate C.\ I et al
Gut 19H9: .~0 ( Pre . . .ented at HSG Septt'mber l9H9 ). ). Hetzel D Jet al Ga. . .trocntcrology 19HH.
95 903-12. 6.llavelund T et:il Bril ~ted_l 19H8; 296 H9-92. -. \':uurappen Get al Dig Di,..., Sci
19HH; .B ')25·9. H. I.unddll. eta\ Gastroenterology l9H9: 96 (.:; pt 1) A...1l0.
For further information please contact
A'itra Pharmaceuticab Ltd
Telephone: ( 092--166191
I.n~cc i~ a rcgi,tcn..•d tradt.: mark

Thomas Morson Pharmaceuticals
Hertford Road, Hoddesdon, Hertfordshire
Division of Merck Sharp & Dohme Limited
ABRIDGED PRODUCT INFORMATION T at night for four to eight weeks. For prevention of
Refer to Hata Sheet before prescribin~. duodenal ulcer recurrence. 20 mg at night. Initiate
antisecretory therap;.' of Zollingcr-Fllis<m syndrome
INDICATIONS Duodenal ulcer: preventit)n of n:lap~e~
with 20 mg every six hours and adiusl to individual
()fdu<)lknal ulceration: heni~n l..!<l"tric ulcer: hvper-
\ecretnr;. conditions such as Znllin!,!er-EIIison response. The maximum dosage u ... ed f<)f up to one year
syndrome. was 4HO mg daily.
OOSAGF. In duodenal and hcnil..!n gastric ulcer. 40 mg CONTRA-INIJICATION Hypersensitivity.
 'Pepcid' PM,
working fast to relieve
the pain of ulcers, 1 quickly
restoring the well-being
of many patients.
This rapid relief, together
with fast, effective healing, 2
is achieved in many patients
with a simple dosage of
just one sm.a1140 mg
tablet at night.
~~~··~---~
r , :
'
.
: ' I
'

...,
CIII--1-DAY

PRECAVTIONS Exclude any lllrdlbood of Jlllllric
carcinomabefoleusing'Aipcid'PM.ConoiclerR!ducing
the daily dose if creatinine clealanc:e faDs to or below
30 ml/min. 'Pbpcid' PM is not recommended in
'IOIIIiting, rub. abdominaldilcoml'ort.81101Uia. fatilue. •Special Jepartingto the CSM required.
BASIC NHS cosr 210 11111 tablers. £14.00 for 2lkJay GDdenoles rqi-.ed tnldemark of Merck &. Co.• Inc .•
calendar pack ancl"£25.00 b bottles of 50. 40 11111
tableu, £26.60 b 2lkJay calendar pack and £47.50 for ....._NJ. USA.
Rahway.

prejplllllCy, nuning mothers or childnm. bottles of 50. I. Roluler. H-G •• and GUider. R•• AmBr.l. Mild.. 1986.
SIDE EFFECTS Rarely, headache, dizziness, constipa· ........... u - ~ 21011111 tablets. 0025/0215: 81 (Suppl. 481 13. 2. Dobrilla. G .• 11t DL. Sct~nd. I.
lion, diarrhoea. Less frequently. dry mouth, nausea. 40 11111 tablets 0025/0216. Issued March 1989. Gtuttot~nttlfOI.. 1987. 221Suppl. 341.21.
O!HIIl PCD.88.GB.331M.J.
 IT MAKES LIFE WORTH LIVING.

-
Effective control of ulcerative colitis is only half of Colifoam's success story. As
thousands of patients previously managed with aqueous enemas have found, its
simplicity and ease of retention has transformed their lives.
Colifoam causes little if any disturbance to their daily routine, and enables
patients to enjoy their normal social and outdoor activities!
Equally as effective as steroid enemas).2 Colifoam is now established as the
leading treatment for ulcerative colitis? It is also unique among foam treatments with
an unrivalled 12 years of proven efficacy and safety in clinical practice .

~--------~---- COLIFOAM
10% Hydrocortisone acetate foam

The P.roven choice in ulcerative colitis. •

PRESCRIBING INFORMATION: Presentation: White odourless aerosol containing hydrocortisone acetate PhEur 10%. Uses: Ulcerative colitis, proctosigmoiditis and granular
proctitis. Dosage and administration: One applicatorful inserted into the rectum once or twice daily for two or three weeks and every second day thereafter. Shake can vigorously before use
(illustrated instructions are enclosed with pack). Contra~indications, warnings etc.: Local contra~indications to the use of intrarectal steroids include obstruction, abscess, perforation,
peritonitis, fresh intestinal anastomoses and extensive fistulae. General precautions common to all corticosteroid therapy should be observed during treatment with Colifoam. Treatment should
be administered with caution in patients with severe ulcerative disease because of their predisposition to perforation of the bowel wall. Safety during pregnancy has not been fully
established. Pharmaceutical P.recautions: Pressurized container. Protect from sunlight and do not expose to temperatures above 50°C. Do not pierce or burn even after use. Do not refrigerate.
Keep out of reach of children. For external use only. !&~I categQ!y: POM. Packa@uantity & Basic NHS cost: 25g canister plus applicator, £7.25. Further Information: One applicatorful of
Coli foam provides a dose of approximately 125mg of hydrocortisone acetate, similar to that used in a retention enema, for the treatment of ulcerative colitis, sigmoiditis and proctitis.
Product Licence No., 0036/0021. References I. Somerville KW et al. British Medical journall985; 2%866. 2. Ruddell WSJ et al. Gut 1980; 21,885-889. 3. Independent Research Audit.
Data on File: Further information is available on request. Stafford~ Miller Ltd., Professional Relations Division, Hatfield, Herts. AUO ONZ.
 NEW
INDICATION
AS~COL Mesa)azine* (s-aminosalicylic acid)

IN ACUTE ULCERATIVE COLITIS

~col' is now indicated for the treatment

of mild to moderate acute exacerbations of ulcerative
colitis, as well as maintenance of remission.

Prescribing Information: Presentation: ·As>.col' dose recommendation. Elderly: Use with caution and SK&F
Tablets, PL ooo21mn each cont.lining 400 mg only where renal function is normal. Contra- Smith Kline & French
mesalazine (s-aminosalicylic acid) coated with a indications: A history of sensitivity to salicylates. Laboratories Umited
pH-dependent resin (Eudragit S) formulated to Severe renal impairment (GFR less than 20 ml/min). A SMITH KLINE BECKMAN
release the active ingredient in the terminal ileum and Children under 2 years of age. Precautions: Not COMPANY
colon. too (toblisterpacksoftot.lblets),£23.82. Uses: recommended in patients with renal impairment. Wei~ Garden City.
For the treannent of mild to moderate acute exacer- Caution in patients with a raised blood urea or Hertfordshire AL7 1EY
bations of ulcerative colitis. For the maintenance of proteinurta. Avoid during pregnancy. Do not give
remission of ulcerative colitis. Dosage and admini- with lactulose or similar preparations which lower © 1989 Sm1th Khne & French
stration: Adults: Acute diseoS<: 6 ublets a day in divided stool pH. Adverse reactions: Headache, nausea. U.bor.uories L1m1ted
Authorised User of the tude m.uk
doses, with concomit.lnt corticosteroid therapy abdominal pain, diarrhoea. Exacerbation of the 'As~col' in the UK
where clinically indicated. Maintenance therapy: 3 to sy.mptoms of colitis. Rarely. reversible pancreatitis. *Mesa.Jazine 1s the Brit1sh approved
6 ublets a day in divided doses. Children: There is no Legal category: POM. 1. 8.89. name of !j·aminosalicyhc acid
Indications Gastric and duodenal ulcers. Contra-mdications Severe renal dysfunction.
Use during_p~gnancy There is insufficient data on its use in pregnancy to assess possible
harmful effects. There are no 1nd1cations of harmful effects1n an1mals. Warnings and P-re-
cautions Prolonged use of h1gh doses of bismuth compounds 1s not recommended
qist-brocades Gist-brocades Pharmaceuticals, Division of Royal
Gist-brocades NV, Delft, Holland
because it has occasionally led to reversible encephalopathy. The risk of this is very small
provided De-Nol is used as recommended. It is, however, not advisable to use concomi-
tantly other bismuth-containing drugs or alcohol. Antacids and milk should not betaken
w1thin half an hour before. or half an hour after taking De-Nol, because gastric acid is
necessary for the format1on of the protective layer. The absorption of tetracyclines may
be reduced when De-Nol1s taken concomitantly. Dosagf Two tablets twice daily on an
empty stomach: half an hour before breakfast and dinner. for 4-8 weeks. Alternatively
one tablet four times daily on an empty stomach: half an hour before breakfast. lunch
and dinner and at bedtime, for 4-8 weeks. Thereafter De-Nol or other bismuth-con-
taining drugs should not be taken for 8 weeks. A treatment course may then be pre-
scribed again for 4-8 weeks, if necessary. Side effects Stool blackening may occur from
the formation of bismuth sulphide. This discolourat1on may easily be distinguished from
melaena. There may also be nausea and vomiting. These effects are not dangerous and
disappear upon completion of therapy. DE-NOL

*Non-steroidal anti-inflammatory drug
Prescribing Information. Presentation 'Tagamet Tiltab' Tablets,
PL 0002/0128, each containing 800 mg cimetidine. 30 (2 calendar strips
of 15 tablets), £17.76. 'Tagamet' Tablets, PL 0002/0092, each containing
400 mg cimetidine. 60 (4 calendar strips of 15 tablets), £18.69. Uses
Duodenal and benign gastric ulceration, including that associated with
NSAIDs. Other conditions where reduction of gastric acid by 'Tagamet'
is beneficial: persistent dyspeptic symptoms, particularly meal-related,
including such symptoms associated with NSAIDs. Dosage and
administration For full dosage instnu:tions see Data Sheet. Adults:
Duodenal or benign gastric ulceration, 800 mg once a day at bedtime.
Otherwise usually 400 mg b.d. with breakfast and at bedtime.
If inadequate, 400 mg q.d.s. with meals and at bedtime (1.6 g/day).
Treat for at least 4 weeks (6 weeks in benign gastric ulcer, 8 weeks in
ulcer associated with continued NSAIDs). To prevent relapse of peptic
ulcer, usually 400 mg at bedtime or else 400 mg morning and at
bedtime. Children: Over 1 year: 25-30 mg/kg/day, divided. Contra-
indication Hypersensitivity to cimetidine. Precautions Impaired renal
function: reduce dosage (see Data Sheet). Potentiation of oral anti-
TRGRfflET
BOD
CIMETIDINE
can now be co-prescribed with NSAIDs
coagulants, phenytoin and theophylline (see Data Sheet). Prolonged
treatment: observe patients regularly. Potential delay in diagnosis of
gastric cancer (see Data Sheet). Regularly observe patients with a history
of peptic ulcer and on NSAIDs, especially if elderly. Care in patients
with compromised bone marrow (see Data Sheet). Avoid during
pregnancy and lactation. Adverse reactions Diarrhoea, dizziness. rash,
tiredness. Gynaecomastia, occasional reversible liver damage,
confusional states (usually in the elderly or very ill). Very rarely
interstitial nephritis, acute pancreatitis, thrombocytopenia,
agranulocytosis, headache, myalgia, arthralgia, sinus bradycardia,
tachycardia, heart block, aplastic anaemia; very rare reports of alopecia,
reversible impotence but no causal relationship established at usual
therapeutic doses. Legal category POM. 7.3.89.
Smith Kline & French Laboratories Limited
A SMITHKLINE BECKMAN COMPANY
Welwyn Garden City, Hertfordshire AL71EY SI~&F
© 1989 Smith Kline & French Laboratories Limited
'Tagamet: 'Tiltab" and the appearance of the tablets are trade marks
 Putting back the G.I. prostaglandins.
NSAIDs take out
• Cytotec replaces mucosal protective prostaglandins.
• Effectively heals and prevents NSAID-induced
gastroduodenal injury. 4' 5
_,_ • No effect on valuable anti-arthritic
-- activity of NSAIDs~

CYTOTEC misoprostol

CY'IOTEC 'Y Abbreviated Prescrlblq Information Presentatlon:Thblet containing misoprostol

200 micrograms. Uses: Healing of duodenal and gastric ulcer induced by non-steroidal anti-inflammatory
drugs (NSAID) in arthritic patients at risk, whilst continuing NSAID therapy. Prophylaxis of NSAID-
induced ulcers. Healing of duodenal and gastric ulcer. Dosage: Adults lncludlq the elderly. Heallnc
of duodenal and gastric ulcer: 800 micrograms daily in two or four divided doses taken with breakfast
and/or each main meal and at bedtime. Prophylaxis of NSAID·Induced ulcer: 200 micrograms twice
daily, three times daily or four times daily. Refer to data sheet for additional information. .
Contralndlcatlons: Pregnant women, women of childbearing age, patients allergic to prostaglandins.
Precautions: Cytotec does not produce hypotension in clinical studies at ulcer-healing doses, neverthe-
less exercise caution in disease states where hypotension might precipitate severe complications.
Adverse reactions: Mild and transient diarrhoea may occur. Other adverse events reported included
abdominal pain, dyspepsia, flatulence and nausea, although a causal relationship to Cytotec has not
been established. Basic NHS Price: £13.00 per 56 pack. Product Ucence Number: 0020/0115.
References I. Wilson DE, Ouadros E, Rajapaksa T, Adams A, Noar M. Dig Dis Sci 1986; 37 (suppl): 126s-129s.
2.1senberg JL Hogan DL Koss MA, Selling JA. Gastroenterology 1986; 91: 370.378. 3. Sato N, Kawano S,
Fukuda M,'ISuji S, Kamada T. Am JMed 1987; 83 (suppiiA): 15-21. 4. Graham DV. Agrawal NM, Roth SH. Lancet
1988; II: 1277-1280. 5. Agrawal N, RothS, SEARLE G.D. Searle & Co. Ltd.,
Mahowald M et al. Am J Gastroenterol QIJGOU) P.O. Box 53, Lane End Road,
1987; 82: 962. vt>CIIOSS High Wycombe, Bucks. HPI2 4HL
Cytotec. Gold Cross and Searle are recJstered trademarks.

Data sheet with full prescribing information is available on request

 • •
I IOn

Fybogel Orange-
gentle but effective
Fybogel Orange treats
constipation gently
but effectively by
increasing bulk in the
colon and thus
encouraging normal,
healthy peristalsis with
soft, formed stools.'
Fybogel Orange-rapid
first-line therapy
In a recent study of 224 newly
presenting constipation
patients treated with Fybogel
Orange, 63.1% had a
motion within 24 hours-
and after 48 hours of Fybogel
Orange 89.9% of patients had
achieved bowel movement:
Fybogel Orange-the patients'
first choice for navour
Recent tasting research showed
that patients prefer orange
flavoured bulking agents:

Active lngredtents: Each sachet conla1ns 3.5g lspoghula husk BP lndlcotions: Cond1f1ons requ1nng o h1Qh·f1bre reg1men Dosage and
Administration: (To be token 1n water) Adults and children 011er 12. One sachet morn1ng and evemng. Children under 12: One half to one
level 5ml spoonful depend1ng on age and size, morning and evemng. contro-lndh:atlons. \\timings, etc.: F-,t>ogel is contra-•ndicated
1n cases of •nleshnol obstruchon and colome otooy. Basic NHS Price: At Apnl '88 60 sachets £4 24. E•re 60 sachets IR £4 92. Pl No.:
FjllogeiOrange44/0068,f;OOgel44/004l.lrishPANo., f;OOgeiOrange27/2/2. f;bogel27/2!1 References' I Data annie. 1985.
Reck•" & Colman Phormoceuhcol Drvis1on. 2 Data on file. 1988. ReckiM & Colman Phormaceut•cal DiviSIOn 3. Data on file. 1987
Reckltt & Colman PhormaceutiCOI OMSIOn ~I IS a trade mark Further •nformol1on IS available from Reck1tt & Colman
Ptlarmoceul•col Drv1S1on, Donsom Lone, Hull HUB 70S

·--(j)

One tablet nightly for healing ulcers.
PRESCRIBING INfORMATION· INDICADONS: DUODENAL UlCER. BENIGN GASTRIC ULCER. ULCERS
ASSOCIATED WITH NON-STEROIDAL ANTI-INFLAMMAlORV DRUGS INSAIDs), REFWX OESOPHAGITIS.
CHRONIC EPISODIC DVSPEPSIA.JHli6Gl;.ADULTS: THE USUAL DOSAGE IS 150MG TWICE DAILY IN THE
MORNING AND EVENING. ALTERNATIVELY. PATIENTS WITH DUODENAL ULCERATION. GASTRIC
ULCERATION OR REFWX OESOPHAGITIS MAY BE TREATED WITH A SINGLE BEDilME DOSE OF 300MG. IN
ULCERS FOLlDWING NON-STEROIDAL ANTI-INFLAMMA'IORV DRUG THERAPY. OR ASSOCIATED WITH
CONTINUED NON-STEROIDAL ANTI-INFLAMMAlORV DRUGS OR IN THE MANAGEMENT OF REFWX
OESOPHAGITIS UPTO EIGHT WEEKS' TREATMENT MAY BE NECESSARY. CHRONIC EPISODIC DYSPEPSIA:
15UMG TWICE DAILY FOR SIX WEEKS. INVESTIGATE EARLY RELAPSERS AND NON-RESPONDERS. !SEE
DATA SHEET FOR FULL DOSAGE INSTRUCTIONS.) CON'f'RA.INDIQnONS: PATIENTS WITH KNOWN
HYPERSENSITIVITY 10 RANITIDINE. PRECMJJIONS: EXCWDE THE POSSIBILITY OF MALIGNANCY IN
GASTRIC ULCER BEFORE INSTITUTING THERAPY. ESPECIALLY IN MIDDLE·AGEO PATIENTS WITH
RECENTLY CHANGED DYSPEPTIC SYMPlOMS. SUPERVISION OF PATIENTS WITH PEPTIC ULCERS AND ON
NSAID THERAPY IS RECOMMENDED ESPECIAllY IF ELDERLY REDUCE DOSAGE IN THE PRESENCE OF
SEVERE RENAL FAIWRE !SEE DATA SHEETI LIKE OTHER DRUGS, USE DURING PREGNANCY AND
LACTATION ONLY IF STRICTLY NECESSARY. SIDE EfFECJS; HEADACHE. DIZZINESS. SKIN RASH.
RANITIDINE
OCCASIONAL HEPAmiS. RARELY, REVERSIBLE MENTAL CONFUSION STATES. USUAllY IN VERY Ill OR
ELDERLY PATIENTS. RARE CASES OF LEUCOPENIA AND THROMBOCYlOPENIA. USUAllY REVERSIBLE.
AGRANULOCV10SIS AND PANCVTDPENIA. HYPERSENSITIVITY REACTIONS. ANAPHYLACTIC SHOCK.
RARE CASES OF BREAST SYMP10MS IN MEN. AS WITH OI"HER H2·RECEP10R ANTAGONISTS RARE CASES
OF BRAD't'CARDIA AND A-V BLOCK (SEE DATA SHEET). PftESENIA.DONS: ZANTAC lSO TABLETS
EACH CONTAINING lSOMG RANinDINE (PRbDUCT UCENCE NUMBER 0004/0279, 60 TABLETS £29· 76);
ZANTAC 300 TABLETS EACH CONTAINING 300MG RANITIDINE (PRODUCT UCENCE NUMBER 0004/0302.
30 TABLETS £27 ·43); ZANTAC DISPERSIBLE TABLETS EACH CONTAINING lSOMG RANITIDINE (PRODUCT
LICENCE NUMBER 0004/0298, 60 TABLETS £31·251: ZANTAC SYRUP EACH tOMl DOSE CONTAINING
lSOMG RANITIDINE !PRODUCT LICENCE NUMBER 0004/0310. 300ML BOITLE £22·32). 2IIQIH,lg
UC£NC£ HOLDER: GLAXO OPERATIONS U.K. LIMITED. GREENFORD. MIDDLESEX UB6 OHE
ZANTAC IS A GLAXO TRADE MARK
FURTHER INFORMATION IS AVAILABLE ON REQUEST FROM:
GLAXO LABORATORIES LIMITED
GREENFORD. MIDDLESEX U86 OHE
TEl:Ol·4223434
GZ r,!I
UAt
Vl'Q •.
 1'
PROGRESS
In The Control Of Pancreatic Insufficiency

creon pancreatin

RIGHT ON TARGET- RIGHT FROM THE START

Prescribinslnformation- Presentation: Brown-yellow
capsules containing enteric coated granules of pancreatin
equivalent to: 9,000 BP units of amylase, 8,000 BP units of lipase,
210 BP units of protease. Available In packs of100. Basic NHS price
£13.33.1ndication: Pancreatic exocrine lnsufllclency. Doup
and administration: Adults and children: Initially one or two
capsules with meals, then adjust according to response. The
capsules can be swallowed whole, or for ease of administration
they may be opened and the granules taken with fluid or soft food,
but without ch-lng.lf the granules are mixed with food, It Is
Important that they are taken Immediately, otherwise dissolution
of the enteric coating may result. Contra-indicationa,
Waminp, etc: Contra-Indications: Substitution with
pancreatic enzymes Is contra-Indicated In the early stages of
acute pancreatitis. Warnings: Use In pregnancy: There Is
Inadequate evidence of safety In use during pregnancy. The
product Is of porcine origin. Rarely cases of hyper-uricOsuria and
hyper-uricaemla have been reported with high doses of
pancreatin. Overdosage could precipitate meconium Ileus
equivalent. Perianal Irritation could occur, and, rarely,
Inflammation when large doses are used. Product Ucence
Number: Sn710001. Name and addreu ofUcence
Holder: Kall Chemle Pharma GmbH, Postfach 220, D-3000,
Hannover 1, West Germany.

d Uph ar Further Information Is available from:

Duphar Laboratories Umtted, Gaters Hill, West End, Southampton S03 3JD. Tel: 0703 4n281. CRAd/PEI/1/89
 Predictable
in IVsedation.
I •UIVIE~
....
PRESCRIBING INFORMATION
PRESENTATION Ampoules of a white opaque emulsion containing
diazepam BP 10mg in 2ml.
Indications:
1. Sedation prior to procedures such as endoscopy, dentistry,
cardiac catheterisation and cardioversion.
2. Premedication prior to general anaesthesia.
3. Control of acute muscle spasm due to tetanus or poisoning.
4. Control of convulsions; status epileptic us.
5. Management of severe acute anxiety or agitation including
delirium tremens.
DOSAGE AND ADMINISTRATION
Diazemuls may be administered by slow intravenous injection (1ml
per mini, or by continuous infusion. Diazemuls should be drawn up
into the syringe immediately prior to administration.
1. Sedetion:0.1 -0.2 mgdiazepam/kgbodyweightbyivinjection.
2. Premedication: 0.1-0.2 mg diazepam/kg body weight by iv
injection.
3. Tetanus: 0.1 -0.3 mg diazepam/kg body weight by iv injection
repeated every 1 - 4 hours as required. Alternatively, continuous
infusionof3- 10mg/kg bodyweightevery24hoursmay be used.
4. Statu• eplleptlcua: An initial dose of 0.15-0.25 mg/kg body
weight by iv injection repeated in 30 to 60 minutes if required, and
followed if necessary by infusion of up to 3 mg/kg body weight
over24hr.
The cream of IV sedation
5. Anxiety and tension, acute muscle spasm. acute states of
excitation. delirium tremens: The usual dose is 10 mg repeated at
intervals of4 hours, or as required.
Elderly or debilitated petientl: Elderly and debilitated patients are
particularly sensitive to benzodiazepines. Dosage should initially be
reduced to one half of the normal recommendations.
CONTRA-INDICATIONS. WARNINGS, ETC:
As with other benzodiazepine preparations: should "'Ot be used in
phobic or obsessional states nor in the treatment e~f chronic
psychosis. Treatment with diazepam may cause drowsiness and
increase the patient's reaction time. Use with caution in patienu with
impairment of renal or hepatic function and in patients with
pulmonary insufficiency or myasthenia gravis. Should not be used
alone to treat depression or anxiety associated with depression.
Amnesia may occur. In cases of loss or bereavement psychological
adjustment may be inhibited by benzodiazepines. Disinhibiting
effects may be manifested in various ways. Suicide may be
precipitated in patients who are depressed and aggressive behaviour
toward self and others may be precipitated. Extreme caution should
therefore be used in prescribing benzodiazepines in patients with
personality disorders. Physiological and psychological symptoms of
withdrawal including depression may be associated with
discontinuation of benzodiazepines even after normal therapeutic
dosas for short periods of time.
Diazemuls®
IOmg diazepam in 2m I emulsion
Pregnancy end Lactation: Diazepam crosses the placenta and
should not be used during pregnancy unless considered essential.
Large maternal doSe$ administered during delivery may produce
clinical effects in the newborn. Diazepam can be transmitted in breast
milk and clinical effects may occur in the breast·fed infant.
Side Effecta: May rarely cause local pain or thrombophlebitis. Rare
instances of a local painless erythematous rash around the site of
injection. Urticaria and, rarely, anaphylaxis have been reported.
Overdosage: CNS depression and coma. Treatment symptomatic.
PHARMACEUTICAL PRECAUTIONS: See Data Sheet
Pack Size& Cost: 10 x 2mlampoules: NHS Price£:6.29
Product Licence No: 10183/0001
Date of preparation: April1989
I Diazemuls is a registered trademark. I
Product Licence Holder: Dumex Ltd.,
Riverside Way,
UXBRIDGE.
Middx. UB8 2YF
Tel: Uxbridge (0895) 51144
Distributed in the UK by KabiVitrum Ltd
KV881/5/89
 How long is a
P-iece of string?
antac
For the lifetime of the disease
PRESCRIBING INFORMATION: INDICATIONS: DUODEI'AL ULCER, AENIGN GASTRIC
L'LCER. ULCERS ASSOCIATED WITH ~ON-STEROIDAL ANTI-INFLAMMATORY DRUGS
(N~Atn,). REFLliX OESOPHAGITIS, CHRONIC EPISODIC DYSPEPSIA. D.Q.S.AGf; AllULTS·
TilE l'SL'AL DOSAC.iE IS !SCMG TWICE DAILY IN THE MORI'-.:ING AND EVENISG
ALTERKATIVELY, PATIESTS WITH DUODE)'.;AL L'LCERATIOS, GASTRIC ULCERATIOS OR
REFLUX l)ES(WJlAUITIS MAY BE TREATED WITH A SINGLE BEDTIME (XJSE OF 100MCi. IN
L'LCERS FOLLOWIMJ SON-STEROIDAL Al\Tl-INFLAMMATORY DRlXi THERAPY. OR
ASSlX:IATEI1 WIT!! CO!'TINUEI) NOl'-STEROil1AL ANTI-INFLAMMATORY DRUGS l)R 11'\
TilE MANACJEME!'JTOFREFLUX ( 1ESOPHACIITIS l rpm EIGHTWEEKS' TREATMENT MAY BE
NECESSARY. CHRONIC EPISODIC DYSPEPSIA· ISOMG TWICE ['AlLY FOR SIX WEEKS,
INVESTIGATE I::ARLY RELAPSERS AND NON-RESPONDERS. (SEE DATA SHEET FOR Fl'll
noSACJE 11'STRL:CTIONS.l CONTI!A-!NDICATIONS: PATIE~TS WITH Kl\;OWN HYPER-
S~SSITIVITY TO RANITIDINE. PRECAUTIONS: EXCU;DE THE POSSIBILITY OF MALIG-
NANCY IN CJASTRIC ULCER BEFORE INSTITUTING THERAPY, ESPECIALLY IN MIPDLE-
ACJED PATIENTS WITH RECENTLY CHASCJED DYSPEPTIC SYMPTOMS. SUPER\'ISIOS' OF
PATIE~TS WI Tit PEPTIC ULCERS ANl1l )N NSAIDTilERAPY IS RECC1MMEKDE[) ESPECIALLY
IF HDERLY. REDLICE DOSACiE IN TilE PRESENCE OF SEVERE RENAL ~AlLURE (SEE DATA
SIIEETl LIKE t1THER DRl 'CS. l'SE DL"Rl~G PREGJ\:ASCY ASll LAC1ATJOS OSLY IF
STRICTLY NH :fSSARY. SIDE..EFFECTS: HEA!lACllE, DIZZINESS, SKIJ\" RASII,CXX:ASlllNAL
RANITIDINE
HEPATITIS. RARELY. REVERSIBLE MENTAL Cl)NFUSION ~'TATES, USUALLY I!' VERY ILL OR
ELDERLY PATIENTS. RARE CASES l)f LEUCOPENIA AND THROMBOCYTOPENIA, USUALLY
REVERSIBLE, AGRANULCX:YTOSIS AND PANCYTOPENIA. HYPERSENSITIVITY REAC-
T!Ot-.;S, ANAPHYLACTIC SHCX::K. RARE CASES OF BREAST SYMPTOMS ll\: MEN. AS WIT! I
OTHER H~-RECEPTOR ANTAGOJ\"ISTS RARE CASE:-1 OF BRAIWC..ARDIA ANO A-V BLLX:K
(SEE DATA SHEET). _fRESENTATION,S_: ZAl\:TAC ISO TABLETS EACH CONTAINING !SOMG
RAN!TIDINE (PRODUCT LICEl\;CE NUMBER 000410179, no TABLETS £29·76); ZANTAC k\,
TABLETS EACII CONTAINIJ\"G 300MG RAN!Til11NE (PRODUCT LICENCE NUMBER 0004
03Cl, 30 TABLETS £27·43); ZANTAC DISPERSIBLE TABLETS EACH CONTAINING !SOMli
RAl"ITlllll"E (PRODl:C.T LICENCE NUMBER Ol""\0410298, 60 TABLETS£ 31· 25), ZAJ'\TAC SYRL:r
EACH IOML DOSE COJ\TAINING !SOMG RANITIDINE (PRODUCT LICENCE !'UMBER
0004/03\C, 300ML BOTTLE £22·32). PRODUCT LICENCE HOLDER: CLAXO OPERATK'~J\":'
C.K LIMITED, GREENFORD. MIDDLESEX l TB6 CHE
ZANTAC ISA CiLAXllTRADE MARK
61.r.!lvn CIPA
Fl'RTHER JNFORMATIO:'\ I~ A\'A!LABLI: tlS
REQUEST FROM·
GLAXO LABORATORIES LI\HTE!l
GREEJ\"FORl\ MIDDLESEX l'B6l'lll:
TEL 01-4223434 Ult.U ....
 IRRITABLE BOWEL SYNDROME
TM

( L'llll'ril·- mated pcppnmint oil) C:\I'Sl'LES

Delivers effective relief right where it hurts

Pn·"l'lll:ilion: \ lr~ill bltr.:/d.u ~ bltiL' L!l!Lill-cll,l[~·d ,,ql~Uk \\llh .I h.md hd\IL'L'll L.ljl .!lld rilL ,·,ql .... llk~ . . hill!id IW\ h, hr(lh'll tiT .. hL'\\L•.i hL'<-.!\hL thh \\i1Uid r,·k.r-. ..· till' j1L'PP'-'llllllll (\j]

hroth I .tell Llllll.irll.., II .1 1111 ,q] B I' l 'l'': lr11 !r,·.rtnh·nt od -..\mptulll.., ul ]'IL!ll.ill!JL'h. )'l""rhll ,.rll,l!l!-! lo,.ilrrrrLrtrorn 11] !ilL' TlHHJ!h.rrrd (0,.,,1)1h.t!-!ll" l'.rlrL'llh \\ hor,dr,·.rlh
dhL' olll[ll]\ I I[ .thdll!lll!l,ti l l diL dr-.\Ll1'i' Ill h\ p.tliL'rlh \\ !\ iJ II 11Lthk hrn\ L'] '>IJ[JLr flillll ilL',! I lhUIIl \11111.:1 llllL'' L'\j'L'IIL'TlLL' .111 L"\.lc LJ h.l\i(lll (I] [ hl''>l' ' ' Jlljl[i111l., \\ilL' I] Ll~l!l!-! [ilL'
'' !Hir.,rrh· ()u,a~.:l' and \dmini .. tration: \dull dn~L· .~ ,·,q1~11k\ till~·: lllllL'" .1 d,tl, )(I m llll!IL'' ~ '·ll'\llk I 1·:.11m :nl \ht lllld he· tl1~~~ '11!11111~·d 111 th<:.,L' )1.ll IL'IJ!-. I )I, Tltl\ !.tf..,· JIHII).2_l'.,IJUJI Jl'Illl'dll'\
\1' tllh' IJ, lUI h,·[l IT L' l1 H lll. .111d l.tf..L'Tl \\11 h .I -.111.111 qU.!Il\11\ 11f 1\.lll'l I he· ~.I['"Lik\ .,f111Uid 1111! )1t._' 11 \ .1\ 1 ilL· ~.llllL' \1!11L' 1 d d,t\ .I~ I 111-. 11L'.II111L'I11 ld1 1 I 11 'l!r 1 I 1 [[,·,t: \)111111. "L'Tl\llll 11\ lc',tdlilll\ \II
l.t~o.,·JJ 1111111 :dJ.tt,·l\ .ltt,·r fu1 1d I h ..· -.hu1Jid h: l.if..L'Il until -.1 111)1\llJll., TL'"I 1)1 L'. Lhll.tll~ Tillotts n~c·nt h1 tl. 11111 .. II 1.rre .111d 1:h l~~tL· ,·r 1 1 hL'Il\.111 llh ,f.. In J,t-.h. 11..-.rd.t .. he. I'T.tth ..·.trdJ.t. 11111., .. k
\\11 IIIli 'l]ll,' ill I\\( I \\ L·,·r..~ \1 11!11L'" \\ 111j'\1111h .II,. 1111 ilL' i'· 1 \1'\c'Jll. the L.lj1\lJk-. L:l11 ]1,' ~llo *' \"• '/' I I ,'1111 I[ .111d .t!.t \ ],[ Ph:.Hrna~·t•ulka r l'n•raulion .. : "ill q ,. '11 .I~·)( I] r·I.ILL' \II lid dltL'd -.uJlil~ht
,,>JJIITI'_.,·d lt•T j'c'T'tld-. ,,) :1l'\l\c'~'rl .~ I•• i '"1'!1111\ Ill, I: 1-.1111 ,'\l'l':ll'llLL' 111 \Ill' lhl' , __./ l.t·~.:aiL·atl'I.!Or~: P l'rodiH'II in·nn·: fll 11-t~..fitlilti<J Ba .. k'\11~( u .. t: l.l.~ ]-. )1c'l [1111 ll:lll'of
d .. tj'-.,.1.-,,Jl ,md,r th~·.t).2_c'td ]'1,'.11" ( ontra-indiration ... "arninj.!..,.l'll'/'•r,,;:l/:"11' j..,..,lll': \l.trch ]<J;-.<1 ( <'lj','Tllllll 1' l·.td...: \l.tlf.. COL.ADl
 Rapid
relief for
patients
gripped
byiBS
Colofac rapidly relieves the
symptoms of Irritable Bowel
Syndrome by a direct action on
oolonic smooth muscle.
Colofac eliminates spasm without
an1ti-choilinc~rgjc side effects that
w",,,,_,• ..,......... troublesome to the patient.

Prescribing Information
Presentation: White, sugar-coated tablets each
contalnlngl35mg mebeverlne hydrochloride.
Available In packs of 100. Basic NHS price £8.35.
Yellow, banana-ftavoured sugar-free suspcnaion
containing mebevertne pamoate equivalent to
50mg mebeverlne hydrochloride per 5ml. Available
inbottleaof300ml,Basii:NHSprlce£3.50.
lndk:adons' I. Irritable bowel syndrome. 2. Gastro-
loosens the grip of IBS
intestinal spasm secondary to organic diseases.
Dosage and Administration' Tablets' Adults and
children ten years and over: One: tablet three times a
day, preferably 20 minutes before meals. Suspension:
Adults and children ten years and ovc" ISml
( 150mg) three times a day. preferably 20 minutes
before meals. Contra·lndk:a-., warnings, etc'
Animal experiments bavclillled to show any terato·
mebeverine
genic effects. However, the usual precautions concern·
ing the administration of any drug during pregnancy
should be observed. Product Licence Number:
Tab/eU,05l210044,suspenslo"'05l2!006l.
Further information is available on request to
the Company. Duphar Laboratories Limited,
duphar Gaters Hill, West End, Southampton,
503 3JD. Telephone,0703472281
C/Hosp Ad!I/88
 I

In the management of reflux oesophagitis and hiatus

hernia the role of Liquid Gaviscon is well established.
Liquid Gaviscon deals with reflux simply and physically
by forming a neutral layer or 'raft' on gastric contents to
inhibit reflux and so bring effective relief of reflux-related
upper gastro-intestinal symptoms.
More recently an in-vitro comparison: using computer-
based techniques, has shown that Liquid
Gaviscon produces a 'raft' more resistant to
upward pressures than any other alginate-
containing compound tested.

Sodium Alginate BPC, Sodium Bicarbonate Ph.Eur.,

Calcium Carbonate Ph.Eur.

a logical choice in reflux

........._
...._..... . lnfwmatlon Note: 10mlliquid contains 6.2mmol sodium. Bale NHS Cast:
Active lngredlenb: Sodium Alginate BPC 500mg, Sodium As at Jan. 1988: 500mlliquid £2.88, Irish Price IR £3. 72.
Bicarbonate Ph.Eur. 267mg per 10ml; calcium carbonate 160mg PL: 44/0056. Irish P.A. No.: 27/12/1.

(!)
per 10ml dose. lndloMions: Heartburn, including heartburn of
pregnancy, dyspepsia associated with gastric reflux, hiatus hernia 1. Washington, N. eta/., Int. J. Pharmaceut. (1988) 28, 139-143
and reflux oesophagitis. Contnl-lncllclltlons: None known. Further information is available on request.
Douge •nd Admlnlatr8tlon: Adults, children over 12: 10-20ml Reckitt & Colman Pharmaceutical Division,
liquid after meals and at bedtime. Infants: not recommended. HuiiHU87DS.
Children under 12: 5-10mlliquid after meals and at bedtime. *Registered trade mark.
PRESCRIBING INFORMATION· INDICATIONS; DUODENAL ULCER. BENIGN GASTRIC
ULCER. ULCERS ASSOCIATED WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS
(~SAID•). REFLUX OESOPHAGITIS. CHRONIC EPISCDIC DYSPEPSIA. I1QSAGE; ADULTS;
THE USUAL DOSAGE IS 150MG TWICE DAILY IN THE MORNING AND EVENING.
ALTERNATIVELY. PATIENTS WITH DUODENAL ULCERATION. GASTRIC ULCERATION OR
REFLUX OESOPHAGITIS MAY BE TREATED WITH A SINGLE BEDTIME DOSE OF 300MG. IN
ULCERS FOLLOWING NON-STEROIDAL ANTI-INFLAMMATORY DRUG THERAPY. OR
ASSOCIATED WITH CONTINUED NON-STEROIDAL ANTI-INFLAMMATORY DRUGS OR IN
THE MANAGEMENT OF REFLUX OESOPHAGITIS UP TO EIGHT WEEKS" TREATMENT MAY
BE NECESSARY. CHRONIC EPISODIC DYSPEPSIA• 150MG TWICE DAILY FOR SIX WEEKS;
INVESTIGATE EARLY RELAPSERS AND NON-RESPONDERS. (SEE DATA SHEET FOR FULL
DOSAGE INSTRUCTIONS.) CONTRA-INDICATIONS; PATIENTS WITH KNOWN HYPER·
SENSITIVITY TO RANITIDINE. PRECAUTIONS, EXCLUDE THE POSSIBILITY OF MALlO·
NANCY IN GASTRIC ULCER BEFORE INSTITUTING THERAPY. ESPECIALLY IN MIDDLE·
AGED PATIENTS WITH RECENTLY CHANGED DYSPEPTIC SYMPTOMS. SUPERVISION OF
PATIENTS WITH PEPTIC ULCERS AND ON NSAID THERAPY IS RECOMMENDED
~s':EE~~~~~YJ~:.flDCI~i'"J\.~~~~~~~8iE1~J~~~RPEiJ~~!~~~~E~C:g~~6~~~~~
IF STRICTLY NECESSARY. SIDE EFFECTS; HEADACHE. DIZZINESS. SKIN RASH.
OCCASIONAL HEPATITIS. RARELY. REVERSIBU MENTAL CONFUSION STATES. USUALLY
IN VERY ILL OR ELDERLY PATIENTS. RARE CASES OF LEUCOPENIA AND THROMBO·
CYTOPENIA. USUALLY REVERSIBLE. AGRANULOCYTOSIS AND PANCYTOPENIA.
HYPERSENSITIVITY REACTIONS. ANAPHYLACTIC SHOCK. RARE CASES OF BREAST
SYMPTOMS IN MEN. AS WITH OTHER H,-RECEPTOR ANTAGONISTS RARE CASES OF
BRADYCARDIA AND A.Y BLOCK (SEE DATA SHEET!. PRESENTATIONS; ZANTAC
150 TABLETS EACH CONTAINING 150MG RANITIDINE (PRODUCT LICENCE NUMBER
000410219. 60 TABLETS £29·76); ZANTAC 300 TABLETS EACH CONTAINING 300MG
RANITIDINE (PRODUCT LICENCE NUMBER 000410302. 30 TABLETS £21-43); ZANTAC
DISPERSIBLE TABLETS EACH CONTAINING 150MG RANITIDINE (PRODUCT LICENCE
NUMBER 000410298. 60 TABLETS £31· 25); ZANTAC SYRUP EACH IOML DOSE CONTAINING
150MG RANITIDINE (PRODUCT LICENCE NUMBER 000410310. 300ML BOTTLE £22·32).
PRQDUCI LICENCE HOLDER• GLAXO OPERATIONS U.K. LIMITED. GREENFORD.
cit
MIDDLESEX UB6 OHE
ZANTAC IS A GLAXO TRADE MARK
FURTHER INFORMATION IS AVAILABLE ON REQUEST FROM'G1.
GLAXO LABORATORIES LIMITED
GREENFORD. MIDDLESEX UB6 OHE
a~o
TEL, OJ.422 3434 ·
Pentax UK Limited, Pentax Medical Division, Pentax House, South Hill Avenue, South Harrow, Middlesex HA2 OLT. Tel: 01-864 4422.
 THE 4-HOUR PREP

TOTAL ORAL Gl LAVAGE FOR COLONOSCOPY,

BARIUM ENEMA AND SURGERY IN 4 HOURS
WITHOUT DIETARY RESTRICTIONS, ENEMAS OR
SUPPOSITORIES.
FAST... administration of GoLYTELY solution can begin just 4 hours prior to examination
or surgery, 3 hours for drinking plus an hour to complete evacuation. Home patients
can stay active for longer. Length of stay of hospitalized patients is reduced.
EXCELLENT RESULTS ••• clinical comparison with standard prep regimens has shown
that GoLYTELY significantly improves bowel emptying and subsequent visualization.1' 2
THOROUGH ... with a clean bowel, the need for repeat examinations is reduced.
SAFE ... because GoLYTELY produces no significant changes in fluid or electrolyte
balance, it is well tolerated by virtually all patients including those who are elderly,
poorly hydrated, or have impaired cardiac or renal function.
EASY TO USE ... premeasured, unit-of-use packaging guarantees accurate
reconstitution and guards against incorrect or inadequate usage.
PATIENTS PREFER GoLYTELY because it offers them dietary freedom, short 2 ,3 .4
preparation time, a more convenient routine to follow at home and is less distressing.
SURGERY. .. GoLYTELY is indicated as a pre-operative bowel preparation for surgery.

GoLYTELY PRESCRIBING INFORMATION
DESCRIPTION: A white powder for reconstitution containg 236g polyethyfeoe glycol absofbed.
=~-!J~i~=:~·,~~o~:t~r:::;:,~~e::t!::~i~of
41itres. GoLYTELY is an isosmotic solution having a mildly salty taste. GolYTELY is
administered orally or via nasogastric tube.
~~~==¥ho~~J;Y=~:~::r::::~r~~z~r::~~
and the electrolyte concentration resuh in virtually no net absorption or excretion of
~h~~~~~~;~Qc~~~~~~·~~~Y:~~~es may be administered without significant
INDICATIONS AND USAGE: GoLYTELY is indicated for bowel cleansing prior to
colonoscopy, x-ray examination and surgery.
CONTRAINDICAT10NS: GoLYTELY is contraindicated in patients with gastrointestinal
obstruction, gastric retention, bowel perforation, toxic colitis, toxic megacolon or
ileus.
WARNINGS: No additional ingredients, e.g. flavourings, should be added to the
solution. GoLYTELY should be ustd with caution in p.atlents with severe ulcerative
colitis. KEEPOUTOFREACHOFCHILDREN.
PR£CAUnoNS:
:::::na:si:':n:~:~~~~Y:~ ~~!:lr~~~n~~~~~ g~==~~~,;~~~ts,
~~~~~:x';e~~~~~!~~=~~~~e~~~;~~=;~j ;~~~~~~::i~~a
should be slowed or temporarily diSContinued until the symptoms abate.lf
gastrointestinal obstruction or perforation is suspected, appropriate studies should
be performed to rule out these conditions before administration of GoLYTELY.
lnf0rm1tlon for patients: GoLYTELY produces a watery stool which cleanes the bowel
~:~~:~~~i~~Y~~:~~ftj~.t~~rs:~i:~~~~~~~~d~:!t":~~~o;:~~~~em':r 1 e. =~~~n:~~i~:~:'h~~~~i=~ra~~o;'~~:~~~,i::~:~n~:cittO:r ~~~~~
1=~~t~~~~~i~~:!:~?~k~~~~~L~Iution, but in no case should solid
Drink 240ml (Soz) every 10 minutes. Rapid drinking of each portion is better
than drinking small ~mounts continuously. The first boWel movement should occur
approximately one liour after the start of GoLYTELY administration. You may
experience some abdominal bloatinr~ and distention before the bowels start to
move. If severe discomfort or distention occur, stop drinking temporarily or drink
===~~'t!~::Va~~~=:=~r:~~!':T~~~::e:r~n~
litres and it is best to drink all of the solution. Any unused portion should be
discltded.
~ lmer.ctlons: Oral medication administered within one hour of the start of
administration of GolYTELY may be flushed from the gastrointestinal tract and not
cardnogtntlis. Mutaglntlis. knp&innent of Fertility: CaKinogenic and
reproductive studies With animals have not been performed.
Pnanancy.Animal reproduction studies have not been conducted with GolYTELY. It
is afso not known whether GolYTELY can cause fetal harm when administered to a
pregnant woman or can affect rept"oductive capacity. GolYTELYshould be given to a
a::.;:ns!~~r:==nchildren have not been estabfished.
ADVERSE REAcnoNS: N . Braintree, MA 02184, USA.
common adverse rea of
GoLYTELY. Abdominal uently.
of urticaria,
rhinorrhea and dermatitis ave been reported whic may represent allergic
reactions.
DOSAGE AND ADMINISTRATION: The recommended dose for adults is 41itres of
~"J:~va~W:r.~;~::,~~:~~l~:~:~m~f=~~n:.i:;,~c;~P~~~~~f"
should fast for approximately three or four hours prior to GoLYTELY administration,
b!Jt In no cast should solid foOd be given for at least two hours before the solution is
g1ven.
topa~~~~!Zo1 ~~~!%::::~;~~:fe~;~~:{h~~l~ig~~0,!\~~~%1:::0~:!'
at a rate of 240ml (Soz) t!'!'!'flO minutes, until41itres are consumed or the rectal
=~~~isi~;~~r~u~?s[~. ~~=~~:t~~~~~~~~t~~~edr~~ek~~~~~~~~ per
minute (1.2-1.811tres per hour). The first bowel movement should occur
approximately one hour after the start of GoLYTELY administration.
Various regimens have been used. One method is to Khedule patients for
is to administer GoLYTELY on the evening before the examination, particularly if the
patient is to have a barium enema.
lftparatlon of the solution: GoLYTELY solution is prepared by filling the
container to the 41itre mark with water and shaking v1gorously several t1mes to
~:=~~~~.~~T~Yo~r~~~~'=a~:\rc~~~~ f~~~:!3!rni~~~ion. The
reconstituted solution should be refrigerated and used within 48 hours. Discard any
unused portion.
:C~=c!~~~~~':·!>~~~=a:::!~3"J~~e
gtycol4000 BP, 22.14 g sodium sulphate BP, 6.14g sodium bicarbonate •P, S.86 g
Sodium chloride BP, and 2.97 g potassium chloride BP. When made up to 41itres
volume with water, thesolutioncontains PEG 4000 17.6 mmolll. sodium 125 mmolll,
sulfate 40 mmolll. chloride 35 mmolll. bicarbonate 20 mrnolll and potassium 10
mmolll.
UGAL CATEGORY: POM.
STORAGE: Store in sealed container at 59"-86"f. When reconstituted keep solution
refrigerated. Use within 48 hours. Discard unused portion.
PRODUO LICENCE NUMBER: 8653f0001
PRODUO LICENCE HOLDER: Braintree Laboratories Inc, PO Box 361,
UNmD KINGDOM DISTRIBUTOR: Seward Medica/limited
131 Great Suffolk Street, london, SE1 1PP
Phone: 01 357 6817 Fax: 01 357 6563
PRICE AVAILABLE ON REQUEST
FURTHER INFORMATION IS AVAILABLE ON REQUEST

~ !Ilf1~ M®xoJO~~~
131 Great Suffolk Street, London SE 1 1PP
Telephone: 01-357 6817 Fax: 01-357 6563
 1g
Mesalazine Enema

I NORDICX I
Anew cornerstone in the
management of ulcerative colitis
0 PENTASA enema - effective and well tolerated.
0 PENTASA enema - formulation keeps active substance in
contact with affected mucosa for a prolonged period.
0 PENTASA enema - resulted in significantly greater frequency
of remission of clinical symptoms during the first 2 weeks
(c.f. prednisolone enemas).
0 PENTASA enema - can be safely administered to patients who
are sensitised to the sulphapyridine moiety of sulphasalazine.
0 PENTASA enema - at least as effective as hydrocortisone and
well tolerated.

PENTASA Mesalazine Enema "'

Abridged prescribing information: Presentation: Unit dose plastic enema bottles containing I g Mesalazine in I 00 ml suspension.
Uses: Treatment of ulcerative colitis affecting the distal colon and recrum. Dosage and Adminlstradon: Adults: The recommended dosage is one
enema at bedtime. Children: Not recommended. COntraindications: Known sensitivity to salicylates. Precautions, Warnings, etc: PENTASA
is not recommended in patients with renal impainnent. Patients with raised blood urea or proteinuria should be treated with caution. PENTASA
should be used with caution during pregnancy and lactation. Adverse reactions: Adverse reactions including nausea, headache and abdominal
pain may occur in a small proportion of patients. Mesalazine may be associated with the exacerbation of the symptoms of colitis in patients who
have previously had this problem with sulphasalazine. Legal category: POM. Package Quantity: canons containing seven individually foil-
wrapped 100 ml enemas. Basic NHS price: £19.45 per canon. Product Licence: PL 3194/0027.
Full prescribing information is available on request:
NORDIC PHARMACEUTICALS LTD.,
11 Mount Rd, Feltham, Middlesex TW13 6JG. Tel: 01-898 8396.
PENTASA is a ttade mark.
((A man apart
. " . . uA tru Iy remarkable man " . . .
((Distinction of mind, of bearing, of character . . . characterised him always. n

Ryle was an outstanding clinician and

an orijiltal ~Jinical itwestigator, his work
on the fracttonal test meal and the
introdUction of "Ryle's tube" for taking
gastric samples earning him an
The Natural History
international reputation. With a holistic
approa(h to medicine he saw the physician
as a naturalist who must study how of Disease
and why man reacts to disease as well
as how disease progresses in man.

The awareness of a wider perspective

led to his accepting the first chair of
social medicine, at Oxford, where
among his pupils was Michael
She~, now professor at the JOHN A RYLE
Ins · of Psyc · 1 who has WITH AN INTRODUCTION BY MICHAEL SHEPHERD

· to the new
le ., .. kyle's · ·
The !Utural Hist f Disease.
First published in t9]6. the
~o~n. ~f 3• lectures ~d e~f~ _.·
~~ ~ns;.e ~=t~~>
son stateslid
the~ u his work
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 Just published
Many medical journals, including the British
Medical Journal, now expect scientific papers
submitted to them to contain confidence
intervals when appropriate. Why? what are
they? and how do you calculate them?
Statistics with Conftdmce tells you. A clear
explanation of the reasons for using
confidence intervals is followed by detailed
presentation of methods of calculation,
including numerous worked examples and
specially compiled tables. To make things
even easier, a computer programme,
Confidence Interval Analysis (CIA), for
calculating confidence intervals, has been
specially designed by Mattin Gardner and
details are available from the Publishing
Depattment, British Medical Journal.
Eighth edition
The statistical testing of data is
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by step instruction. Subjects
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Fourth Second edition

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STATISTlCS N impression Epidemiology has its own
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No doctor can afford to ignore
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 Autobiographical
The BMJ' s new series

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MEMOIR
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The second book in the series,

published in November 1987, is
Recollections and Reflections by Douglas
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occupant of important posts when
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 CIA software - available now
Calculate with confidence:
Confidence Interval Analysis (CIA) is a computer program that takes the sweat out of
calculating confidence intervals. Devised by Martin Gardner, professor of medical
statistics, MRC Environmental Epidemiology Unit, University of Southampton. The
program is menu driven with easy access to each chapter and to the method required
within each chapter. Topics covered include calculating confidence intervals for:

• means and their differences

• proportions and their differences
• regression and correlation
• non-parametric analyses

For each method relevant intermediate statistics and the required confidence interval are
produced on the screen. Complete with its own manual, the program may also be used in
conjunction with the book Statistics with Confidence, which provides numerous worked
examples. The software is available for IBM compatibles on either a 5V.," or a 3%" disk.

Price: £65.00. Educational establishments, research institutes, and the

NBS- £45.95. Prices include VAT in the UK and air mail despatch abroad.

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