Boehringer Ingelheim Israel Ltd

Thrombolytic Agent. Alteplase 20 mg/vial, 50 mg/Vial.
VIAL. (pwdr.+ solvent for sol. for inject./
infus.): 1 + 1 vial of solvent. Dosage
must be ajust. individ according to pt.
med. cond.
Acute MI: In adults for the lysis of thrombi
obstruct. coron. arteries, the reduction of
infarct size, the improve. of ventr. func., the
reduction of the incidence of congest.
heart fail., reduct. of mortality assoc. with
AMI. Tmt. should be initiated as soon as
possible after the onset of AMI sympt.
Acute Massive Pulmon. embol. with
hemodynamic deprivation.: Management
of acute massive pulmonary embolism
(PE) in adults: For the lysis of acute pulm.
emboli, defined as obstruct. of blood flow
to a lobe or multiple segments of the lung,
For the lysis of pulmon. emboli
accompanied by unstable hemodynamics
e.g. fail.to maintain blood pressure
without supportive measures.
The diagnosis should be confirmed by
objective means, such as pulmon.
angiography or noninvasive procedures
such as lung scanning.For fibrinolytic
treatment of acute ischaemic stroke Tmt.
must be started as early as possible within
4.5 hrs. after onset of stroke sympt.and
after exclusion of intracr. haemorrhage by
appropriate imaging techniques (e.g.
cranial CT or other diag. imaging method
sensitive for the presence of
haemorrhage). The tmt. effect is timedependent;
therefore earlier tmt. incr. the
probability of a favourable outcome.
C/I: Hypersens. High risk cases of
haemorrhage such e.g.: Signific. bleed.
disor. at present or within the past 6
mnths. Known haemorrhage.diathesis.
Pts. receiving effective oral anticoag.
tmt., e.g. warfarin sodium (INR>1.3). Manifest or recent severe or dangerous bleed. Known hist. of or suspected intracran.
haemorrhage. Suspected subarachnoid
haemorrhage/condition after subarachnoid haemorrhage from aneurysm. Any history of CNS damage (i.e. neoplasm, aneurysm, intracran./spinal surg.). Recent (less than 10 days) traumatic external heart massage,
obstetrical delivery, recent puncture of a
non-compressible blood-vessel (e.g.
subclavian or jugular vein puncture).
Severe uncontrol.arterial hypertens.
Bact. endocarditis, pericarditis. Acute
pancreatitis. Documented ulcerative GI
dis. during the last 3 mnths., oesophageal varices, arterial-aneurysm, arterial/venous malformations.
Neoplasm with incr. bleed.risk. Severe liver dis., includ. hep. fail., cirrhosis, portal hypertension (oesophageal varices) and active hepatitis. Major surg. or signific. trauma in past 3 mnths.
Addit. contraind. in acute massive pulmonary embolism, MI, acute ischaemic stroke: see lit.
Acute ischaemic stroke in child. under 16 yrs old.

Anticholinergic. Ipratropium Bromide 0.25 mg/ml.
SOLN: (with dropper): 20 ml x 0.25 mg/
ml (20 drops). Adults: 0.1-0.5 mg (8-40
drops) up to 4 x dly. Child. 6-12 Yrs.: 0.25mg  (20 drops, i.e., 1 ml) 3 - 4 times dly. Child. < 6 yrs of age: the follow. dose schedule should only be given under regular med. supervision:The single inhaled dose is 0.1 - 0.25 mg , (8-20 drops, i.e.: 0.4-1.0 ml) the dose may need to be diluted (only normal saline ) in order to obtain a final volume suitable for the nebulizer being used.

Relief sympts. reversible bronchosp. assoc.
with asth., chron. bronchit., emphysema,
concomitant. with inhaled β-agonists.
C/I: Known hypersens. to drug, to
atropine and its derivs., or to any other
ingred. in prep.

Anticholinergic. Ipratropium Bromide 0.02 mg.
VIAL + MOUTHPIECE: 10 ml (200
metered doses): 1-2 puffs 4 x dly. Not to exceed 12 inhals. in 24 hrs. Child: 6-12 yrs: 1-2 puffs 3 x dly. same  recommendations are the for child. <6 years of age.See lit. 

Relief sympts. reversible bronchosp. assoc.
with asth., chron. bronchit., and
emphysema.
C/I: Known hypersens. to drug, to
atropine and its derivs., or to any other
ingred. in prep.

Protein Kinase Inhibitor. Afatinib (as dimaleate) 20, 30, 40, 50 mg.
F.C TABS: 7, 14, 28 × 20 mg, 30 mg, 40
mg, 50 mg.
40 mg 1 x dly., 3 hrs. before meal and at
least 1 h. after. May incr. up to 50 mg 1 x
dly after 3 wks. without serious adverse
events. Tmt. should be cont. until dis.
progres. or until no longer tolerat. By
the pt. see lit.
As monother. for the tmt. of: EGFR TKInaïve
adult pts. with local. advanc. or
metastat. NSCLC with activat. EGFR
mutation(s); Local. advance. or metast.
NSCLC of squamous histology progress. on
or after platin. -based chemother.
C/I: Hypersens., pregnancy, lact.

DPP-4 Inhibitor, SGLT2 Inhibitor. Empagliflozin 10, 25 mg, Linagliptin 5 mg.
F.C.TABS.: 30. The recomm. dose of this drug is 10 mg empagliflozin/5 mg linagliptin once dly. in the morn., taken with/ without food. In pts. tolerat. this formul., the dose may be incr. to 25 mg empagliflozin/5 mg linagliptin once dly. See lit.
Indic. as an adjunct to diet and exercise to improve glycem. control in adults with type 2 diab. mell. when tmt. with both empagliflozin and linagliptin is approp..
C/I: Sev. ren. impair., end-stage renal dis., or dialysis. Hist. of hypersens. reaction to linagliptin, such as anaphylax., angioedema, exfoliative skin condit., urticaria, or bronch. hyperreactivity. Hist. of serious hypersens. reaction to empagliflozin.

SGLT2 Inhibitor. Empagliflozin 10 mg, 25 mg.
F.C. TABS.: 30×10, 25 mg. In pts. with volume depletion, correct. this condition prior to init. of empagliflozin is recomm.
Recomm. dose for all indic. is 10 mg orally daily.
- For addit. glycemic ctrol., incr.to 25 mg in pts. tolerating 10 mg dly.
- Use for glycemic control is not recomm. in pts. with eGFR less than 30 mL/min/1.73 m². See lit.
 Products 10 and 25 mg indic.:
as an adjunct to diet and exercise to improve glyc. ctrol. in adlts. with type 2 diabetes mell.
to red. the risk of CV death in adlt pts. with type 2 diabetes mell. and established CV dis.
10 mg indic.:
•to red. the risk of CV death and hosp. for HF in adlts with HF.
•to red. the risk of sust. decline in eGFR, end-stage kidney dis., CV death, and hosp. in adlts with chron. kidney dis. at risk of progr.
as an adjunct to diet and exercise to improve glyc. ctrol. in ped. ptts. aged 10 years and older with type 2 diabetes mell.
C/I: Hypersens., angioedema react. occurred.