Napharangan effervescent tablets 500mg Nam Ha cooled down, relieves pain, treatment of mild to medium fever (4 blisters x 4 tablets)

Dosage form Effervescent tablet
Specifications Box of 4 blisters x 4 tablets
Ingredient Paracetamol
Indication Sinusitis, fever, dysmenorrhea, cold, headache, migraine, body aches
Contraindication Anemia

Ingredient

Composition information	Content
Paracetamol	500mg

Uses

indications

Napharangan 500 mg is indicated in the following cases:

Treatment of pain and fever from mild to medium. However, otherwise aspirin, paracetamol is not effective for inflammation treatment. The drug acts on the hypothalamus, causing cooling down, increasing heat caused by vasodilation and increasing peripheral blood flow reduces body temperature in the fever, but rarely reduces normal heat.

In the treatment dose, analgesic effect, antipyretic equivalent to aspirin but paracetamol has little impact on the cardiovascular system and respiratory system, does not change acid -base balance, does not cause irritation, scratches or stomach bleeding as when using salicylate, because paracetamol does not work on cycloxygenase. Paracetamol only affects cyclooxygenase/prostaglandin of the central nervous system. When the paracetamol overdose will produce a metabolic substance, N - Acetyl - Benzoquinonimin, toxic to the liver. Acute overdose (> 10 g) damage the liver is deadly.

Pharmacokinetics

absorption

Paracetamol is quickly absorbed and almost completely through the gastrointestinal tract. Foods can slow down the absorption of paracetamol and carbohydrate -rich foods that reduce the absorption rate of paracetamol. The peak concentration of plasma is within 30 - 60 minutes after taking the dose of treatment.

Distribution

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

Metabolism

Paracetamol metabolizes in Cytochrome P450 in the liver N - Acetyl Benzoquinonimin is an intermediate reaction, this substance continues to be associated with the glutathion sulfhidryl group to create non -active substances.

When using high doses of paracetamol (> 10 g/day), it will produce multiple N - Acetyl Benzoquinonimin depleting liver glutathion, then N - Acetyl Benzoquinonimin will react with the sulfhydryl group of liver protein causing liver damage, liver necrosis, which can be fatal if not emergency in time.

Elimination

Paracetamol's plasma sale time is 1.25 - 3 hours and this time can last for toxic doses or in patients with liver damage.

After drinking can be found 90 - 100% of the urine on the first day, mainly the combined form in the liver with glucuronic acid (about 60%); Sulfuric acid (about 35%) or cysteine (about 3%), a small amount of hydroxyl metabolic - chemical and reduction of acetyl. Young children are less likely to match Glucuronic with drugs than adults.

Before taking Napharangan effervescent tablets 500mg Nam Ha cooled down, relieves pain, treatment of mild to medium fever (4 blisters x 4 tablets)

How to use

Put the pill in a cup of boiled water to cool (about 200 ml) until completely dissolved and drink.

Dosage

Children over 11 years old and adults: usually take 1 tablet/time, 4-6 hours/time when necessary, do not drink more than 4 g/day.

Higher doses (1 g/time) can be helpful to relieve pain in some patients.

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?

Symptoms

Paracetamol poisoning may be used by 1 single -dose or when repeating high doses of paracetamol (7.5 - 10 g/day for 1-2 days), or for long -term medication.

The liver necrosis depends on the dose is the most serious toxic effect due to overdose and can cause death.

Nausea, vomiting, abdominal pain usually occur within 2-3 hours after taking toxic doses. Blood methemoglobin leads to green purple, mucous membranes and nails is a characteristic sign of acute poisoning P - aminophenol; Small amount of sulfhemoglobin can also be generated. Children tend to create methemoglobin easier than adults after taking paracetamol.

When the poisoning is severe, it may initially stimulate the central nervous system, agitated and delirious. Next can inhibit the central nervous system (stunned, lower body temperature, tired, fast breathing, shallow, weak, weak, irregular, low blood pressure and circulatory failure). Vascular collapse due to relative hypoxemia and central inhibition effects occur only in huge doses. Can shock if a lot of vasodilation. The suffocating convulsions may occur.

Handling

Use medical control measures (gastric lavage within 4 hours, use activated carbon ...) as soon as an overdose occurs even without symptoms.

Must drink N - Acetylcystein immediately if less than 36 hours from taking paracetamol. Treatment with N - Acetylcysteine is more effective when used less than 10 hours after taking paracetamol.

Give patients N - Acetylcystein with the first dose of 140 mg/kg, then take 17 more doses, each dose of 70 mg/kg each 4 hours apart. Termination of treatment if the paracetamol test in plasma shows the risk of low liver toxicity.

Can use methionine without N - Acetylcystein.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Napharangan 500 mg, you may experience unwanted effects (ADR).

Skin rash and other allergic reactions occur. Usually erythema or urticaria, but sometimes worse and may be accompanied by drugs and mucosal lesions.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

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

Contraindicated

Napharangan medicine 500 mg is contraindicated in the following cases:

People are sensitive to paracetamol.

Patients with G6PD deficiency.

Caution when using

paracetamol is relatively non -toxic to the dose of treatment.

Doctors need to warn patients on signs of serious skin reactions such as Stevens - Johnson syndrome, poisoned skin necrosis syndrome or Lyell syndrome, acute overseas acne syndrome.

Avoid or limit drinking alcohol when taking the drug because it increases toxicity to the liver of paracetamol.

Persons impaired liver -kidney function.

People with phenylceton - urinary, anemia patient.

For pregnant and breastfeeding women, they must consult a doctor.

The ability to drive and operate machinery

The drug does not affect the ability to drive and operate machinery.

Pregnancy

Consult your doctor before taking the medication.

Breastfeeding period

should consult a doctor before taking the medication.

Interactive drug

anticoagulant oral drugs

Long -doses of high -dose Paracetamol increases the anticoagulant effects of cooumarin and indoors. Research data is not clear about this interaction, so paracetamol is preferred to use Salicylate when it is necessary to relieve mild pain or reduce fever for patients who are using cooumarin or indandion derivatives.

Pay attention to the likelihood of serious heat lowering the patient to use simultaneously phenothiazine and cooling therapy (such as paracetamol).

Out of alcohol too much and long may increase the risk of paracetamol's liver toxicity.

Anti -convulsions (phenytoin, barbiturat, carbamazepin)

Causes enzyme induction in the liver microsome, which can increase the harmful effects on the liver of paracetamol due to increased drug conversion into liver toxins.

In addition, simultaneous use of isoniazid with paracetamol can also lead to an increase in the risk of toxicity to the liver, but the mechanism has not been determined. The risk of paracetamol toxicity significantly increases in patients with paracetamol doses greater than the recommended doses while taking anti -convulsions or isoniazid. Often do not need to reduce the dose in patients with simultaneous doses of paracetamol treatment and anti -convulsions; However, patients must restrict their own Paracetamol self -use while taking these drugs.

Probenecid may reduce paracetamol elimination and increase the half -life of plasma of paracetamol.

Storage

The cool dry place, avoiding light.

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