Why Tinnex Caroverine Injection, Caroverine 20 mg Capsules are effective Tinnitus Treatment?

1. TINNITUS Tinnex Caroverine 160 mg/8ml Injection Caroverine 20 mg Capsules B r o u g h t t o y o u i n p u b l i c i n t e r e s t b y M a k e r s o f : Tinnex F o r m o r e d e t a i l s , p l e a s e w r i t e t o : " L i n c o l n H o u s e " , S c i e n c e C i t y R o a d , S o l a , A h m e d a b a d - 3 8 0 0 6 0 . G u j a r a t , I n d i a P h o n e : + 9 1 - 7 9 - 6 7 7 7 8 0 0 0 | F a x : + 9 1 - 7 9 - 6 7 7 7 8 0 6 2 E - m a i l : p r o d u c t @ l i n c o l n p h a r m a . c o m | W e b s i t e : w w w . l i n c o l n p h a r m a . c o m KNOW YOUR TINNITUS KNOW YOUR TINNITUS IS TINNITUS A CURABLE DISEASE ? IS TINNITUS A CURABLE DISEASE ? Now you don’t have to live with it... Now you don’t have to live with it... Caroverine and other therapies available for Tinnitus “Treatment of Tinnitus with the use of one or more types of the following therapy, along with the suggested guidance, helps to Functionally ear is divided into three parts treat more than 90% patients of Tinnitus.” 1.External ear 2. Middle Ear and 3. Inner ear Recently in article published for various psychopharmacological External ear collects the sound and directs it to Middle ear. agents to treat tinnitus. Caroverine (tinnex) clearly emerged as “potentially effective for Middle ear amplifies the sound. tinnitus” among TCA’s,SSRI’s,Mood Stabilizers,sedative- Inner ear converts sound signals in to the electrical signals. hypnotics/BZDs Normally, the inner ear generates an electric impulse, only, in Ref- H. Belli et al. / General Hospital Psychiatry 34 (2012) 282–289 response to the incoming sound signals. But if inner ear cells What is Tinnitus? What is Tinnitus? are damaged, it does not generate required electric signals in Tinnitus, referred as, ringing or noise in the ear, is purely, a response to sound signals. So such patients don't hear subjective experience. In fact, there is no existence of any such properly. Simultaneously some time damaged inner ear hair sound in the environment. 60% of the inner ear diseases cause cells may reach to the state of 'spontaneous depolarization'. Tinnitus. Symptoms may include buzzing, roaring, ringing, Meaning by, it goes on generating electrical signals, whistling, or hissing sounds perceived in the ear. These sounds continuously without any incoming signals. This is the reason may be intermittent, continuous, or pulsatile. Tinnitus may such patients hear such sounds continuously in the ear / head interfere with normal activities and sleep, and there may be an even though there is no existence of such sound in the associated decrease in the ability to hear conversations or other environment. sounds in the environment. To understand your symptom of Tinnitus it is necessary to understand the mechanism of hearing. How Ear In rare cases, such state may also appear due to damage in the works? neural connections between inner ear and the auditory 1 2

2. 2. Speech Discrimination centers of the brain. Could you hear the noise, What is the cause of such inner ear damage? when you are in middle of work. Inner ear is structurally very close to middle ear. So, Blast / Ear injury(Trauma) commonest cause is diseases of the middle ear, which extend Hyperlipidemia (disturbed Metabolism) to the inner ear. Usually, an ENT surgeon can easily diagnose Thyroid this. In such patients there may be a history of ear pain, ear Excessive exposure to noise pollution (Near by Airport, discharge, recurrent nasal or throat infections and/or Railway Station, mills & factory exposure to noise) deafness. *If 2 yes, then you are likely to suffer Tinnitus and If In majority of the cases of Tinnitus it is found that, ear drum not then seek other medical attention. (Tympanic membrane) and middle ear are structurally normal. These are the situations where possibilities of damage to inner ear are direct. It could be due to local cause or 3. Otoscopy – could be due to one or more generalized diseases or metabolic If ear and drums are free. disorders. Patient History How long the patient is 4. Dizziness/Vertigo – suffering from, Whether it is Are you suffering with any kind of long term/short term. dizziness time to time or you have some sign of vertigo or 'sinking'/ ‘Dizzy –feeling'. 1. By clenching your teeth If yes, then it is easy to decide does the frequency change? for doctor to possible treatment. If yes, then it is for dentist to treat. 3 4 Desai(Mumbai),Total number of Patients 100 (73 patients 5. Objective Audiogram – standard continued till the end of study). As per Study of Caroverine test for speech discrimination If Capsule 75-80 % Success rate in reducing severity intensity & ears are free and if discrimination duration of tinnitus with enhanced hearing is little louder, then it is clear that tinnitus is generated in the inner Caroverine Capsules has to be taken orally with the dose of 2 ear and that indicates it as capsules BID(At a time) for at least 3 to 6 month. 'Cochlear Synaptic Tinnitus' & Ever since the launch of oral formulation of Tinnex Capsule Tinnex Inj. (Caroverine (2012) more than 4000 patients got benefitted from hydrochloride, Slow I.V. is to be caroverine drug. given@2 ml/m). What to avoid with after oral caroverine therapy If there is successful result ( B) Prevention of Tinnitus:- 6. Only Exception Only one 1. Train yourself to ignore Ear ringing. sided hearing loss with 2. Avoid exposure to loud sounds. Tinnitus - vertigo, a CT scan is 3. Excessive use of headphone is harmful. necessary to find out 4. Avoid cold drinks, Ice cream. Acoustic Neuroma. 5. Avoid tobacco in any form. 6. Avoid coffee and chocolates and any cocoa products. As your damage is diagnosed in the cochlea, CAROVERINE is 7. Avoid certain ototoxic drugs and drugs like aspirin and the preferred drug for you. Bruffen. Recent Study “Newer Emerging Trends in Tinnitus 8. Early treatment of middle ear disease avoids the Management” conducted by Dr Ashim 5 6

3. possibility of damage to the inner ear. perfect programming of hearing aid are vital for this. 9. Avoid Chinese food Totally (glutamate content). 2. For those with normal hearingyour ENT surgeon may 10. Heavily sweetened breakfast cereals. prescribe an alternate medication. Certain combinations are proved to give better results. 11. Avoid Fermented Food. What foods to be taken during tinnitus: 3. An alternative option is Tinnitus retraining therapy (TRT). Your audiologist may explain you better about this. In fact, 1. Eat vegetables which contains folate. it is a therapy by which your brain's attention is diverted 2. Diet which contain rich Vitamin B complex. from Tinnitus, by a specific and established method. 3. Increase diets rich in omega-3 fats. 4. Certain foods helps in reduction of Ear ringing - Like 4. Magnesium Supplements. Vitamin A, Vitamin D, Iron, Zinc, low salt diet, low sugar 5. High Fiber foods like Spinach, Carrots, Kidney beans. diet and Low fat foods are the usual food guidance. 6. Proteins like eggs, corn. Molecular Structure: For no result with Caroverine Capsule :- There are many more options available, and these options in combinations give better results. Caroverine Glutamate Optional therapies are: - Caroverine is chemically derived from isoquinoline, the basic 1. In resistance cases of tinnitus opt Tinnex injection structure of papaverin. followed by Tinnex capsule for minimum 3 months. - Caroverine is Glutamate receptor antagonist, Antioxidant as 2. For those with deafness Programmable digital hearing well as Calcium channel blocker. aid will solve both problems together. It not only improves the hearing but also masks the Tinnitus. Large numbers of - Caroverine has similar molecular structure as Glutamate patients are benefited this way. Proper selection and hence Caroverine has high affinity for glutamate receptors and offers glutamate antagonistic effect. 7 8 Continuous Mechanism of Action: Otoneuroprotective action Analog wave Drug ½ Life: 2 and half hrs moreover excreted through faeces. Caroverine in Cochlear Synaptic Tinnitus: Glutamate is likely to act as the neurotransmitter between the Discrete Analog IHCs and their afferents. On the postsynaptic afferent GP receptor dendritic membranes. Two classes of ionotropic glutamate receptor subtypes, i.e. N-methyl-d-aspartate (NMDA) and a- - Tinnitus as an isolated phenomenon appears to have a amino-3-hydroxy- 5-methyl-4-isoxazone-propionicac id (AMPA) receptors, mediate the glutamatergic particular cause, namely the disturbed interplay of glutamate receptor sub-types which are independent of one another and neurotransmission. The NMDA and AMPA receptors, which which have been damaged to different degrees. This determine the spontaneous and sound-induced disturbed interplay modulates the spontaneous activity of the depolarization patterns of the auditory nerve, work as a dual nerve in such a way that pathological depolarization occur, receptor system. Under pathological tinnitus-generating which simulate the excitation effects of sounds and are conditions, spontaneous, receptor-dependent, afferent misinterpreted centrally as signals from peripheral sounds depolarization patterns mimic sound-induced patterns, which (Fig.1). are subjectively perceived as tinnitus, irrespective of the degree of a possible accompanying hearing loss. - Selectively binds with NMDA & AMPA receptors at post CST, which is regarded as a glutamate receptor linked inner ear synapse level thus stabilizes disturbed membrane thereby disease, may be associated clinically with a wide range of inner inner hair cells & outer hair cells starts functioning in a normal ear diseases: presbycusis, sound-induced hearing loss or physiological way. sudden hearing loss. Caroverine works as competitive AMPA Caroverine works as and non competitive NMDA antagonist as well as antioxidant. Glutamate Antagonistic effect Sensorineural Hearing Loss (SNHL) and Tinnitus Ca++ channel blocker effect - Tinnitus is a common symptom in SNHL. Approximately 91% Potent Free radical Scavenger effect(Antioxidant) of individuals with SNHL report that they have tinnitus in the 9 10

4. affected ear or in both ears. Tinnitus occurs at the same time Absolute Contraindications as hearing loss in some individuals with SSNHL and may be the Should not to be given to Kidney Failure Patients. first symptom before hearing loss. Tinnitus begins some days Approval Status after the hearing impairment in some individuals. The tinnitus -It has got approved by Indian Authorities e.g., Indian FDA, may be caused by sound deprivation caused by the hearing DCGI (Drug Controller General of India) after all trials & Indian loss, which is known to be able to start central nervous system Studies. reorganization processes that can lead to tinnitus and -It is not approved by USFDA instead Patented in US by Prof. hyperacusis. Klause Ehrenberger. - Glutamatergic neurotoxicity is considered to be one of the key pathological factors in SNHL. Caroverine as being glutamate antagonist offers otoneuroprtection which confirms efficacy of caroverine in SNHL. (Rational Pharmacotherapy of the Inner Ear, Page no. 161) Details Tinnex 20 mg Capsules 1 Strip (10Caps) Dosage 2 Caps (at a time) twice a day (Morning & Evening) Before Meal meaning by Total 80 mg to be given at least for 3 Months & up to 6 months, the noticeable results would obtained within 1 month of therapy in some patients. Indications Tinnitus, Presbycusis, Speech Discrimination, SNHL. Drug interactions Tinnex (Caroverine) to be avoided with frusemide, Lasix, Lasilactone, Digoxine as it may cause hypotension. 11 12