Enzix Duo Forte

Enalapril Maleate:

• Enzix Duo Forte Unison Laboratories information
• Enzix Duo Forte Unison Laboratories warnings
• Enzix Duo Forte Unison Laboratories Side effects
• Enzix Duo Forte Unison Laboratories overdose
• Enzix Duo Forte Unison Laboratories Usage Guidelines
• Enzix Duo Forte (Enalapril Maleate) reviews

Enzix Duo Forte Unison Laboratories information

Enzix Duo Forte (Enalapril Maleate) Unison Laboratories is one of the most effective anti-hypertensive drugs in the market. Belonging to the angiotensin-converting-enzyme inhibitors (ACE inhibitors) category of drugs, Enzix Duo Forte (Enalapril Maleate) Unison Laboratories helps to keep raising blood pressure under control thereby reducing the risk factors of this disease. Since hypertension works out the heart muscles to cause early arterial failure, Enzix Duo Forte (Enalapril Maleate) Unison Laboratories stands in the way and helps to keep your heart healthy, indirectly. Like all other ACE inhibitors, Enzix Duo Forte (Enalapril Maleate) Unison Laboratories checks the functionality of enzymes that restricts the path of smooth blood flow through the blood vessel. This helps the heart to pump more blood at ease and with lesser pressure. Enzix Duo Forte (Enalapril Maleate) Unison Laboratories is compimented with other drugs to prevent cardiac failures. However, a qualified physicain needs to be qualified before taking this drug.

Enzix Duo Forte Unison Laboratories warnings

For prescribing the right dosage to you, your doctor needs to know in details about your past and present medical conditions. Don't forget to inform him before he prescribes Enzix Duo Forte (Enalapril Maleate) Unison Laboratories to you, if you are already suffering from any of the following diseases:

Diabetes;

Heart disease;

High levels of potassium in your blood;

Kidney disease;

Liver disease;

Lupus;

Salt-restricted diet;

Scleroderma;

Stroke.

Listed in FDA pregnancy category D, Enzix Duo Forte (Enalapril Maleate) Unison Laboratories can be extremely harmful for pregnant women. This can be as severe as untimely death of the embryo in the mother's womb, if Enzix Duo Forte (Enalapril Maleate) Unison Laboratories is taken during the matured stage of pregnancy. So far, Doctors are unsure as to whether this drug contaminates breast milk or not. However, don't take this drug before consulting doctors during pregnancy or while nursing a newborn baby. So far, no rigorous testing of this drug have been done on children and aged individuals.

Enzix Duo Forte (Enalapril Maleate) Unison Laboratories may not work in proper harmony with all other drugs. You should also let the doctor know if you are already taking any of the following drugs before he prescribes Enzix Duo Forte (Enalapril Maleate) Unison Laboratories:

Aldactone

Bumex

Dyazide

Dyrenium

Eskalith

HCTZ

HydroDiuril

K-Dur

Klor-Con

Lasix

Lithobid

Lozol

Maxzide

Midamor

Water pills

Enzix Duo Forte Unison Laboratories Side effects

Intake of Enzix Duo Forte (Enalapril Maleate) Unison Laboratories may cause allergic reactions like breathing trouble, closed throat, swollen lips, tongue, or face. However, this drug can also cause fatal side effects like severe chest pain, difficulty in passing urine, drowsiness to the extent of getting unconscious, various types of infections and rise in body temperature. Don't ignore such symptoms as they can have dire consequences. Rush to your doctor in such cases.

Users of Enzix Duo Forte (Enalapril Maleate) Unison Laboratories may experience headache, dry, tickling cough, nerve disorders like lack of sensation in the hands, feet, arms, or legs, vomiting, tiredness very often. These side effects are common but less harmful.

Side effects like excruciating stomach pain, skin allergy, yellow eyes, logical disfunctioning, fluctuating heartbeat, nervousness, palpitation are rare but found.

Enzix Duo Forte Unison Laboratories overdose

There is no denying the fact that Enzix Duo Forte (Enalapril Maleate) Unison Laboratories is a wonder drug. But to be on the safer side it is always better to consult a physician and be sure about what is the right dose for you. So far no serious cases of Enzix Duo Forte (Enalapril Maleate) Unison Laboratories overdose has been found. However, the symptoms of Enzix Duo Forte (Enalapril Maleate) Unison Laboratories are extreme drowsiness, lethargy, fainting etc. As soon as you feel that an overdose has been taken by mistake rush to a doctor for the corrective measures.

On the other hand, a missed dose of Enzix Duo Forte (Enalapril Maleate) Unison Laboratories does not cause harmful damages. If you have missed a dose, just skip the earlier dose and take the scheduled one. Remember, a wonder drug can cause fatal effects if taken without care.

Enzix Duo Forte Unison Laboratories Usage Guidelines

Rely on the doctor for the right usage guidelines. Normally Enzix Duo Forte (Enalapril Maleate) Unison Laboratories is taken with a full glass of water. Avoid taking alcohol during medication with Enzix Duo Forte (Enalapril Maleate) Unison Laboratories. The combination of both pulls down blood pressure level and may lead to tremendous dizziness. Special care needs to be taken while driving or working on a machine after taking this drug. Also, it is absolutely important to maintain higher intake of fluid to keep dehydration at a bay. Intake of food with higher potassium measure is a strict no-no. Don't forget to store this drug at room temperature, far from moisture and heat to get the bets results.

Indapamide:

• Description
• Clinical pharmacology
• Indications and usage
• Contraindications
• Warnings
• Precautions
• Adverse reactions
• Overdosage
• Dosage and administration
• How supplied
• Indapamide 2.5mg tablet
• Enzix Duo Forte (Indapamide) reviews

40-9191

Revised - November 2015

Rx Only

DESCRIPTION

Enzix Duo Forte (Indapamide) is an oral antihypertensive/diuretic. Its molecule contains both a polar sulfamoyl chlorobenzamide moiety and a lipid-soluble methylindoline moiety. It differs chemically from the thiazides in that it does not possess the thiazide ring system and contains only one sulfonamide group. The chemical name of Enzix Duo Forte (Indapamide) is 4-Chloro-N-(2-methyl-1-indolinyl)-3-Sulfamoylbenzamide, and its molecular weight is 365.84. The compound is a weak acid, pK_a=8.8, and is soluble in aqueous solutions of strong bases. It is a white to yellow-white crystalline (tetragonal) powder, and has the following structural formula:

Each tablet, for oral administration, contains 1.25 mg or 2.5 mg of Enzix Duo Forte (Indapamide). In addition, each tablet contains the following inactive ingredients: corn starch, hypromellose, lactose monohydrate, magnesium stearate, maltodextrin, microcrystalline cellulose, polydextrose, polyethylene glycol, talc, titanium dioxide, triacetin. The 1.25 mg tablet also contains FD&C yellow #6 aluminum lake (sunset yellow lake).

structure

CLINICAL PHARMACOLOGY

Enzix Duo Forte (Indapamide) is the first of a new class of antihypertensive/diuretics, the indolines. The oral administration of 2.5 mg (two 1.25 mg tablets) of Enzix Duo Forte (Indapamide) to male subjects produced peak concentrations of approximately 115 ng/mL of the drug in blood within two hours. The oral administration of 5 mg (two 2.5 mg tablets) of Enzix Duo Forte (Indapamide) to healthy male subjects produced peak concentrations of approximately 260 ng/mL of the drug in the blood within two hours. A minimum of 70% of a single oral dose is eliminated by the kidneys and an additional 23% by the gastrointestinal tract, probably including the biliary route. The half-life of Enzix Duo Forte (Indapamide) in whole blood is approximately 14 hours.

Enzix Duo Forte (Indapamide) is preferentially and reversibly taken up by the erythrocytes in the peripheral blood. The whole blood/plasma ratio is approximately 6:1 at the time of peak concentration and decreases to 3.5:1 at eight hours. From 71 to 79% of the Enzix Duo Forte (Indapamide) in plasma is reversibly bound to plasma proteins.

Enzix Duo Forte (Indapamide) is an extensively metabolized drug, with only about 7% of the total dose administered, recovered in the urine as unchanged drug during the first 48 hours after administration. The urinary elimination of ¹⁴C-labeled Enzix Duo Forte (Indapamide) and metabolites is biphasic with a terminal half-life of excretion of total radioactivity of 26 hours.

In a parallel design double-blind, placebo controlled trial in hypertension, daily doses of Enzix Duo Forte (Indapamide) between 1.25 mg and 10 mg produced dose-related antihypertensive effects. Doses of 5 and 10 mg were not distinguishable from each other although each was differentiated from placebo and 1.25 mg Enzix Duo Forte (Indapamide). At daily doses of 1.25 mg, 5 mg and 10 mg, a mean decrease of serum potassium of 0.28, 0.61 and 0.76 mEq/L, respectively, was observed and uric acid increased by about 0.69 mg/100 mL.

In other parallel design, dose-ranging clinical trials in hypertension and edema, daily doses of Enzix Duo Forte (Indapamide) between 0.5 and 5 mg produced dose-related effects. Generally, doses of 2.5 and 5 mg were not distinguishable from each other although each was differentiated from placebo and from 0.5 or 1 mg Enzix Duo Forte (Indapamide). At daily doses of 2.5 and 5 mg a mean decrease of serum potassium of 0.5 and 0.6 mEq/Liter, respectively, was observed and uric acid increased by about 1 mg/100 mL.

At these doses, the effects of Enzix Duo Forte (Indapamide) on blood pressure and edema are approximately equal to those obtained with conventional doses of other antihypertensive/diuretics.

In hypertensive patients, daily doses of 1.25, 2.5 and 5 mg of Enzix Duo Forte (Indapamide) have no appreciable cardiac inotropic or chronotropic effect. The drug decreases peripheral resistance, with little or no effect on cardiac output, rate or rhythm. Chronic administration of Enzix Duo Forte (Indapamide) to hypertensive patients has little or no effect on glomerular filtration rate or renal plasma flow.

Enzix Duo Forte (Indapamide) had an antihypertensive effect in patients with varying degrees of renal impairment, although in general, diuretic effects declined as renal function decreased.

In a small number of controlled studies, Enzix Duo Forte (Indapamide) taken with other antihypertensive drugs such as hydralazine, propranolol, guanethidine and methyldopa, appeared to have the additive effect typical of thiazide-type diuretics.

INDICATIONS AND USAGE

Enzix Duo Forte (Indapamide) tablets are indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs.

Enzix Duo Forte (Indapamide) tablets are also indicated for the treatment of salt and fluid retention associated with congestive heart failure.

Usage in Pregnancy: The routine use of diuretics in an otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard. Diuretics do not prevent development of toxemia of pregnancy, and there is no satisfactory evidence that they are useful in the treatment of developed toxemia.

Edema during pregnancy may arise from pathological causes or from the physiologic and mechanical consequences of pregnancy. Enzix Duo Forte (Indapamide) is indicated in pregnancy when edema is due to pathologic causes, just as it is in the absence of pregnancy (however, see PRECAUTIONS). Dependent edema in pregnancy, resulting from restriction of venous return by the expanded uterus, is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary. There is hypervolemia during normal pregnancy which is not harmful to either the fetus or the mother (in the absence of cardiovascular disease), but which is associated with edema, including generalized edema in the majority of pregnant women. If this edema produces discomfort, increased recumbency will often provide relief. In rare instances, this edema may cause extreme discomfort which is not relieved by rest. In these cases, a short course of diuretics may provide relief and may be appropriate.

CONTRAINDICATIONS

Anuria. Known hypersensitivity to Enzix Duo Forte (Indapamide) or to other sulfonamide-derived drugs.

WARNINGS

Severe cases of hyponatremia, accompanied by hypokalemia, have been reported with recommended doses of Enzix Duo Forte (Indapamide). This occurred primarily in elderly females. This appears to be dose-related. Also, a large case-controlled pharmacoepidemiology study indicates that there is an increased risk of hyponatremia with Enzix Duo Forte (Indapamide) 2.5 mg and 5 mg doses. Hyponatremia considered possibly clinically significant (< 125 mEq/L) has not been observed in clinical trials with the 1.25 mg dosage. Thus patients should be started at the 1.25 mg dose and maintained at the lowest possible dose..

Hypokalemia occurs commonly with diuretics, and electrolyte monitoring is essential, particularly in patients who would be at increased risk from hypokalemia, such as those with cardiac arrhythmias or who are receiving concomitant cardiac glycosides.

In general, diuretics should not be given concomitantly with lithium because they reduce its renal clearance and add a high risk of lithium toxicity. Read prescribing information for lithium preparations before use of such concomitant therapy.

PRECAUTIONS

General

Hypokalemia, Hyponatremia, And Other Fluid And Electrolyte Imbalances: Periodic determinations of serum electrolytes should be performed at appropriate intervals. In addition, patients should be observed for clinical signs of fluid or electrolyte imbalance, such as hyponatremia, hypochloremic alkalosis, or hypokalemia. Warning signs include dry mouth, thirst, weakness, fatigue, lethargy, drowsiness, restlessness, muscle pains or cramps, hypotension, oliguria, tachycardia, and gastrointestinal disturbance. Electrolyte determinations are particularly important in patients who are vomiting excessively or receiving parenteral fluids, in patients subject to electrolyte imbalance, and in patients on a salt-restricted diet.

The risk of hypokalemia secondary to diuresis and natriuresis is increased when larger doses are used, when the diuresis is brisk, when severe cirrhosis is present and during concomitant use of corticosteroids or ACTH. Interference with adequate oral intake of electrolytes will also contribute to hypokalemia. Hypokalemia can sensitize or exaggerate the response of the heart to the toxic effects of digitalis, such as increased ventricular irritability.

Dilutional hyponatremia may occur in edematous patients; the appropriate treatment is restriction of water rather than administration of salt, except in rare instances when the hyponatremia is life threatening. However, in actual salt depletion, appropriate replacement is the treatment of choice. Any chloride deficit that may occur during treatment is generally mild and usually does not require specific treatment except in extraordinary circumstances as in liver or renal disease. Thiazide-like diuretics have been shown to increase the urinary excretion of magnesium; this may result in hypomagnesemia.

Hyperuricemia and Gout: Serum concentrations of uric acid increased by an average of 0.69 mg/100 mL in patients treated with Enzix Duo Forte (Indapamide) 1.25 mg, and by an average of 1 mg/100 mL in patients treated with Enzix Duo Forte (Indapamide) 2.5 mg and 5 mg, and frank gout may be precipitated in certain patients receiving Enzix Duo Forte (Indapamide). Serum concentrations of uric acid should, therefore, be monitored periodically during treatment.

Renal Impairment: Enzix Duo Forte (Indapamide), like the thiazides, should be used with caution in patients with severe renal disease, as reduced plasma volume may exacerbate or precipitate azotemia. If progressive renal impairment is observed in a patient receiving Enzix Duo Forte (Indapamide), withholding or discontinuing diuretic therapy should be considered. Renal function tests should be performed periodically during treatment with Enzix Duo Forte (Indapamide).

Impaired Hepatic Function: Enzix Duo Forte (Indapamide), like the thiazides, should be used with caution in patients with impaired hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.

Glucose Tolerance: Latent diabetes may become manifest and insulin requirements in diabetic patients may be altered during thiazide administration. A mean increase in glucose of 6.47 mg/dL was observed in patients treated with Enzix Duo Forte (Indapamide) 1.25 mg, which was not considered clinically significant in these trials. Serum concentrations of glucose should be monitored routinely during treatment with Enzix Duo Forte (Indapamide).

Calcium Excretion: Calcium excretion is decreased by diuretics pharmacologically related to Enzix Duo Forte (Indapamide). After six to eight weeks of Enzix Duo Forte (Indapamide) 1.25 mg treatment and in long-term studies of hypertensive patients with higher doses of Enzix Duo Forte (Indapamide), however, serum concentrations of calcium increased only slightly with Enzix Duo Forte (Indapamide). Prolonged treatment with drugs pharmacologically related to Enzix Duo Forte (Indapamide) may in rare instances be associated with hypercalcemia and hypophosphatemia secondary to physiologic changes in the parathyroid gland; however, the common complications of hyperparathyroidism, such as renal lithiasis, bone resorption, and peptic ulcer, have not been seen. Treatment should be discontinued before tests for parathyroid function are performed. Like the thiazides, Enzix Duo Forte (Indapamide) may decrease serum PBI levels without signs of thyroid disturbance.

Interaction With Systemic Lupus Erythematosus: Thiazides have exacerbated or activated systemic lupus erythematosus and this possibility should be considered with Enzix Duo Forte (Indapamide) as well.

Drug Interactions

Other Antihypertensives: Enzix Duo Forte (Indapamide) may add to or potentiate the action of other antihypertensive drugs. In limited controlled trials that compared the effect of Enzix Duo Forte (Indapamide) combined with other antihypertensive drugs with the effect of the other drugs administered alone, there was no notable change in the nature or frequency of adverse reactions associated with the combined therapy.

Lithium: See WARNINGS.

Post-Sympathectomy Patient: The antihypertensive effect of the drug may be enhanced in the post-sympathectomized patient.

Norepinephrine: Enzix Duo Forte (Indapamide), like the thiazides, may decrease arterial responsiveness to norepinephrine, but this diminution is not sufficient to preclude effectiveness of the pressor agent for therapeutic use.

Carcinogenesis, Mutagenesis, Impairment Of Fertility

Both mouse and rat lifetime carcinogenicity studies were conducted. There was no significant difference in the incidence of tumors between the indapamide-treated animals and the control groups.

Pregnancy

Teratogenic Effects

Pregnancy category B. Reproduction studies have been performed in rats, mice and rabbits at doses up to 6,250 times the therapeutic human dose and have revealed no evidence of impaired fertility or harm to the fetus due to Enzix Duo Forte. Postnatal development in rats and mice was unaffected by pre-treatment of parent animals during gestation. There are, however, no adequate and well-controlled studies in pregnant women. Moreover, diuretics are known to cross the placental barrier and appear in cord blood. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. There may be hazards associated with this use such as fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in the adult.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because most drugs are excreted in human milk, if use of this drug is deemed essential, the patient should stop nursing.

Pediatric Use

Safety and effectiveness of Enzix Duo Forte in pediatric patients have not been established.

Geriatric Use

Clinical studies of Enzix Duo Forte (Indapamide) did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Severe cases of hyponatremia, accompanied by hypokalemia have been reported with recommended doses of Enzix Duo Forte (Indapamide) in elderly females (see WARNINGS).

ADVERSE REACTIONS

Most adverse effects have been mild and transient.

The Clinical Adverse Reactions listed in Table 1 represent data from Phase II/III placebo-controlled studies (306 patients given Enzix Duo Forte (Indapamide) 1.25 mg). The clinical adverse reactions listed in Table 2 represent data from Phase II placebo-controlled studies and long-term controlled clinical trials (426 patients given Enzix Duo Forte (Indapamide) 2.5 mg or 5 mg). The reactions are arranged into two groups: 1) a cumulative incidence equal to or greater than 5%; 2) a cumulative incidence less than 5%. Reactions are counted regardless of relation to drug.

All other clinical adverse reactions occurred at an incidence of < 1%.

Approximately 4% of patients given Enzix Duo Forte (Indapamide) 1.25 mg compared to 5% of the patients given placebo discontinued treatment in the trials of up to eight weeks because of adverse reactions.

In controlled clinical trials of six to eight weeks in duration, 20% of patients receiving Enzix Duo Forte (Indapamide) 1.25 mg, 61% of patients receiving Enzix Duo Forte (Indapamide) 5 mg, and 80% of patients receiving Enzix Duo Forte (Indapamide) 10 mg had at least one potassium value below 3.4 mEq/L. In the Enzix Duo Forte (Indapamide) 1.25 mg group, about 40% of those patients who reported hypokalemia as a laboratory adverse event returned to normal serum potassium values without intervention. Hypokalemia with concomitant clinical signs or symptoms occurred in 2% of patients receiving Enzix Duo Forte (Indapamide) 1.25 mg.

Because most of these data are from long-term studies (up to 40 weeks of treatment), it is probable that many of the adverse experiences reported are due to causes other than the drug. Approximately 10% of patients given Enzix Duo Forte (Indapamide) discontinued treatment in long-term trials because of reactions either related or unrelated to the drug.

Hypokalemia with concomitant clinical signs or symptoms occurred in 3% of patients receiving Enzix Duo Forte (Indapamide) 2.5 mg q.d. and 7% of patients receiving Enzix Duo Forte (Indapamide) 5 mg q.d. In long-term controlled clinical trials comparing the hypokalemic effects of daily doses of Enzix Duo Forte (Indapamide) and hydrochlorothiazide, however, 47% of patients receiving Enzix Duo Forte (Indapamide) 2.5 mg, 72% of patients receiving Enzix Duo Forte (Indapamide) 5 mg, and 44% of patients receiving hydrochlorothiazide 50 mg had at least one potassium value (out of a total of 11 taken during the study) below 3.5 mEq/L. In the Enzix Duo Forte (Indapamide) 2.5 mg group, over 50% of those patients returned to normal serum potassium values without intervention.

In clinical trials of six to eight weeks, the mean changes in selected values were as shown in the tables below.

No patients receiving Enzix Duo Forte (Indapamide) 1.25 mg experienced hyponatremia considered possibly clinically significant (<125 mEq/L).

Enzix Duo Forte (Indapamide) had no adverse effects on lipids.

The following reactions have been reported with clinical usage of Enzix Duo Forte (Indapamide): jaundice (intrahepatic cholestatic jaundice), hepatitis, pancreatitis, and abnormal liver function tests. These reactions were reversible with discontinuance of the drug.

Also reported are erythema multiforme, Stevens-Johnson Syndrome, bullous eruptions, purpura, photosensitivity, fever, pneumonitis, anaphylactic reactions, agranulocytosis, leukopenia, thrombocytopenia and aplastic anemia. Other adverse reactions reported with antihypertensive/diuretics are necrotizing angiitis, respiratory distress, sialadenitis, xanthopsia.

To report SUSPECTED ADVERSE EVENTS, contact Actavis at 1-800-432-8534 or FDA at 1-800-FDA-1088 or http://www.fda.gov/ for voluntary reporting of adverse reactions.

OVERDOSAGE

Symptoms of overdosage include nausea, vomiting, weakness, gastrointestinal disorders and disturbances of electrolyte balance. In severe instances, hypotension and depressed respiration may be observed. If this occurs, support of respiration and cardiac circulation should be instituted. There is no specific antidote. An evacuation of the stomach is recommended by emesis and gastric lavage after which the electrolyte and fluid balance should be evaluated carefully.

DOSAGE AND ADMINISTRATION

Hypertension: The adult starting Enzix Duo Forte (Indapamide) dose for hypertension is 1.25 mg as a single daily dose taken in the morning. If the response to 1.25 mg is not satisfactory after four weeks, the daily dose may be increased to 2.5 mg taken once daily. If the response to 2.5 mg is not satisfactory after four weeks, the daily dose may be increased to 5 mg taken once daily, but adding another antihypertensive should be considered.

Edema Of Congestive Heart Failure: The adult starting Enzix Duo Forte (Indapamide) dose for edema of congestive heart failure is 2.5 mg as a single daily dose taken in the morning. If the response to 2.5 mg is not satisfactory after one week, the daily dose may be increased to 5 mg taken once daily.

If the antihypertensive response to Enzix Duo Forte (Indapamide) is insufficient, Enzix Duo Forte (Indapamide) may be combined with other antihypertensive drugs, with careful monitoring of blood pressure. It is recommended that the usual dose of other agents be reduced by 50% during initial combination therapy. As the blood pressure response becomes evident, further dosage adjustments may be necessary.

In general, doses of 5 mg and larger have not appeared to provide additional effects on blood pressure or heart failure, but are associated with a greater degree of hypokalemia. There is minimal clinical trial experience in patients with doses greater than 5 mg once a day.

HOW SUPPLIED

Product: 63629-5216

NDC: 63629-5216-1 30 TABLET, FILM COATED in a BOTTLE

NDC: 63629-5216-2 90 TABLET, FILM COATED in a BOTTLE

Enzix Duo Forte 2.5mg Tablet