Pacemin Hataphar tablets treat symptoms of headache, runny nose, sneezing, mild pain relief (50 blisters x 10 tablets)

Dosage form Tablet
Specifications Box of 50 blisters x 10 tablets
Ingredient Paracetamol, chlorpheniramine

Ingredient

Thành phần cho 1 viên

Composition informationContent
Paracetamol325mg
Chlorpheniramine2mg

Uses

indications

Pacemin is indicated in the following cases:

  • Symptomatic treatment: headache, runny nose, sneezing, mild analgesic.

    Paracetamol (acetaminophen or N - acetyl - P - Aminophenol) is a metabolic substance with the activity of phenacetin, an effective analgesic - antipyretic drug that can replace aspirin; However, unlike aspirin, paracetamol is not effective in treating inflammation: with equal doses calculated by grams, paracetamol has the effect of reducing pain and reducing fever similar to aspirin. Paracetamol reduces body temperature in fever, but rarely reduces the body temperature in normal people.

    The drug acts on the hypothalamus, causing cooling off, increasing heat due to vasodilation and increased peripheral blood flow. Paracetamol, with treatment, less impact on the cardiovascular and respiratory system, does not change acid -base balance, does not cause irritation, scratches or stomach bleeding like when using salicylate, because paracetamol does not work on the body cycloxygenase, only affect cycloxygenase/ prostaglandin of the central nervous system. Paracetamol does not work on platelets or bleeding time.

    When an overdose of paracetamol, a metabolic substance is N - Acetyl - Benzoquinonimin that is toxic to the liver. Normal doses, paracetamol tolerated well, without many side effects of aspirin. However, an acute overdose (over 10 g) causes liver damage to death, and the poisoning and suicide with paracetamol has increased worrying in recent years. In addition, many people including physicians, seemingly unaware of Paracetamol's poor anti -inflammatory effects.

    chlorpheniramin maleat

    Clorpheniramin Maleat is an antihistamine with very little sedative effects. Like most other histamine resistance, chlorpheniramine also has side effects against acetylcholin, but this effect is different between individuals. The antihistamine effect of chlorpheniramine through the closing body competes the H1 receptors of the acting cells.

    pharmacokinetics

    paracetamol

    absorption:

    Paracetamol is quickly absorbed and almost completely through the gastrointestinal tract. Foods can make long -lasting release pellets in partially absorbed Paracetamol and carbon -rich foods that reduce the absorption rate of paracetamol. The peak concentration of plasma is within 30 to 60 minutes after drinking with the dose of treatment.

    Distribution:

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

    Metabolism - Elimination:

    The half -life of paracetamol plasma is 1.25 - 3 hours, which can last for toxic doses or in patients with liver damage. After the treatment dose, 90 to 100%of the urine can be found on the first day, mainly after the liver combination with glucuronic acid (about 60%), sulfuric acid (about 35%) or cysteine ​​(about 3%); Small amounts of hydroxyl metabolites are found - chemical and reducing acetyl. Young children are less likely to be more in line with the drug than adults.

    paracetamol is n - hydroxylation by cytochrom P450 to create N - Acetyl - Benzoquinonimin, an intermediate reaction. This metabolic substance normally reacts with sulfhydryl groups in glutathion and thus is dedicated. However, if taking high doses of paracetamol, this metabolic is formed in sufficient amount to exhaust the glutathion of the liver, in that situation, its reaction to the sulfhydryl group of the liver protein increases, which can lead to liver necrosis.

    chlorphentramin maleat

    absorption - Distribution:

    chlorpheniramin maleat absorbs well when taken and appears in plasma within 30-60 minutes. Plasma peak concentration reaches 2.5 to 6 hours after drinking. Low biological use, reaching 25-50%. About 70% of the drug during the circulation associated with the protein. The distribution volume is about 3.5 liters/ kg (adults) and 7 - 10 liters/ kg (children).

    Metabolism - Elimination:

    chlorpheniramin maleat is fast and highly metabolized. The metabolites include Desmethyl - Didesmethyl -Clorpheniramin and some unknown substances, one or more of them are active. The concentration of chlorpheniramine in serum is not correlated in accordance with the antihistamine effect because there is an unknown metabolite that also works.

    The drug is excreted mainly in urine in a constant or metabolic form, the excretion depends on the pH and the urine flow. Only a small amount is seen in the feces. The sale time is 12 - 15 hours and in patients with chronic renal failure, lasting up to 280 - 330 hours.

    • Before taking Pacemin Hataphar tablets treat symptoms of headache, runny nose, sneezing, mild pain relief (50 blisters x 10 tablets)

    How to use

    Take oral use.

    Dosage

    Adults and children over 12 years old

    Take 2 capsules each time, each time 4-6 hours apart.

    Children 6 - 12 years old

    Take 1 tablet/ time, each time 4-6 hours apart.

    Children under 6 years old

    Should use the form of dosage different from the more appropriate content. Or as directed by the physician.

    Note: The distance between drinking is recommended every 4-6 hours when necessary, but not more than 4 g paracetamol (12 tablets)/ day.

    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?

    paracetamol

    Overdose:

    Paracetamol poisoning can be used by a single dose, or due to a large dose: paracetamol (for example: 7.5 - 10 g per 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 may cause death.

    Nausea, vomiting, and abdominal pain usually occur within 2-3 hours after taking the poisonous dose of the drug. Methemoglobin - blood, leading to purple blue, mucous and nails is a sign that acute poisoning P - Aminophenol: A small amount of sulfhemoglobin can also be produced. Children tend to create methemoglobin easier than adults after taking paracetamol.

    When severe poisoning, it may initially stimulate the central nervous system, agitated, and delirium. Next can be inhibiting the central nervous system; Stunned, lower body temperature; tired; Breathing fast, shallow; fast, weak, uneven circuit; Low blood pressure and circulatory failure. Vascular collapse due to relative hypoxia and central inhibition effects, this effect only occurs in huge doses. Shock may occur if a lot of vasodilation. The suffocating convulsions may occur. Often coma occurs before dying suddenly or after a few days of coma.

    Clinical signs of liver damage become clearly within 2 to 4 after taking toxic doses. Aminotransferase plasma increases (sometimes very high) and the concentration of bilirubin in plasma can also increase; In addition, when the liver damage spreads the prolifers. It is possible that 10% of patients with untreated poisoning have serious liver damage; Among them 10% to 20% finally die from liver failure. Acute renal failure also occurs in some patients.

    Liver biopsy detects central necrosis subtracting the area around the portal vein. In cases of non -death, liver lesions recover after weeks or months.

    How to handle:

    Early diagnosis is important in the treatment of paracetamol overdose. There are methods to quickly determine the concentration of drugs in plasma. However, do not delay treatment while waiting for the test results if the history is suggested to overdose. When severe poisoning, it is important to treat positive support. Gastric lavage is needed in any case, preferably within 4 hours after drinking.

    The main detoxification is the use of sulfhydryl compounds, perhaps partly due to the addition of glutathion reserves in the liver.

    n - acetylcysteine ​​works when taking or intravenously. Must give the drug immediately if less than 36 hours after taking paracetamol. Treatment with N - Acetylcystein is more effective when giving the drug for less than 10 hours after taking paracetamol. When drinking dilute N - acetylcystein solution with water or drinks without alcohol to achieve a 5% solution and must be taken within 1 hour after mixing. Give N - Acetylcysteine ​​at the first dose of 140 mg/ kg, then give 17 more doses, each dose of 70 mg/ kg 4 hours apart. Termination of treatment if the paracetamol test in plasma shows a low risk of liver toxicity.

    The unwanted effect of N - Acetylcystein includes skin rods (including urticaria that does not require stopping the drug), nausea, vomiting, diarrhea and anaphylactic reaction.

    If there is no N - acetylcystein, methionine can be used (see specialized methionine). Also can use activated carbon and/ or salt bleach, they have the ability to reduce the absorption of paracetamol.

    chlorpheniramin maleat

    Overdose:

    Dosage of chlorpheniramine is about 25 - 50 mg/ kg body weight. Symptoms and overdose signs include sedation, reverse stimulation often TKTW, mental disorder, seizures, apnea, convulsions, anti -secretion effects Acetylcholin, hypertonic reaction and cardiovascular collapse, arrhythmia.

    How to handle:

    Symptomatic treatment and support for living functions, special attention should be paid to liver, kidney, respiratory, heart and water balance.

    Gastric or vomiting. Then, use activated carbon and bleach to limit absorption.

    When experiencing hypotension and arrhythmia, it should be actively treated. It is possible to treat convulsions with intravenous diazepam or phenytoin intravenously. May have to be blood transfusion in heavy cases.

    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. Do not use double the prescribed dose.

    Side Effects

    When using pacemin, you may experience unwanted effects (ADR).

    paracetamol

    Common

    usually erythema or urticaria; But sometimes worse may be accompanied by fever due to drugs and mucosal damage. Patients with susceptibility to rare salicylate sensitive to paracetamol and related drugs. A small number of Paracetamol individually causes neutropenia, thrombocytopenia and hypoglycemia. Da Da and other allergic reactions occasionally occur.

    Less:

    DA (Ban); stomach - intestines (nausea, vomiting); Hematology (hematopoietic disorders, neutropenia, all bloody hemocyst, leukopenia, anemia); Kidney (kidney disease, kidney toxicity when abused for a long time).

    Rare:

    Hypersensitivity reaction.

    chlorpheniramin maleat

    Sedative effects are very different from sleeping mild chicken to deep sleep, dizziness and irritation occurs when interrupted treatment. However, most patients suffer from side effects when treating continuously, especially if increasing the dose slowly.

    Common

    Central nervous system (sleeping, sedation); digestion (dry mouth).

    Rare:

    Body (dizziness); Digestive (nausea).

    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

    Pacemin is contraindicated in the following cases:

    Hypersensitivity to one of the ingredients of the drug. (Excipients include: ERAGEL, Cassava starch, amidson, Gelatin, Sodium Laurylsulfat, Magnesi Stearat, Talc powder, Sunset Yellow, Tartrazin).

    paracetamol: People with anemia many times or have heart disease, kidney or liver. Patients with glucose deficiency - 6 - phosphate dehydrogenase.

    Clorpheniramin Maleat: Patients with acute asthma attacks. The patient has symptoms of prostate hypertrophy. Glaucom narrow angle, bladder neck obstruction, stomach ulcers, pyloric - duodenum. Pregnant or lactating women, newborns and children are lacking in months. Patients taking oxidase inhibitors (Mao) within 14 days, up to the time of treatment with chlorpheniramine because of the anti -secretion properties of acetylcholin of chlorpheniramine increased by Mao inhibitors.

    Caution when using

    chlorpheniramin maleat

    Clorpheniramine may increase the risk of urinary retention due to the anti -acetylcholin secretion side effects, especially in people with prostate hypertrophy, urinary tract, pyloric garges and worsen in patients with myasthenia gravis.

    The sedative effect of chlorpheniramine increases when drinking alcohol and when used simultaneously with other sedatives.

    There is a risk of respiratory complications, respiratory decline and apnea, which can cause very trouble in people with obstructive pulmonary disease or children. Must be cautious when chronic lung disease, shortness of breath or shortness of breath.

    There is a risk of tooth decay in patients treated for a long time, due to anti -secretion effects: acetylcholin, causing dry mouth.

    Avoid using patients with glaucoma like Glaucom.

    Use medication cautiously with the elderly (> 60 years old) because these people often increase sensitivity to anti -secretion effects acetylcholin.

    For extended use must monitor kidney function.

    paracetamol

    Paracetamol is relatively non -toxic to treatment. Sometimes there are skin reactions including rugged rash and urticaria; Other sensitive reactions include larynx edema, angioedema, and anaphylactic reactions that may rarely occur. Platelets, leukopenia, and all bloody hematuria have occurred with the use of p - aminophenol derivatives, especially when used for large doses. Neutral leukopenia and thrombocytopenic hemorrhage occur when using paracetamol. Rarely loss of granulocytes in patients using paracetamol.

    People with phenylceton - urinary (meaning, gene deficiency determines the status of phenylalanin hydroxylase) and people who have to limit the amount of phenylalanin put into the body must be warned that some paracetamol preparations contain Aspartam, which will metabolize in the stomach - the intestinal citadel of phenylalanin after drinking.

    Some forms of paracetamol drugs on the market containing sulfit can cause allergic reactions, including anaphylaxis and life -threatening or less serious henses in some hypersensitivity people. It is unknown the general ratio of hypersensitivity to sulfit among the people in general, but it must be low; Such hypersensitivity seems to be more common in patients with asthma than people without asthma.

    Must use paracetamol carefully in patients with anemia before, because purple blue may not manifest clearly, although there are dangerous high concentrations of methemoglobin in the blood.

    Drinking plenty of alcohol can cause toxicity to the liver of paracetamol; Should avoid or limit drinking.

    The doctor should warn the patient about the signs of serious skin reactions such as Steven - Johnson syndrome (SJS), toxic skin necrosis syndrome (Ten - Toxic Epidermal Necrolysis) or Lyell syndrome, acute all -body pustular syndrome (Acute Generalized Examthematous Pustuosis).

    Expiry date: 36 months from the date of manufacture. Do not use the expired drug.

    Note: When you see the tablet is moldy, color transfer, the label prints the number of production lots, the limit is blurred ... or there are other suspicious manifestations to bring the drug to return the place of sale or the address of the address in the single.

    The ability to drive and operate machinery

    The drug can cause chickens, dizziness, dizziness, blurred vision, drugs that are at risk of drowsiness and mental impairment in some patients and can seriously affect the ability to drive or operate the machine.

    Need to avoid being used for people who are driving or making machines.

    Pregnancy

    No drugs.

    breastfeeding period

    No drugs.

    Drug interaction

    paracetamol

    Long -term and high doses of Paracetamol increases the anticoagulant effect of COMAARIN and conducting indandion. This effect is less or not clinically important, so paracetamol is more popular than salicylate when it is necessary to relieve mild pain or reduce fever for patients who are using cooumarin or indandion derivatives.

    It is necessary to pay attention to the likelihood of serious antipyretics in patients to use simultaneously phenothiazine and cooling therapy.

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

    Anti -seizure drugs (including Phenytoin, Barbiturat, Carbamazepin) that induce enzyme induction in the liver microsom, which can increase the toxicity of paracetamol due to increased drug conversion into toxic substances to the liver. In addition, ISONIAZID simultaneous use with paracetamol can also lead to an increased risk of toxicity to the liver but have not determined the exact mechanism of this interaction.

    The risk of paracetamol toxicity to the liver significantly increases in patients who take paracetamol doses greater than the recommended dose while using 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 limit and use paracetamol themselves while taking anti -convulsions or isoniazid.

    chlorpheniramin maleat

    Do not take the drug with monoamine oxydase inhibitors that extend and increase the anti -secretion effect of acetylcholin of antihistamine drugs. Be careful when coordinating with sedatives causing sleep because it can increase the effect of inhibiting the central nervous system. Should not be used with phenitoin because the metabolic inhibitor of phenitoin leads to phenitoin poisoning.

    Storage

    In a dry place, avoid light, temperatures below 300C.

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