Padolcure gracure hard -term painful Padolcure

Dosage form Hard capsules
Specifications Box of 3 blisters x 10 tablets
Ingredient Paracetamol, tramadol HCl

Ingredient

Thành phần cho 1 viên

Composition information	Content
Paracetamol	325mg
Tramadol HCl	37.5mg

Uses

Indications

Padolcure is indicated for short -term treatment (3 days or less) acute pain and severe to severe.

Pharmacokology

paracetamol has pain and cooling properties.

tramadol is an opioid synthetic analgesic with an analgesic and addictive mechanism like the Morphin.

O-Desmethyltramadol (M1) drugs of tramadol attached to the nerve neuron and reducing the re-import of norepinephrin and serotonin into the cells should be 6 times higher than tramadol.

Pain relief appears after 1 hour of taking the drug and reaches the maximum effect after 2-3 hours. Unlike morphine, tramadol does not cause histamine release, does not affect the heart frequency and left ventricle function in willow treatment, tramadol is less respiratory inhibitors than morphine.

pharmacokinetics

paracetamol is distributed into most tissues in the body. Paracetamol passes the placenta and is present in milk. Mount with negligible plasma proteins at conventional treatment concentrations, but increase when increasing the concentration. Paracetamol is metabolized mainly in the liver and excreted pepper mainly in the form of a combination of glucuronid and sulfate. Under 5% Paracetamol is excreted in unproperated form.

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 maximum concentration time in the blood between 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. In the blood of the drug attached to protein about 20% and is distributed about 2.7 liters/kg.

In tramadol body is metabolized through N and O Methyl reactions under the catalyst of isenzyme CYP3A4 and CYP2D6. Under the catalyst of CYP2D6, tramadol converts into M1 and has analgesic effect, so when used with some substances that can cause this isoenzym, it is capable of changing the effect of tramadol. The activity of isoenzym CYP2D6 is inherited.

Weakness -based activity rate accounts for about 7%. In addition to the metabolism through phase I, tramadol and specialized chat are also metabolized through phase II through the reaction conjugated with glueuronic acid or sulfuric acid.

The drug is excreted mainly through the kidneys (90%) and 10% through the stool, below the unprocessed, accounting for 30% and has been metabolized by 60%.

The drug passes through the placenta and breast milk. Tramadol's excretion half -life is 6.3 hours and the eyelashes are 7.4 hours. The pharmacokinetics of tramadol less change with age.

In people over 75 years of age, the selling time increases slightly.

In people with kidney failure, the clearance of tramadol decreases in parallel with creatinine clearance: the sale time is about 12 hours. In people with liver failure, tramadol clearance decreases depending on the severity of the liver failure.

Before taking Padolcure gracure hard -term painful Padolcure

How to use

Padolcure hard capsules for oral tablets.

Dosage

This drug is only used as prescribed by a physician. Used for adults and children over 16 years old. Do not overdose.

Acute pain: Take a dose of 2 capsules every 4 - 6 hours when it is necessary to relieve pain. Do not use more than 8 tablets a day.

kidney failure:

For patients with creatinine clearance

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?

Initial symptoms of tramadol overdose may include respiratory failure and convulsions. First pay attention to maintain good ventilation with supportive measures. Sometimes using Naloxon can only treat a few, not all overdose symptoms. Using naloxon is at risk of increasing the ability to cause seizures. Symptomatic treatment and support for insomnia and convulsions with benzodizapin/barbiturates.

Tramadol is less excreted with hemorrhage or dialysis. Therefore, the treatment of acute poisoning with padolcure is merely by hemorrhage or dialysis is not too effective.

Symptoms of Paracetamol poisoning in the first 24 hours are pale, nausea, vomiting, appetite, abdominal pain. Liver damage becomes clearer from 12-48 hours after overdose. Abnormal metabolism and metabolic acid poisoning.

Acute renal failure with acute renal necrosis may progress even without severe liver damage.

Phracic arrhythmia is also reported. Symptoms in the first two days of acute poisoning do not reflect the serious risk of overdose. Nausea, vomiting, anorexia, abdominal pain can exist for 1 week or more. The liver damage becomes clear on the 2nd day (or later) the beginning is the activity of lactic dehydrogenase and increased serum transaminase, increased serum bilirubin levels and prolonged prothrombin time. Liver damage can lead to brain disease, coma and death.

Cerebral edema, non -specific myocardial failure can also occur.

In case of an overdose, consult a doctor or take the patient immediately to the nearest hospital.

It is necessary to treat special treatment as soon as possible. Any patient who takes 7.5 g of paracetamol should be washed with a stomach for 4 hours after drinking. The specific detoxification solution is to use acetylcysteine or methionine. If according to this decision, intravenously should be injected as soon as possible.

acetylcystein

Acetylcysteine should be used as soon as possible, more appropriate than within 8 hours after overdose.

Intravenous infusion: The starting dose of 150 mg/kg in 200 ml of glucose injection solution is transferred for more than 15 minutes, 4 hours then intravenous infusion at a dose of 50 mg/kg in 500 ml of glucose injection solution, 16 hours then intravenous injection at a dose of 100 mg/kg in 1000 ml of glucose injection solution. The volume of the infusion solution should be adjusted for children.

Oral dose: The starting dose of 140 mg/kg as a 5%oral solution, then 17 more dose, each dose of 70 mg/kg every 4 hours. Acetylcysteine is effective if treated within 8 hours after an overdose.

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

What to do when forgetting 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

When using Padolcure often has unwanted effects (ADR) such as:

tramadol

digestive system:

Nausea, abdominal pain, constipation, flatulence, vomiting, dry mouth, indigestion and diarrhea.

Dizziness, headache, nervousness, restlessness, anxiety, refreshment, easily emotional, hallucinations increase tone and tremor. Sleep, insomnia, anorexia, increased sweat, blush, rash and weakness.

Other side effects reported related to the use of tramadol include: anaphylactic shock, liver enzyme increased, vertical or cardiac hypotension and heart-toxic dermatitis and
Stevens-Johnson syndrome.

paracetamol

Paracetamol may cause allergic reactions or skin rashes. Usually rashes include erythema or urticaria and may be accompanied by fever and muscle damage. Using Paracetamol is associated with neutropenia, hypogonadic reduction and leukopenia.

Notify the doctor with unwanted effects when taking the drug.

Warnings

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

Contraindicated

Padolcure drugs contraindicated in the following cases:

Contraindicated for patients with hypersensitivity to tramadol, paracetamol or other opoids such as Codeine.

Precautions when using

do not rage at the same time Padolcure with drugs containing tramadol or other paracetamol.

Padolcure should not be used with alcoholic drinks. Simultaneous use of Padolcure with central neurological inhibiting painkillers such as alcohol, opioid, anesthetic, phenothiazines, sedatives or sleeping pills that can increase and pull the radio to the central nervous system.

Padolcure should be used carefully in patients with renal failure and patients at risk of seizures or shock.

used for pregnant women and nursing women

Pregnant women

Because tramadol is an active ingredient in Padolcure formula, should not be used during pregnancy.

Paracetamol: Epidemiological studies on pregnant women do not show side effects because paracetamol is used in recommended dose.

tramadol: tramadol should not be used during pregnancy because there is no adequate evidence to evaluate the safety of tramadol for pregnant women.

breastfeeding women

Because tramadol is an active ingredient in Padolcure formula, should not be used during breastfeeding.

Paracetamol: Paracetamol is excreted in breast milk but in negligible amounts. Clinical data shows that non -contraindications for nursing women when using the drug contain only one active ingredient Paraccetamol.

tramadol: tramadol and its metabolites are found in small amounts in breast milk. Children can absorb about 0.1% dose from the mother. Tramadol should not be used during breastfeeding.

The effect of drugs on driving and operating machinery

Visual, dizziness, dizziness, drowsiness, or other central nervous system disorders occur in patients while using padcure so avoid driving and operating machinery while using padcure.

Medicinal interaction

Simultaneous use of padolcure and carbamazepin can significantly reduce the concentration of tramadol.

Patients with simultaneous use of carbamazepine and padolcure may significantly reduce the pain effect of tramadol ingredients.

Concentrated with CYP2D6 inhibitors such as fluoxetin, paroxetin, quinidin and amitriptylin can lead to tramadol metabolism inhibitors.

Concentrated with cimetidine does not change significantly tramadol levels in serum. Therefore, there is no need to change the dose of padolcure for patients who are taking cimetidine therapy.

Do not use padolcure in combination with Mao inhibitors or newly stopped drugs within 14 days due to the ability to inhibit the re -import of serotonin and noradrenalin.

Survey before being marketed shows that rarity reports Digoxin toxicity and changes in warafin effects including increasing prothrombin time. Should monitor Prothrombin regularly when using padolcure simultaneously with Warafin.

Simultaneous use of diflunisal and paracetamol increases 50% of plasma paracetamol levels in normal volunteers. Should be cautious when using padolcure and patients must be carefully monitored.

Storage

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

To be out of reach of children.

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