PMS-MexCLD Plus Imexpharm tablets relieve pain, reduce fever, do not cause drowsiness (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Acetaminophen, caffeine

Ingredient

Composition information	Content
Acetaminophen	500mg
Caffeine	65mg

Uses

indications

Mexcold Plus drugs are indicated in the following cases:

Treatment of pain symptoms such as headache, toothache, back pain, muscle aches, dysmenorrhea, rheumatism, muscle aches.

Paracetamol is a metabolic substance that has the activity of phenacetin, for analgesic - antipyretic effect. The drug acts on the hypothalamus causing cooling, increasing heat due to vasodilation and increasing peripheral blood flow.

Paracetamol with a low dosage that affects 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 affects cycloxygenase/prostaglandin of the central nervous system. Paracetamol does not work on platelets or bleeding time.

paracetamol reduces body temperature in fever but rarely reduces body temperature in normal people. When overdose is used, the metabolic substance will produce n-acetyl-benzoquinonimin, toxic to liver cells.

caffein

Cafeine is a methylxanthine, giving the central nerve stimulation effect. Caffeine inhibits phosphodiesterase enzyme and has antagonistic effects at the central adenosin receptor. In addition, caffeine can stimulate the respiratory center and give poor diuretic effects.

With a dose of 50 - 100 mg, caffeine is used as a mild central nerve stimulant. In oral painkillers such as aspirin, paracetamol, or codeine, caffeine is often used in combination with a dose of 15 - 65 mg.

Dynamic pharmacokinetics

paracetamol

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

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

Paracetamol is metabolized mostly in the liver and excreted mainly through urine in the form of an associate with glucuronic acid.

Selling time is about 1.25 - 3 hours, may last for toxic doses or patients with liver damage.

caffein

Cafeine is quickly absorbed after drinking and widely distributed throughout the body, including central nerves and saliva. Cafein is breast milk in small amounts.

Cafeine has been metabolized almost entirely in the liver through oxidation, reduction of methyl, acetylation and excretion in urine in the form of 1-methyl uric acid, 1-methylxanthine, 7-methylxanthine, 1.7-dimethylxanthine (paraxanthin), 5-acetylamino-6-likelamino-3-methyluracil (Acrmu), and other, and other. Other metabolites and about 1% in constant form.

In newborns, caffeine is poorly metabolized because the liver enzyme system has not fully developed and is excreted in urine in a constant form. When children are 9 months old, the ability to excrete will grow and similar to adults.

Selling time is about 3-7 hours in adults, 3-4 hours in newborns.

Before taking PMS-MexCLD Plus Imexpharm tablets relieve pain, reduce fever, do not cause drowsiness (10 blisters x 10 tablets)

How to use

take medicine with a full cup of water.

Can be used with food or not.

Dosage

Adults and children aged 12 and older

Take 1 - 2 capsules x 2-3 times/day. Do not drink more than 8 capsules/day.

Do not use drugs that contain paracetamol to treat pain relief for more than 10 days in adults or more than 5 days in children, unless the physician is instructed.

Do not use paracetamol for adults and children to treat high fever by themselves (above 39.5 ° C), fever lasts for more than 3 days or recurrent fever, unless it is indicated by a physician.

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

Symptoms

Nausea, vomiting, abdominal pain, anorexia, methemoglobin - Blood leads to purple blue, mucous and nail. Children tend to create methemoglobin easier than adults after taking paracetamol.

Handling

Need to wash the stomach in any case, preferably within 4 hours after drinking.

Treatment with n-acetylcystein: is the main detoxification measure, must be used immediately within 36 hours and more effectively within 10 hours after taking paracetamol. Give N-acetylcystein oral at the first dose of 140 mg/kg, then give 17 more doses, each dose of 70 mg/kg every 4 hours apart.

Methionine treatment: without n -acetylcystein, methionine can be used and treated for 10 - 12 hours after taking paracetamol. The initial oral dose is 2.5 g, then every 4 hours to drink 2.5 g, drink about 3 times. Treatment depends on plasma paracetamol levels.

can use activated carbon or salt detergent because they have the ability to reduce paracetamol absorption.

caffein

Symptoms

Cafein overdose rarely occurs. Symptoms include: fever, fast breathing, insomnia, restlessness, tachycardia, limb tremor, convulsions.

Handling

Symptomatic treatment and support. Convulsions can be treated by intravenous diazepam or barbiturate intravenously as sodium pentobarbital.

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 MexCLD Plus, you may experience unwanted effects (ADR).

paracetamol

Skin rash and other allergic reactions occur occasionally, usually erythema or urticaria, but sometimes worse and may be accompanied by drugs and mucosal lesions. Patients with susceptibility to rare salicylate sensitive to paracetamol and related drugs. In a few individual cases, paracetamol causes neutropenia, thrombocytopenia and hypoglycemia.

Uncommon: skin rash, nausea, vomiting, headache, insomnia, hematopoiia, anemia, kidney disease, kidney toxicity when abused for a long time.

Rare: Hypersensitivity reactions.

caffeine

The unwanted effects of caffeine include: insomnia, stress, anxiety, irritability, headache, digestive disorders (nausea, vomiting, diarrhea, constipation). Serious side effects rare such as rash, itching or swelling (especially on the face, tongue, throat), dizziness, shortness of breath, angina.

Instructions on how to handle ADR

When encountering 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

MEXCLD Plus drugs contraindicated in the following cases:

Hypersensitivity to paracetamol, caffeine or any ingredients of the drug.

Patients with anemia many times.

heart disease, lung disease, liver failure, renal failure.

Patients with glucose-6-phosphate dehydrogenase deficiency.

Children under 12 years old.

Be cautious when used

Sometimes skin reactions include lumpy, itching and urticaria; Other hypersensitivity reactions include laryngeal edema, angioedema and anaphylactic reactions that rarely occur. Neutral leukemia and thrombocytopenic hemorrhage occurred when using Paracetamol -containing drugs. Rarely loss of granulocytes in Paracetamol users.

Be cautious in patients with anemia before because purple blue may not manifest, although there are dangerous high concentrations of methemoglobin in the blood.

Avoid drinking alcohol during treatment with Paracetamol -containing drugs due to the risk of liver toxicity.

Use carefully with people with impaired liver or kidney function.

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

The ability to drive and operate machinery

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

During pregnancy

Currently, there has been no unwanted effect in pregnant women when using paracetamol. However, caffeine can cross the placenta and cause abnormalities for the embryo when used in very high doses.

It is necessary to have a doctor's guidance when using Mexcold Plus for pregnant women.

The period of breastfeeding

Research in the mother using paracetamol, not seeing unwanted effects in children. Caution should be used because caffeine can diffuse into breast milk but there is no acknowledgment of abnormal effects for breastfeeding.

Drug interaction

Long -term oral high doses of paracetamol increases the anticoagulant effect of COMAARIN and indandion derivatives. This effect seems to be little or not important in clinical.

Need to pay attention to the likelihood of serious antipyretics in patients with phenothiazine and cooling therapy.

Out of alcohol too much and long may increase the risk of paracetamol toxic to the liver.

Anti -seizure drugs (phenytoin, barbiturat, carbamazepine): Causes the enzyme induction in the liver microsom, increases paracetamol conversion into toxic substances to the liver.

Coordination with Isoniazid also causes increased liver toxicity.

fluvoxamine, ciprofloxacin, enoxacin, pipemidic acid increase the sale time and reduce the clearance of caffeine.

Phenytoin increases the average clearance and reduces the selling time of caffeine in epilepsy patients, causing increased caffeine concentration in plasma.

Oral contraceptives reduce the metabolism of caffeine, thus reducing the clearance and increasing the selling time of caffeine.

Avoid using the drug simultaneously with foods and drinks containing caffeine due to increasing the side effects of caffeine.

Storage

Store less than 30 ° C, avoid moisture and light.

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