Hi-tavic danapha medicine treats pain from medium to severe (6 blisters x 10 tablets)

Dosage form Film bag tablets
Specifications Box of 6 blisters x 10 tablets
Ingredient Paracetamol, tramadol hydrochloride

Ingredient

Thành phần cho 1 viên

Composition information	Content
Paracetamol	325mg
Tramadol hydrochloride	37.5mg

Uses

indications

Hi-tavic drug indicated to treat pain from medium to severe.

Pharmacological

tramadol is an opioid synthetic analgesic with an analgesic effect according to the central mechanism. O-Desmethyltranadol (M1D of the tramadol is attached to the normic noron and reduces the re-import of norepinephrin and serotonin into the cell, so it has an analgesic effect.

Analgesic effects appear after 1 hour and maximum after 2-3 hours. Unlike morphine, tramadol does not cause histamine release, does not affect the heart frequency and left ventricle function and at the dose of tramadol treatment less respiratory inhibitors than morphine.

Paracetamol is an active metabolite of phenacetin, is another central painkiller. With the dose of treatment, paracetamol has little impact on the cardiovascular and respiratory system, does not change acid -base balance, does not cause irritation, scratches or stomach bleeding like using salicylate, because paracetamol does not work on cyclooxygenase, only affect cyclockygenase/prostaglandin of the central nervous system.

Pharmacokinetics

absorption

Paracetamol is absorbed quickly and almost completely through the digestive tract. The peak concentration of plasma is within 30 to 60 minutes after drinking with the dose of treatment.

Tramadol absorbs well through the digestive tract but has a strong metabolism through the strong liver, so the absolute bioavailability of the drug is only 75 %. The time to reach the maximum concentration in different colors holds tramadol and metabolites. Tramadol has a maximum concentration in the blood after use 2 hours, while M1 metabolic products are 3 hours. Food less affects the absorption of drugs.

Distribution

Paracetard is quickly and evenly distributed in most body tissues. About 25% Paracetamol in the blood combined with plasma protein.

tramadol in color attached to protein is about 20% and is distributed in all organs with an integral distribution of about 2.7 liters/kg.

Metabolism

In tramadol body is metabolized through N reaction, changing the effect of tramadol. The activity of ISOENZYM CYP2D6 is inherited. The rate of enzyme activity is about 7%. In addition to the metabolism through phase I, tramadol and metabolites are also metabolized through phase II through the reaction conjugated with glucuronic acid or sulfuric acid.

Elimination

The half -life of paracetamol plasma is 1.25 - 3 hours, which can last for toxic doses or in patients with liver damage.

Paracetamol is excreted from the combination with glucuronic and sulfate depending on the dose. Under 9% Paracetamol is eliminated in the form of unchanged urine.

tramadol is excreted mainly through the kidneys (90 %) and 10 % in the stool, in the form of unprovered, accounting for 30 % and has been metabolized 60 %. The drug goes through the placenta and breast milk. The half -life of tramadol blowing is 6.3 hours and M1 is 7.4 hours.

Before taking Hi-tavic danapha medicine treats pain from medium to severe (6 blisters x 10 tablets)

How to use

HI-TAVIC medicine used by oral, drinking whole tablets without chewing, drinking hi-tavic is not affected by food.

Dosage

Adults and children over 12 years: The maximum dose is 1 to 2 capsules, every 4 to 6 hours and no more than 8 tablets in a day.

Children under 12 years: The safety and effectiveness of the drug has not been studied.

Elderly (over 65 years): There is no difference in safety or pharmacokinetics between users over 65 years old and younger users.

Note: The above dose 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? Clinical manifestations of overdose medication may be signs or symptoms of tramadol poisoning, paracetamol or both.

tramadol: The serious consequences of overdose tramadol may be respiratory failure, coma, convulsions, cardiac arrest and death.

paracetamol: using very high doses of paracetamol can be toxic to the liver on some patients. Early symptoms may occur after the liver is damaged by paracetamol overdose including: irritating the digestive tract, anorexia, sadness, vomiting, discomfort, pale, sweating. Symptoms of liver toxicity may appear after 40 to 72 hours after taking the medicine.

Management:

Immediately transfer to emergency units, maintain respiratory function and circulation.

Before starting treatment, quantifying paracetamol and tramadol in plasma.

Stomach pins perform in patients with vomiting (when the patient is still conscious) by stimulating or emptying the stomach.

Supporting treatment such as maintaining ventilation, maintaining cardiovascular function, naloxon is used to recover respiratory failure, fainting can be controlled by diazepam.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

The most often side effects occur, especially on the central nervous system and the digestive system.

Notify the physician the unwanted effects when using the drug.

Warnings

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

contraindicated

Hi-tavic drugs contraindicated in the following cases:

Patients with a history of sensitivity to tramadol, paracetamol or any ingredients of the drug or with opioid drugs. Treatment.

Be cautious when used

Unused with any drug containing paracetamol or tramadol without a doctor's guidance.

People with liver and kidney functions need to reduce the dose

Be cautious when taking medication for patients with an opioid dependence, as it can cause dependence again.

In the treatment dose, the drug can cause seizures, so it must be very careful in people with a history of epilepsy or a number of diseases that have many risks of convulsions or when combined with IMAO, 3 -ring anti -depression drugs, sedative drugs.

In case it is necessary to coordinate with central neurological inhibitors, the dose must be reduced.

Patients show signs of increased cranial pressure or head injury, when using medication, mental status must be monitored.

tramadol has the potential for addictive morphine. Patients crave drugs and increase dose due to greasy. Avoid prolonged medication and should not stop sudden but must gradually reduce the dose.

The doctor should warn the patient about the signs of serious skin reactions (related to Paracetamol) such as Steven-Johnson syndrome (SJS), multi-infectious necrotic syndrome (Ten) or Lyell syndrome, acute overseas pustular syndrome (AGEP).

Do not use overdue drugs on the box, or when there are doubts about the quality of the drug such as: wet tablets, discoloration.

Read the instructions carefully before use. If you need more information, please consult your doctor or pharmacist.

Use drugs for women during pregnancy and nursing mothers

Pregnant women: The drug passes through the placenta, so it is very careful and only taken the drug when it has been carefully calculated between the effect and the risk of toxicity and the fetus.

Lactating women: Do not use medication for breastfeeding women because of the safety of infants and young children after taking the drug that has not been studied.

The effect of the drug on the ability to drive and operate machinery

The drug can cause drowsiness, hallucinations, difficulty focusing, so do not use drugs for people who regularly drive and operate machinery.

Medicinal interaction

used with imao drugs and inhibiting Serotonin reabsorption: may increase the risk of wide effects, including convulsions and serotonin syndrome.

Used with carbamazepine: significantly increases tramadol metabolism. The pain relief effect of tramadol in hi-tavic may be reduced with patients with carbamazepin.

Used with quinidine: quinidine inhibits CYP2D6 reduces metabolism and increases the effects of tramadol.

Used with substances belonging to the warfarin group: tramadol extends prothrombin time, when used in combination with warfarin, it is necessary to check the regular prothrombin time,

Used with CYP2D6 inhibitors: HI-TANIC and CYP2D6 inhibitors can limit the metabolism of tramadol, whereas tramadol inhibits the re-import of Noradrenalin and Serotonin. Therefore, not coordinated in treatment.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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