combination therapy.

Hypertension is the most important risk factor for cardio vascular disease. But, the key question remains: which of the many available types of blood pressure lowering drugs is the better choice as first line medication. Hence, the prospective, randomized, single blind , Comparative study was conducted  at tertiary care Hospital to  assess  the beneficial outcomes of drugs by comparative method. The study concludes that the physicians were prescribed the ACEIs for hypertension with various co morbidities as per JNC-7 guidelines. The study conclude that the A+E+N is the most effective combination therapy for better control of hypertension. The study indicates that the combination therapy can be individualized according to the presence of co morbidities  with  HTN.

Concomitant therapy of anti inflammatory agent and disease modifying drug in pulsatile pattern proves the best treatment for pain relief and in remission of disease. In the current work, combination therapy of aceclofenac and leflunomide was studies for rheumatoid arthritis. Tab in tab formulation was developed with inner leflunomide and outer aceclofenac fraction. Outer fraction provides instant relief from symptomatic pain and inner part provides disease remission. pH sensitive polymers were investigated for coating and coating parameters were optimized. Considering the pH solubility of Eudragit S 100 and Eudragit L 100 in different ratio, final composition was derived. With final composition, desired lag phase observed in the drug release study. Further, X-ray studies and Pharmacokinetic study with final formulation also proves the efficacy of the final formulation w.r.t. desired lag phase and drug plasma concentration in-vivo. Final formulation found stable in 3 months stability study w.r.t. physical and chemical parameters. Optimized novel pulse release combination therapy developed to provide the relief to arthritis patient.