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Current File : /storage/v11800/affypharma/public_html/wp-content/plugins/formcraft3/templates/Contact (1).txt
{"plugin":"FormCraft","created":"2015-04-15 17:31:48","html":"<div class=\\\"fc-pagination-cover fc-pagination-1\\\">\\n\t\t\t\t\t<div class=\\\"fc-pagination\\\" style=\\\"width:330px\\\">\\n\t\t\t\t\t\t<div class=\\\"pagination-trigger \\\" data-index=\\\"0\\\">\\n\t\t\t\t\t\t\t<span class=\\\"page-number\\\"><span class=\\\"\\\">1<\/span><\/span>\\n\t\t\t\t\t\t\t<span class=\\\"page-name \\\">Step 1<\/span>\\n\t\t\t\t\t\t\t\\n\t\t\t\t\t\t<\/div>\\n\t\t\t\t\t<\/div>\\n\t\t\t\t<\/div>\\n\t\t\t\t\\n\t\t\t\t<style class=\\\"\\\">#ui-datepicker-div.fc-datepicker .ui-datepicker-header,.formcraft-css .fc-form .stripe-amount-show,.formcraft-css .fc-form.fc-form-19 .form-element .fileupload-cover .button-file,.formcraft-css .fc-form.fc-form-19 .form-element .slider-cover .ui-slider-range,.formcraft-css .fc-form.fc-form-19 .form-element .submit-cover .submit-button{background-color:#6199ed;color:#fff}#ui-datepicker-div.fc-datepicker .ui-datepicker-header,html .formcraft-css .fc-form .field-cover>div.full hr{border-color:#5586d0}#ui-datepicker-div.fc-datepicker .ui-datepicker-next:hover,#ui-datepicker-div.fc-datepicker .ui-datepicker-prev:hover,#ui-datepicker-div.fc-datepicker select.ui-datepicker-month:hover,#ui-datepicker-div.fc-datepicker select.ui-datepicker-year:hover{background-color:#5586d0}.formcraft-css .fc-pagination>div.active .page-number,.formcraft-css .form-cover-builder .fc-pagination>div:first-child .page-number{background-color:#48e;border-color:#3b77d1;color:#fff}#ui-datepicker-div.fc-datepicker table.ui-datepicker-calendar td.ui-datepicker-today a,#ui-datepicker-div.fc-datepicker table.ui-datepicker-calendar th,.formcraft-css .fc-form.fc-form-19 .form-element .customText-cover a,.formcraft-css .fc-form.fc-form-19 .form-element .star-cover label,.formcraft-css .prev-next>div span:hover,html .formcraft-css .fc-form.label-floating .form-element .field-cover.has-focus>span{color:#6199ed}.formcraft-css .fc-form.fc-form-19 .form-element .customText-cover a:hover{color:#5586d0}html .formcraft-css .fc-form.label-floating .form-element .field-cover>span{color:#999}html .formcraft-css .fc-form.label-floating .form-element .field-cover input[type=text],html .formcraft-css .fc-form.label-floating .form-element .field-cover input[type=password],html .formcraft-css .fc-form.label-floating .form-element .field-cover input[type=tel],html .formcraft-css .fc-form.label-floating .form-element .field-cover select,html .formcraft-css .fc-form.label-floating .form-element .field-cover textarea{border-bottom-color:#999}.formcraft-css .fc-form.fc-form-19 .form-element .star-cover label .star{text-shadow:0 1px 0 #5586d0}.formcraft-css .fc-form.fc-form-19 .form-element .slider-cover .ui-slider-range{box-shadow:0 1px 1px #5586d0 inset}.formcraft-css .fc-form.fc-form-19 .form-element .fileupload-cover .button-file,.formcraft-css .fc-form.fc-form-19 .form-element .stripe-amount-show,.formcraft-css .fc-form.fc-form-19 .form-element .submit-cover .submit-button{border-color:#5586d0}.formcraft-css .fc-form .stripe-cover.field-cover div.stripe-amount-show::before{border-top-color:#5586d0}.formcraft-css .fc-form .stripe-cover.field-cover div.stripe-amount-show::after{border-right-color:#6199ed}.formcraft-css .fc-form.fc-form-19 .form-element .stripe-amount-show,.formcraft-css .fc-form.fc-form-19 .form-element .submit-cover .submit-button .text{text-shadow:2px 0 4px #5586d0}.formcraft-css .fc-form.fc-form-19 input[type=checkbox]:checked,.formcraft-css .fc-form.fc-form-19 input[type=radio]:checked{border-color:#48e;background-color:#48e}.formcraft-css .fc-form.fc-form-19 input[type=checkbox]:focus,.formcraft-css .fc-form.fc-form-19 input[type=checkbox]:hover,.formcraft-css .fc-form.fc-form-19 input[type=radio]:focus,.formcraft-css .fc-form.fc-form-19 input[type=radio]:hover,.formcraft-css .fc-form.fc-form-19 label:hover>input[type=checkbox],.formcraft-css .fc-form.fc-form-19 label:hover>input[type=radio]{border-color:#48e}.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=text]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=month]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=number]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=search]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=time]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=url]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=week]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=password]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=tel]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=color]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=date]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=datetime]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=datetime-local]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html input[type=email]:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html select:focus,.formcraft-css .fc-form.fc-form-19 .form-element .form-element-html textarea:focus{border-color:#6199ed}.formcraft-css .fc-form.fc-form-19{font-family:Merriweather}<\/style><div class=\\\"form-cover\\\">\\n\t\t\t\t\t<form data-separator=\\\"\\\" data-delay=\\\"\\\" ondragover=\\\"allowDrop(event)\\\" data-id=\\\"19\\\" class=\\\"fc-form fc-form-19 align- spin- save-form- dont-submit-hidden- label-floating frame-visible remove-asterisk-true field-alignment-left  \\\" style=\\\"width:330px;color:#999;font-size:120%;background:#fff\\\">\\n\t\t\t\t\t\t<div class=\\\"form-page form-page-0\\\" index=\\\"0\\\">\\n\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t<div class=\\\"form-page-content\\\">\\n\t\t\t\t\t\t\t\t<div data-identifier=\\\"field4\\\" index=\\\"0\\\" style=\\\"width:100%\\\" class=\\\" odd form-element form-element-field4 form-element-0 default-false form-element-type-customText is-required-false options-false index-false\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"absolute-true customText-cover field-cover\\\" style=\\\"left:;top:-.3em;right:0;bottom:;color:#666;background-color:\\\"><div class=\\\"full\\\" style=\\\"text-align:left\\\"><p class=\\\"\\\"><img src=\\\"http:\/\/localhost\/wordpress\/wp-content\/plugins\/formcraft3\/assets\/images\/email-stamp.png\\\" height=\\\"100\\\" width=\\\"100\\\"><\/p><\/div><input type=\\\"hidden\\\" name=\\\"field4\\\" value=\\\"\\\" data-field-id=\\\"field4\\\"><\/div><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div><div data-identifier=\\\"field5\\\" index=\\\"1\\\" style=\\\"width:100%\\\" class=\\\" form-element form-element-field5 default-false form-element-type-customText is-required-false even form-element-1 options-false index-false\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"absolute- customText-cover field-cover\\\" style=\\\"left:;top:;right:;bottom:;color:#888;background-color:\\\"><div class=\\\"full\\\" style=\\\"text-align:left\\\"><h1 class=\\\"\\\">Contact Us<\/h1><\/div><input type=\\\"hidden\\\" name=\\\"field5\\\" value=\\\"\\\" data-field-id=\\\"field5\\\"><\/div><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div><div data-identifier=\\\"field1\\\" index=\\\"2\\\" style=\\\"width:100%\\\" class=\\\" form-element form-element-field1 options-false index-false default-false form-element-type-oneLineText is-required-true odd form-element-2\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"oneLineText-cover field-cover \\\"><span class=\\\"sub-label-true\\\"><span><span class=\\\"\\\">Name<\/span><\/span><span class=\\\"sub-label\\\"><span class=\\\"\\\">your full name<\/span><\/span><\/span><div><span class=\\\"error\\\"><\/span><input type=\\\"text\\\" placeholder=\\\"\\\" data-field-id=\\\"field1\\\" name=\\\"field1[]\\\" data-min-char=\\\"\\\" data-max-char=\\\"\\\" data-val-type=\\\"\\\" data-is-required=\\\"true\\\" data-allow-spaces=\\\"false\\\" class=\\\"validation-lenient\\\" data-placement=\\\"right\\\" data-toggle=\\\"tooltip\\\" tooltip=\\\"\\\" title=\\\"\\\" data-trigger=\\\"focus\\\" data-html=\\\"true\\\" data-original-title=\\\"\\\"><\/div><\/div><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div><div data-identifier=\\\"field2\\\" index=\\\"3\\\" style=\\\"width:100%\\\" class=\\\" form-element form-element-field2 options-false index-false default-false form-element-type-email is-required-true even form-element-3\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"email-cover field-cover \\\"><span class=\\\"sub-label-true\\\"><span><span class=\\\"\\\">Email<\/span><\/span><span class=\\\"sub-label\\\"><span class=\\\"\\\">a valid email<\/span><\/span><\/span><div><span class=\\\"error\\\"><\/span><input placeholder=\\\"\\\" data-field-id=\\\"field2\\\" type=\\\"text\\\" data-val-type=\\\"email\\\" data-is-required=\\\"true\\\" name=\\\"field2\\\" class=\\\"validation-lenient\\\" data-placement=\\\"right\\\" data-toggle=\\\"tooltip\\\" tooltip=\\\"\\\" title=\\\"\\\" data-trigger=\\\"focus\\\" data-html=\\\"true\\\" data-original-title=\\\"\\\"><\/div><\/div><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div><div data-identifier=\\\"field8\\\" index=\\\"4\\\" style=\\\"width:100%\\\" class=\\\" form-element form-element-field8 options-false index-false default-false form-element-type-dropdown is-required-true odd form-element-4\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"dropdown-cover field-cover \\\"><span class=\\\"sub-label-true\\\"><span><span class=\\\"\\\">Issue Type<\/span><\/span><span class=\\\"sub-label\\\"><span class=\\\"\\\">pick one!<\/span><\/span><\/span><div><span class=\\\"error\\\"><\/span><select data-is-required=\\\"true\\\" class=\\\"validation-lenient\\\" data-field-id=\\\"field8\\\" name=\\\"field8\\\" data-placement=\\\"right\\\" data-toggle=\\\"tooltip\\\" tooltip=\\\"\\\" title=\\\"\\\" data-trigger=\\\"hover\\\" data-html=\\\"true\\\" data-original-title=\\\"\\\"><!-- ngRepeat: opt in element.elementDefaults.options_list_show --><option value=\\\"\\\" class=\\\" \\\"><\/option><!-- end ngRepeat: opt in element.elementDefaults.options_list_show --><option value=\\\"Support\\\" class=\\\" \\\">Support<\/option><!-- end ngRepeat: opt in element.elementDefaults.options_list_show --><option value=\\\"Feedback\\\" class=\\\" \\\">Feedback<\/option><!-- end ngRepeat: opt in element.elementDefaults.options_list_show --><option value=\\\"Other\\\" class=\\\" \\\">Other<\/option><!-- end ngRepeat: opt in element.elementDefaults.options_list_show --><\/select><\/div><\/div><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div><div data-identifier=\\\"field6\\\" index=\\\"5\\\" style=\\\"width:100%\\\" class=\\\" form-element form-element-field6 options-false index-false default-false form-element-type-textarea is-required-true even form-element-5\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"textarea-cover field-cover \\\"><span class=\\\"sub-label-true\\\"><span><span class=\\\"\\\">Comments<\/span><\/span><span class=\\\"sub-label\\\"><span class=\\\"\\\">more details<\/span><\/span><\/span><div><span class=\\\"error\\\"><\/span><textarea data-field-id=\\\"field6\\\" placeholder=\\\"\\\" class=\\\"validation-lenient\\\" name=\\\"field6\\\" value=\\\"\\\" rows=\\\"1\\\" data-min-char=\\\"\\\" data-max-char=\\\"100\\\" data-is-required=\\\"true\\\" data-placement=\\\"right\\\" data-toggle=\\\"tooltip\\\" tooltip=\\\"\\\" title=\\\"\\\" data-trigger=\\\"focus\\\" data-html=\\\"true\\\" data-original-title=\\\"\\\" style=\\\"min-height:36px\\\"><\/textarea><div class=\\\"count-true\\\"><span class=\\\"current-count\\\">0<\/span> \/ <span class=\\\"max-count \\\">100<\/span><\/div><\/div><\/div><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div><div data-identifier=\\\"field3\\\" index=\\\"6\\\" style=\\\"width:100%\\\" class=\\\" form-element form-element-field3 options-false index-false default-false form-element-type-submit is-required-false odd form-element-6\\\">\\n\t\t\t\t\t\t\t\t\t<div class=\\\"form-element-html\\\"><div class=\\\"\\\"><div class=\\\"wide-false submit-cover field-cover\\\" style=\\\"text-align:right\\\"><button type=\\\"submit\\\" class=\\\"button submit-button\\\"><span class=\\\"text \\\">Submit Form<\/span><span class=\\\"spin-cover\\\"><i style=\\\"color:\\\" class=\\\"icon-spin5 animate-spin\\\"><\/i><\/span><\/button><\/div><div class=\\\"submit-response \\\"><\/div><input type=\\\"text\\\" class=\\\"required_field \\\" name=\\\"website\\\"><\/div><\/div>\\n\t\t\t\t\t\t\t\t\t\\n\t\t\t\t\t\t\t\t<\/div>\\n\t\t\t\t\t\t\t<\/div>\\n\t\t\t\t\t\t<\/div>\\n\t\t\t\t\t<\/form>\\n\t\t\t\t\t<div class=\\\"prev-next prev-next-1\\\" style=\\\"width:330px;color:#999;font-size:120%;background:#fff\\\">\\n\t\t\t\t\t\t<div><input type=\\\"text\\\" class=\\\"ng-pristine  \\\"><span class=\\\"inactive page-prev \\\"><i class=\\\"icon-angle-left\\\"><\/i><\/span><\/div>\\n\t\t\t\t\t\t<div><input type=\\\"text\\\" class=\\\"ng-pristine  \\\"><span class=\\\"page-next \\\"><i class=\\\"icon-angle-right\\\"><\/i><\/span><\/div>\\n\t\t\t\t\t<\/div>\\n\t\t\t\t<\/div>","addons":"{}","builder":"rawdeflate,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","meta_builder":"{\"fields\":[{\"identifier\":\"field4\",\"type\":\"customText\",\"elementDefaults\":{\"field_width\":\"100%\",\"identifier\":\"field4\",\"hidden_default\":false,\"required\":false,\"html\":\"<p><img src=\\\"http:\\\/\\\/localhost\\\/wordpress\\\/wp-content\\\/plugins\\\/formcraft3\\\/assets\\\/images\\\/email-stamp.png\\\" height=\\\"100\\\" width=\\\"100\\\"\\\/><\\\/p>\",\"main_label\":\"Text Field\",\"font_color\":\"#666666\",\"alignment\":\"left\",\"floating_type\":\"true\",\"leftPosition\":\"\",\"topPosition\":\"-.3em\",\"main_label_placeholder\":\"\",\"bottomPosition\":\"\",\"rightPosition\":\"0\",\"background_color\":\"\"},\"page\":1,\"is_payment\":false},{\"identifier\":\"field5\",\"type\":\"customText\",\"elementDefaults\":{\"field_width\":\"100%\",\"identifier\":\"field5\",\"hidden_default\":false,\"required\":false,\"html\":\"<h1>Contact Us<\\\/h1>\",\"main_label\":\"Text 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email\",\"has_sub_label\":true,\"main_label_placeholder\":\"\",\"autoresponder\":false},\"page\":1,\"is_payment\":false},{\"identifier\":\"field8\",\"type\":\"dropdown\",\"elementDefaults\":{\"field_width\":\"100%\",\"identifier\":\"field8\",\"hidden_default\":false,\"required\":true,\"main_label\":\"Issue Type\",\"sub_label\":\"pick one!\",\"options_list\":\"==\\nSupport\\nFeedback\\nOther\",\"has_sub_label\":true,\"main_label_placeholder\":\"\",\"options_list_show\":[{\"value\":\"\",\"show\":\"\"},{\"value\":\"Support\",\"show\":\"Support\"},{\"value\":\"Feedback\",\"show\":\"Feedback\"},{\"value\":\"Other\",\"show\":\"Other\"}]},\"page\":1,\"is_payment\":false},{\"identifier\":\"field6\",\"type\":\"textarea\",\"elementDefaults\":{\"field_width\":\"100%\",\"identifier\":\"field6\",\"hidden_default\":false,\"required\":true,\"main_label\":\"Comments\",\"sub_label\":\"more details\",\"field_height\":\"1\",\"main_label_placeholder\":\"\",\"has_sub_label\":true,\"show_count\":true,\"Validation\":{\"minChar\":\"\",\"maxChar\":\"100\"}},\"page\":1,\"is_payment\":false},{\"identifier\":\"field3\",\"type\":\"submit\",\"elementDefaults\":{\"field_width\":\"100%\",\"identifier\":\"field3\",\"hidden_default\":false,\"required\":false,\"main_label\":\"Submit Form\",\"isWide\":false,\"alignment\":\"right\",\"main_label_placeholder\":\"\"},\"page\":1,\"is_payment\":false}],\"config\":{\"Logic\":[],\"messages\":[],\"autoresponder\":{\"email_body\":\"<p>Hello [Name],<\\\/p><p><br><\\\/p><p>We have received your submission. Here are the details you have submitted to us:<\\\/p><p>[Form Content]<\\\/p><p><br><\\\/p><p>Regards,<\\\/p><p>Nishant<\\\/p>\",\"email_subject\":\"Thank you for your submission\"},\"notifications\":{\"_method\":\"php\",\"email_body\":\"<p>Hello,<\\\/p><p><br><\\\/p><p>You have received a new form submission for the form [Form Name]. 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ESTRELLA Pharma – Affy Pharma Pvt Ltd

TREPODOX

POWDER FOR ORAL SUSPENSION
30ML (HDPE BOTTLE)

Composition

Cefpodoxime 50mg/5ml

Indications & Uses

UTIs, LRTs

TREPODOX – CV

POWDER FOR ORAL SUSPENSION
30ML (GLASS BOTTLE)

Composition

Cefpodoxime 50mg + Potassium Clavulanate 31.25mg/ 5ml

Indications & Uses

Upper & lower respiratory infections, Uncomplicated skin infections, Urinary Tract Infections

ESTY CLAV

POWDER FOR ORAL SUSPENSION
30ML (GLASS +HDPE BOTTLE)

Composition

Amoxycillin 200mg + Potassium clavulanate 28.50 mg/ 5ml

Indications & Uses

Community Acquired Pneumonia, Acute Exacerbations of Chronic Bronchitis, Upper Respiratory Tract Infections, Urinary Tract Infections

ESTRIXIME – CV

POWDER FOR ORAL SUSPENSION
30ML (GLASS BOTTLE)

Composition

Cefixime 50mg + Potassium clavulanate 31.25mg/5ml

Indications & Uses

Urinary Tract Inefctions, AECB, Otitis Media, Typhoid/p>

ESTRIXIME

POWDER FOR ORAL SUSPENSION
30ML (HDPE BOTTLE)

Composition

Cefixime 50mg/5ml

Indications & Uses

Urinary Tract Inefctions, Gastroenteritis

REOMELL

ORAL SUSPENSION
15 ml

Composition

Azithromycin 200mg/5ml

Indications & Uses

Community Acquired Pneumonia, Acute Exacerbations of Chronic Bronchitis,

TAMEST – DS

ORAL SUSPENSION
60 ml

Composition

Paracetamol 250mg/5ml

Indications & Uses

Fever, Pain

STREFEN

ORAL SUSPENSION
60 ml

Composition

Paracetamol 125mg + Mefenamic Acid 50mg/5ml

Indications & Uses

Pain, Fever

STREFOX

ORAL SUSPENSION
30 ml

Composition

Ofloxacin 50mg/5ml

Indications & Uses

Acute exacerbations of chronic Bronchitis, Diarrhoea

TAMACET-P

SYRUP
60 ml

Composition

Paracetamol 125mg + PPH 5mg + Cetirizine HCI 2mg/5ml

Indications & Uses

Fever, common cold & Flu

HEPTRELL

ORAL SUSPENSION
200ml

Composition

Cyproheptadine HCI 2mg + Tricholine citrate 0.275mg/5ml

Indications & Uses

Stimulate Apetite, Induces Weight Gain, Cure Allergies

TREP-DSR

CAPSULES ( HARD GELATIN)
10X10 (Alu-Alu)

Composition

Pantoprazole 40mg (EC) + Domperidone 30mg (SR)

Indications & Uses

GERD, Dyspepsia, Acid Peptic Disorders, Gastritis

RALE-DSR

CAPSULES ( HARD GELATIN)
11X10 (Alu-Alu)

Composition

Rabeprazole 20mg (EC) + Domperidone SR

Indications & Uses

GERD, Dyspepsia, Acid Peptic Disorders, Gastritis

STRETOP-40

INJECTION
40ml

Composition

Pantoprazole Sodium 40mg + NaCL

Indications & Uses

Acid-peptic disorders in hospitalized patients, Zollinger – Ellison Syndrome, Treatment of GERD Associated with Erasive Esophagitis, GL Bleed

DIMACID

SUSPENSION
170ml

Composition

Activated Dimethicone 25mg + Magnesium Hydroxide 200mg+ Aluminium Hydroxide Gel 200mg/10ml

Indications & Uses

Heartburn, Acid Indigestion

ELLAZYME

SYRUP
200ml

Composition

Alpha Amylase (1:2000) 50mg, Pepsin(1:3000) 10mg/5ml

Indications & Uses

Dyspepsia, Flatulence, Anorexia, Pancreatic Insufficiency

ARBOLL-Z

CAPSULES (HARD GELATIN)
10X3X10

Composition

Vitamin C 75mg + Vitamin B12 5mcg + Carbonyl Iron 100mg + Folic Acid 1.5mg + Zinc Sulphate 61.8mg

Indications & Uses

Hyphocromic Anemia in Pregnancy, Chronic and / or Acute Blood Loss, Post-gynaesurgery, Iron Deficiency Anemia

EST-D3 60K

CAPSULES (SOFT GELATIN)
10X1X4

Composition

Cholecalciferol 60000 UI

Indications & Uses

Osteoporosis, Osteoarthritis, Musculoskeletal Pain, Type- 2 Diabetes, Menstrual Irregularities, Pre-eclampsia, IUGR

STREBONA

ORAL SUSPENSION
200ml

Composition

Calcium Carbonate 625mg, Vitamin D3 125 IU/5ml

Indications & Uses

Osteomalacia, Osteoporosis, Fractures, Premenstrual Syndrome

STREFE-III

SYRUP (IRON TONIC)
300 ml

Composition

Iron (III) Hydroxide Polymaltose 50mg, Folic Acid 0.5mg/15ml

Indications & Uses

Pregnancy and lactation, Iron Deficiency Anaemia, Anaemia due to Excessive Haemorrhage, Anaemia Associated with Infections and Malignant Disease

STRECIUM

CAPSULES (SOFT GELATIN)
5X2X15

Composition

Calcitriol 0.25mcg + Calcium Carbonate 500mg + Zinc Sulphate 7.5mg

Indications & Uses

Osteoporosis, Hypoparathyroidism, Pregnancy & Lactation, Premenstrual Syndrome

ESTRE-SPAS

TABLETS
20X10

Composition

Mefenamic Acid 250mg + Dicyclomine HCI 10mg

Indications & Uses

Dysmenorrhea, Irritable Bowel Syndrome, Colic and Bladder Spasm, Abdominal Pain

TAMEST-A

TABLETS (BLISTERS)
20X10

Composition

Nimeulide 100mg + Paracetamo; 325mg

Indications & Uses

Arthritis Pain, Soft Tissue Trauma Including Sprains, Musculoskeletal Pain, Pain Following Dental Extraction

PARTRA FORTE

TABLETS

20X10

Composition

Tramadol 37.5mg + Paracetamol 325mg

Indications & Uses

Chronic Back Pain, Osteoarthritis, Postoperative Pain

UMRELY GEL

GEL
30g

Composition

Diclofenac Diethylamine 1.16% w/w + Oleum Linseed Oil 3 % w/w + Menthol 5% w/w +Methyl Salicylate 10% w/w

Indications & Uses

Sprains & Strains, Lower Back Pain, Joint Pain, Knee Pain

MOISTACT

CREAM
20g

Composition

Urea 10% +Lactic Acid 10% + Propylene Glycol 10% + Liquid Paraffin 10%

Indications & Uses

Foot Cracks, Keratolytic

BELODIP

OINTMENT
15g

Composition

Clotrimazole 1% w/w + Beclomethasone Dipropionate 0.025% w/w + Neomycin 0.5% w/w

Indications & Uses

Eczema, Psoriasis, Corticosteroid Responsive Dermatoses

MIN-DAND

LOTION
100 ml

Composition

Ketoconazole 2% w/v

Indications & Uses

Pityriasis, Dandruff

MIN-DAND-Z

LOTION
100 ml

Composition

Ketoconazole Shampoo 2% w/v + ZPTO 1% w/v

Indications & Uses

Pityriasis, Dandruff

MIN-DAND

SOAP
75g

Composition

Ketoconazole 1% w/w

Indications & Uses

Tinea Versicolor, Prophylaxis of Pityriasis Versicolor

FLUTRELLA

TABLETS
20X1X1

Composition

Fluconazole 200mg

Indications & Uses

Vaginal Candidiasis, Brochopulmonary Infections, Candiduria, Tinea Pedis, Corposis, Cruris, Versicolor

ESTRAVIT

SYRUP
200ml

Composition

L-Iysine HCI 25mg + Vitamin B1 2.5mg + Vitamin B2 2.5mg + Vitamin B6 0.75mg + D-panthenol 3mg +Niacinamide 25mg + Mecobalamin 2mcg/10ml

Indications & Uses

Sub-optimal Growth, Poor Weight Gain, Malnutrition, Prolonged Illness

LYCOSTER PLUS

SYRUP
225ml

Composition

Each 10ml Contains: Lycopene 6% 1000mcg + Vitamin A Palmitate 2500 IU + Vitamin E 10 IU + Ascorbic Acid 50mg + Selenium (as Sodium Selenate) 35mcg + Zinc (As Zinc Gluconate) 3mg + Manganese (as Manganese Gluconate) 2mg + Iodine ( As Potassium Iodine) 100mcg + Copper (As Copper Sulphate0 500mcg + Thiamine HCI 2mg + Riboflavine 3mg + Pyridoxine HCI 1.5mg

Indications & Uses

Tiredness, Stress, Feeling of Weakness, Vitality Deficiency

OSERON

CAPSULES (SOFT GELATIN)
10X1X10

Composition

Antioxidant, Multivitamin & Multiminerals

Indications & Uses

Tiredness, Stress, Feeling of Weakness, Vitality Deficiency

GERMELLA

CAPSULES (SOFT GELATIN)
10X1X10

Composition

Vitamin E (Natural) 400 IU + Wheat Germ Oil 100mg + Omega 3 Fatty Acids 30mg

Indications & Uses

Ulcerative colitis, Metabolic Syndrome, Rheumatoid Arthritis, Type-2 Diabetes, Cardiovascular Diseases

LYCOSTER GOLD

CAPSULES (SOFT GELATIN)
10X1X10

Composition

Each SG Contains Lycopene 6% 2000 IU + Vitamin A 2500 IU + Vitamin E Acetate 10 IU + Vitamin C 50 mg + Zinc sulphate Monohydrate 27.45mg + Selenium Dioxide 70mcg

Indications & Uses

Idiopathic Male Infertility, Pre-eclampsia, Prostate Cancer, Cardiovascular Diseases, Diabetes Mellitus

OSERON -G

CAPSULES (SOFT GELATIN)
10X1X11

Composition

Ginseng + Multivitamin + Multimineral

Indications & Uses

Tiredness, Stress, Feeling of Weakness, Vitality Deficiency

OSERON -G

CAPSULES (SOFT GELATIN)
10X1X11

Composition

Ginseng + Multivitamin + Multimineral

Indications & Uses

Tiredness, Stress, Feeling of Weakness, Vitality Deficiency

ESTRIXIME-200 LB

TABLETS (Alu-Alu)
20X10

Composition

Cefixime 200mg + Lactic Acid Bacilus 2.5 billion spores

Indications & Uses

Otitis Media, Pharyngitis & Tonsillitis, Uncomplicated Urinary Tract Infections, Acute Exacerbations of Chronic Bronchitis, Enteric Fever

ESTRIXIME-CV-325

TABLETS (Alu-Alu)
10X1X6

Composition

Cefixime 200mg + Potassium Clavulanate 125mg

Indications & Uses

Respiratory Tract Infections, Urinary Tract Infections, Skin & Skin Structure Infections

ESTY CLAV-625 LB

TABLETS (Alu-Alu)
10X1X6

Composition

Amoxycillin 500mg + Potassium Clavulanate 125mg

Indications & Uses

Respiratory Tract Infections, Community Acquired Pneumonia, Gynaecological Infections, Acute Exacerbations of Chronic Bronchitis, Skin and Soft Tissue Infections

FLOXEST

TABLETS (Blister)
20X10

Composition

Ofloxacin 200mg + Ornidazole 500mg

Indications & Uses

Surgical ions, Diarrheas of Mixed Etiology, Gynaecological Infections, Orofacial and Dental Infections

VOFLOX-500

TABLETS
10X10

Composition

Levofloxacin 500mg

Indications & Uses

Acute Bacterial Sinusitis, Acute Bacterial Exacerbations of Chronic Bronchitis, Skin & Skin Structure Infections, Chronic Bacterial Prostatitis, Urinary Tract Infections

FLOXEST – O

TABLETS (Alu-Alu)
20X10

Composition

Cefixime 200mg + Ofloxacin 200mg

Indications & Uses

Community Acquired Pneumonia, Multiple Drug Resistant-TB, Typhoid

FLOXEST

TABLETS (Alu-Alu)
20X10

Composition

Ofloxacin 200mg

Indications & Uses

Community Acquired Pneumonia, Multiple Drug Resistant-TB, Typhoid

ESTY CLAV- 1.2

INJECTIONS
1.2g

Composition

Amoxycillin 1000mg + Potassium Clavulanate 200mg + WFI

Indications & Uses

Community Acquired Pneumonia, Gynaecological Infections, Upper Respiratory Tract Infections, Skin and Soft Tissue Infections, Urinary Tract Infections, Acute Exacerbations of Chronic Bronchitis

TRELLON-SB 1.5

INJECTIONS
1.5g

Composition

Ceftriaxone 1000mg + Sulbactam 500mg + WFI

Indications & Uses

Gynaecological Infections, Lower Respiratory Tract Infections, Intra-abdominal Infections with Aerobic Organisms, Surgical Prophylaxis

TRELLON-TZ 1.125

INJECTIONS
1.125gm

Composition

Ceftriaxone 1000mg + Tazobactam 500 mg + WFI

Indications & Uses

Bone & Joint Infections, Intra-abdominal Infections, Bacterial Meningitis, Pre-operative Surgical Prophylaxis

RELLAM

INJECTIONS
1gm

Composition

Meropenem 1gm + WFI

Indications & Uses

Complicated Intra-abdominal Infection (cIAI), Complicated Skin & Skin Structure Infections (cSSSI), Bacterial Meningitis, Noscocomial Pneumonia

TRELIN-Z 4.5

INJECTIONS
4.5gm

Composition

Piperacillin 4000mg + Tazobactam 500mg + WFI

Indications & Uses

Intra-abdominal Infections, Complicated Urinary Tract Infections, Febrile Neutropenia, Lower Respiratory Tract Infections

TRELIN-Z 4.5

INJECTIONS
4.5gm

Composition

Piperacillin 4000mg + Tazobactam 500mg + WFI

Indications & Uses

Intra-abdominal Infections, Complicated Urinary Tract Infections, Febrile Neutropenia, Lower Respiratory Tract Infections

BUTRELLA

SYRUP

100ml

Composition

Ambroxol HCI 15mg + Guaiphensin 50mg + Terbutaline Sulphate 1.5mg + Mentholated Base/5ml

Indications & Uses

Bronchitis, Productive Cough, Emphysema, Bronchial Asthma

BUTRELLA-BR

SYRUP

100ml

Composition

Terbutaline Sulphate 1.25mg + Bromhexine HCI 4mg + Guaiphenesin 50mg + Methalated Base/5ml

Indications & Uses

Acute Cough, Abnormal Mucus Secretion, Productive Cough

DEXTRIN

SYRUP
100ml

Composition

Dextromethorphan Hydrobromide 10mg + Phenylpherine 5 mg + Cetrizine 5mg + Mentholated Base/5ml

Indications & Uses

Commom Cold and Flu, Nasal Congestion, Sore Throat

VOTRELL-M

TABLETS (Alu-Alu)
20X10

Composition

Levocetirizine 5mg + Montelukast 10mg

Indications & Uses

Allergic Rhinitis, Nasal Congestion, Asthma

VOTRELL

TABLETS (Alu-Alu)
20X11

Composition

Levocetirizine 5mg

Indications & Uses

Chronic Idiopathic Urticaria (CIU), Seasonal Allergic Rhinitis (SAR), Perennial Allergic Rhinitis (PAR)

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