Efferalgan 80mg Bullets upsa Sas analgesic, reducing fever (2 blisters x 5 tablets)

Dosage form Bullet
Specifications Box of 2 blisters x 5 tablets
Ingredient Acetaminophen
Indication Flu, headache, inflammation, toothache
Contraindication Hepatic failure, crack and anal fistula, rectum, abscess of the anus - rectum

Ingredient

Composition information	Content
Acetaminophen	80mg

Uses

Indications

Efferalgan 80mg bullets are indicated in the following cases:

Treatment of pain from mild to medium and fever. Unlike traditional nonsteroidal anti -inflammatory drugs (NSAID), paracetamol does not inhibit platelet function at the dose of treatment.

The exact mechanism of pain relief and fever effects of paracetamol has not been determined. The mechanism of action can be related to the effects at the central and peripheral.

Pharmacokinetics

absorption

Paracetamol absorption in the rectum is slower than oral. Peak concentration in plasma is about 2-4 hours after rectal use.

Distribution

paracetamol is quickly distributed into most tissues.

In adults, the distribution of Paracetamol is about 1 -2 liters/kg and in children between 0.7 - 1.0 liters/kg.

Paracetamol does not strongly connect with plasma proteins.

Metabolism

Paracetamol is metabolized mainly in the liver in two main paths in the liver: associated with glucuronic acid and associated with sulfuric acid.

Integrated with sulfuric acid quickly saturated when taking higher doses but still within the scope of treatment. The saturation of the glucoronid process appears only when the dose is higher, toxic to the liver.

A small part (less than 4%) is metabolized by Cytochrom P450 forming a high reaction mediator (N-acetyl Benzoquinoneimin), under normal usage conditions, this intermediate will be detoxified by glutathion reduction and is eliminated in urine after connecting with cystein and mercapturic acid. However, when poisoning with high doses of Paracetamol, the amount of metabolites with this toxicity increases.

Elimination

Paracetamol metabolites are mainly eliminated in the urine. In adults, about 90%of the dose is excreted for 24 hours, mainly in the form of glucuronid complex (about 60%) and sulfate complex (about 30%). Less than 5% are eliminated in constant form.

Selling time in plasma is about 2 hours.

Before taking Efferalgan 80mg Bullets upsa Sas analgesic, reducing fever (2 blisters x 5 tablets)

How to use

Efferalgan 80mg analgesic antipyretic drugs for rectal sugar.

If a child has a fever above 38.5 ° C, take the following steps to increase the effectiveness of medication.

Take off your children's clothes.

Give children more liquid.

Do not leave children in the hot place

If needed, bathing children with warm water, with a temperature lower than 2 ° C compared to the child's body temperature.

Dosage

paracetamol has many different types of dose for appropriate treatment depending on the weight of each child.

Daily dose of paracetamol recommends is about 60 mg/kg/day, divided into 4 use, about 15 mg/kg every 6 hours.

Because of the risk of rectal irritation, the treatment with ammunition is shorter as possible, should not exceed 4 times/day and should be replaced as soon as possible by oral.

See specific recommendations in the table below:

Weight (kg) appropriate age* 2 - 80 mg 1 6 hours

(4 tablets) The use of age is based on local standard development curves.

Frequency and time to use drugs:

Using drugs to avoid the vibration of pain or fever.

In children, it is necessary to have a even distance between each medication, both day and night, so it is about 6 hours, or at least 4 hours.

kidney failure:

In patients with severe renal impairment, the minimum distance between the two use of the drug should be adjusted according to the following table:

Creatinine clearance

Medication distance Used above is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Signs and symptoms:

Nausea, vomiting, anorexia, pale, abdominal pain, discomfort, sweat often appear in the first 24 hours.

Overdose (one by more than 7.5 g in adults and 140 mg/kg of disposable body in children) will cause liver cell cancellation, which can cause complete necrosis and non -recovery, leading to liver cell failure, metabolic acidic infection, brain disease that can lead to coma and death.

At the same time, there is an increase in liver transaminase, lactat dehydrogenase and bilirubin along with a decrease in prothrombin levels that can occur from 12 to 48 hours after taking the drug. The clinical symptoms of liver damage are usually pronounced at first after 1 to 2 days, and reach a maximum after 3-4 days.

Emergency measures:

Take it immediately to the hospital.

Take a blood tube as soon as possible to initially test paracetamol in plasma but not earlier 4 hours after taking paracetamol.

Quickly eliminate the amount of medicine used by gastrology.

The common treatment for paracetamol overdose includes taking anti-toxic drugs as soon as possible, n-acetylcystein (oral or intravenous), if possible, before the 10th hour after overdose.

Symptomatic treatment.

Must conduct a liver test at the beginning of treatment and repeat every 24 hours. In most schools, the liver transaminase returns to normal after 1-2 weeks with the full liver function. In case of being too heavy, liver transplant may need.

What do

do when you forget 1 dose? So, if your child is no longer fever or pain you can stop using Efferalgan. However, if the child still has a fever or pain, the next tablet is immediately after you remember, then continue to order the drug as the usual medication calendar (6 hours apart doses). Do not use double dose to compensate for the forgotten dose.

Side Effects

When using Efferalgan 80 mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

No information.

Uncommon, 1/1000

No information.

Not determined frequency

Blood and lymphatic system: reducing the amount of platelets.

Digestive: abdominal pain, diarrhea.

Liver: liver failure, liver necrosis, hepatitis. Increase liver enzyme.

The immune system: Anaphylaxis, hypersensitivity, fleet.

Skin and subcutaneous tissue: Red rash, itching, rash, urticaria, external pustules syndrome, acute body, skin necrosis syndrome, Stevens-Johnson syndrome.

Regarding the preparation:

Using bullets is capable of causing anal and rectal irritation.

Instructions on how to handle ADR

If any of the following undesirable effects occur, notify your doctor or nurse immediately. These are unwanted effects very serious. Children may need emergency medical care.

Allergic reactions - short breath, wheezing or shortness of breath, swelling of the face, lips, tongue or other parts of the body, rash, itching or urticaria on the skin.

jaundice and/or yellow eyes, also known as jaundice.

Other unwanted effects not listed above can occur in some patients. Notify your doctor if you notice anything that makes your child feel unwell.

Do not be warned by unwanted effects that may occur.

You may not have any unwanted effects among them.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Efferalgan bullets 80 mg contraindicated in the following cases:

Know there is an allergy to paracetamol or with propacetamol hydrochloride (the precursor of paracetamol) or the ingredients of the drug.

Having severe liver disease.

new anal inflammation, or rectal, or rectal bleeding.

Caution when using

To avoid the risk of overdose, choose other drugs (including prescription and non -prescribing drugs) without paracetamol.

Maximum recommendations:

For children weighing less than 10 kg. The total dose of paracetamol should not exceed 60 mg/kg per day.

Using bullets is at risk of local irritation, frequency and intensity increase over time, time of placement and dose.

Paracetamol dose is higher than the recommended dose that causes very serious risk of liver damage. Signs and clinical symptoms of liver damage are usually first recorded after 1 to 2 days of paracetamol overdose. Maximum symptoms of liver damage are often observed after 3-4 days, need to use antidote as soon as possible.

Doctors need to warn the patient about signs of serious skin reactions such as Stevens-Johnson syndrome (SJS), toxic skin necrosis syndrome (Ten) or Lyell syndrome, acute pustules syndrome (AGEP).

Use paracetamol carefully in the following cases:

Liver cell failure, including gilbert syndrome (hyperburin blood bilirubin).

Severe renal failure (creatinine purification

Lack of glucose-6-phosphate-phosphate-dehydrogenase (G6PD) (can lead to hemolytic anemia).

Anorexia, incorrect or corrosion, prolonged malnutrition (ie poorly liver glutathion reserves).

Dehydration, reducing blood volume.

The form of ammunition is not suitable in the case of diarrhea.

The ability to drive and operate machinery

is not related.

pregnancy

does not apply.

The period of breastfeeding

does not apply.

Interactive drug

anticoagulant oral drugs:

Simultaneous use of paracetamol with cooumarin including warfarin may slightly change the value of INR. In this case, it is necessary to strengthen the monitoring of the Inr value during the combination of use as well as within 1 week after stopping treatment with paracetamol.

Interaction with laboratory tests.

Using paracetamol can interact with blood uric acid tests by phosphotungstic acid method and with blood sugar tests by glucose-oxydase-peroxidase method.

Effect of other drugs on Efferalgan 80mg:

Phenytoin when used simultaneously can lead to reduction in paracetamol effects and increase the risk of toxicity to the liver. Patients who are being treated with phenytoin should avoid large and/or prolonged paracetamols. Need to monitor patients on signs of toxicity for the liver.

Probenecid may reduce nearly twice in paracetamol's clearance by inhibiting its conjugate with glucuronic acid. Paracetamol dose should be considered when used simultaneously with probenecid.

salicylamid can extend the disposal time (t1/2) of paracetamol.

Enzyme induction substances: Be careful when using paracetamol with enzyme induction substances. These substances include but unlimited barbiturat, isoniazid, carbamazepine, rifampin and ethanol.

Storage

Store at temperatures below 300C.

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