Savimetoc medicine reduces muscle spasms (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Paracetamol, methocarbamol

Ingredient

Thành phần cho 1 viên

Composition information	Content
Paracetamol	325mg
Methocarbamol	400mg

Uses

indications

Savimetoc medicine helps relieve pain related to muscle spasms such as back pain, neck spasticity, dislocated or sprain.

Pharmacology

Pharmacological group: painkillers, muscle relaxation

ATC: N02be51

The effect of the drug is based on a combination of methocarbamol muscle relaxation effects and paracetamol fever -reducing pain. Savimetoc increases the threshold of pain, increases blood flow through the skin, reduces body temperature, increases the sweat.

methocarbamol

Methocarbamol is used in the treatment of acute muscle muscle disorders related to muscle spasms.

The mechanism of action of methocarbamol in humans is not well known, but it may be due to inhibition of the central nervous system. Methocarbamol does not have a direct impact on muscle spasms, motor panels or nerve fibers.

paracetamol

Paracetamol (acetaminophen or N-acetyl-P-P-Aminophenol) is a substance that is the activity of phenacetin, an effective analgesic-antipyretic drug that can replace aspirin; However, unlike aspirin, paracetamol is not effective in treating inflammation. With the equal dose of the province, Paracetamol has analgesic and antipyretic effects similar to Aspirin.

paracetamol reduces the body temperature in fever, but rarely reduces the body temperature in normal people. The drug acts on the hypothalamus causing cooling, increasing heat due to vasodilation and increasing peripheral blood flow.

paracetamol, with treatment dose, less impact on the cardiovascular and respiratory system, does not change acid -base balance, does not cause irritation, scratches or stomach bleeding as when using salicylate. The effect of paracetamol on cyclooxygenase activity is not fully known.

paracetamol does not work on platelets or bleeding time.

pharmacokinetics

methocarbamol

Absorb

Methocarbamol is absorbed quickly and completely through the digestive tract. Peak concentration in plasma is achieved after about 1-3 hours.

Distribution

It is unknown whether methocarbamol will be secreted into breast milk.

Metabolism and elimination

Half lifetime elimination of methocarbamol is about 2 hours.

methocarbamol and its two main metabolites are associated with glucuronic and sulfuric acid and are almost completely eliminated through the kidneys. About 50% of the dose after oral discharge through the urine, only a small part of excretion in the form of unchanged.

paracetamol

Absorb

Paracetamol is absorbed quickly and almost entirely through the gastrointestinal tract. Carbon hydrate -rich foods reduce the absorption rate of paracetamol. The peak concentration of plasma is within 30 - 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 protein.

Metabolism

Paracetamol metabolizes mainly through the Sulfate and Glucuronid complex reaction. A small amount converts into toxic metabolites, N-acetyl-P-Benzoquinonimin (NAPQI). Napqi is detoxified by glutathion and eliminated into urine and/or bile. When metabolites are not connected to glutathion, it will be toxic to liver cells and cause cell necrosis. Paracetamol is safe for treatment, because the amount of Napqi is formed relatively low and glutathion formed in liver cells that are sufficiently associated with NAPQI.

Elimination

The half -life of paracetamol excretion 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 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 hydroxylation and reduction of acetyl metabolites are detected. Children are less likely to glucuro than drugs than adults.

paracetamol is n-hydroxylated by cytochrom paso 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 this situation, its reaction to the sulfhydryl group of liver protein increases, which can lead to liver necrosis.

pharmacokinetics of special cases

kidney failure

In patients with dialysis, the clearance of methocarbamol is reduced by more than 40% compared to normal people; Meanwhile, half -life excreted not much changed compared to normal people.

Hepatic failure

In patients with alcoholic cirrhosis, the average total clearance of methocarbamol decreases about 70% compared to normal people, half -life except for about 3.4 hours. About 40% - 45% methocarbamol attached to plasma proteins; Meanwhile, in normal people of the same age and weight, this ratio is 46% - 50%.

Before taking Savimetoc medicine reduces muscle spasms (3 blisters x 10 tablets)

How to use

oral Savimetoc.

Dosage

The drug must be used as directed by the doctor. Use the minimum doses effectively.

Adults and children 12 years of age:

Take 2 capsules/time, every 6 hours. Do not use more than 8 tablets/day.

Children under 12 years:

Do not use Savimetoc for children under 12 years old.
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 can take a single dose, or due to a large dose of paracetamol (e.g. 7.5 - 10 g per day, for 1-2 days), or for long -term medication. Liver necrosis depends on the dose is the most serious toxic effect due to overdose and can be fatal.

Nausea, vomiting and abdominal pain usually occur within 2-3 hours after taking the poison of the drug. Blood methemoglobin, leading to purple blue, mucosa and nails are a characteristic sign of 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, initially stimulates the central nervous system, agitated and delirious. Next can be inhibiting the central nervous system: dumbfounded, lower body temperature, tired, fast breathing, shallow; Fast, weak, irregular, 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 days 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 lesions spread, the long prothrombin time. 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.

Handling

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. Need to wash the stomach 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-acetylcystein works when taken or intravenously. It must be used to detoxify immediately, as soon as possible if less than 36 hours after taking paracetamol. Treatment with n-acetylcysteine 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-acetylcystein oral at the first dose of 140 mg/kg, then give 17 more doses, with each dose of 70 mg/kg every 4 hours apart.

Termination of treatment if the paracetamol test in plasma shows a low risk of liver toxicity. N-acetylcysteine can also be used by intravenous lines: initial dose is 150mg/kg, dilute 200 ml of 5%glucose, intravenous injection for 15 minutes; Then intravenously dose of 50 mg/kg in 500 ml of 5% glucose for 4 hours; Next is 100 mg/kg in 1 liter of solution within the next 16 hours.

Without 5% glucose solution, 0.9% sodium chloride solution may be used.

The unwanted effect of N-acetylcystein includes skin rash (including urticaria, no need to stop the drug), nausea, vomiting, diarrhea, and anaphylactic reaction.

Without n-acetylcystein, methionine can be used.

If you have used activated carbon before using methionin, you must suck your active carbon from the stomach first. Also can use activated carbon and/or salt bleach, they have the ability to reduce the absorption of paracetamol.

related to methocarbamol

Data related to methocarbamol overdose in humans is limited.

Symptoms

Methocarbamol overdose can cause nausea, drowsiness, blurred vision, hypotension, epilepsy and coma, unconscious. Methocarbamol overdose often occurs when patients drink alcohol or central nervous system inhibitors while being treated with methocarbamol. One survived after intentionally taking 22 - 30 g methocarbamol without any serious toxicity, another person survived after taking the dose of 30-50 g. The most typical symptom of both cases is extremely sleepy.

However, there have been cases of death from methocarbamol overdose.

Handling

Methocarbamol overdose treatment includes symptomatic and supportive treatment. Support measures include keeping airway ventilation, monitoring urine and signs of life, infusion when needed. It is unknown the benefits of dialysis in methocarbamol overdose.

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

Stop medication and see a doctor or the nearest medical facility immediately if allergic reactions appear such as wheezing, rash and itching.

The unwanted effects are divided by the frequency of the following: very common ≥1/10), common (≥1/100 to

related to paracetamol

Serious skin reactions such as Stevens-Johnson syndrome, Lyell syndrome, poisoned epidermal necrosis, acne-based erythema acne, but rarely occur, but likely to cause death. If the skin rash appears or other skin manifestations, the medication must be stopped.

Skin rash and other allergic reactions occur. Usually erythema or urticaria, but sometimes worse and may be accompanied by fever due to drugs and mucosal lesions. If you see fever, bullies around the natural cavities, should think of Stevens-Johnson syndrome. Paracetamol overdose can lead to severe liver damage and sometimes acute renal necrosis. Patients with susceptibility to rare salicylate sensitive to paracetamol and related drugs. In a few individual cases, Paracetamol has caused neutropenia, thrombocytopenia and all bloody hematoma.

immune system

Hypersensitivity includes rash.

Unknown frequency: platelets, granulocytes.

Very rare: Steven-Johnson syndrome (SJS), Poisoned skin necrosis syndrome (Ten) or Lyell syndrome, acute all-body pustular syndrome (AGEP).

The most common side effect of methocarbamol is a headache.

general

Rare: headache, fever, nervous edema.

Very rare: nausea, vomiting.

Nervous system

Rare: Dizziness.

Very rare: restlessness, anxiety, confusion, anorexia.

Rare: allergic reactions (urticaria, rash, itching)

Eyes

Rare: Conjunctivitis with nasal congestion.

Blood and lymph: leukopenia.

Cardiovascular: slow rhythm, flushed face, hypotension, fainting.

Systemic: Anaphylaxis.

Digestive: digestive disorders, jaundice (including jaundice).

Nervous system: dizziness, loss of muscle combination, dementia, double look, eyeball, insomnia, convulsions.

Special senses: taste disorders.

Instructions on how to handle ADR:

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

Savimetoc drug contraindicated in the following cases:

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

Be cautious when used

Do not use other drugs that contain paracetamol or methocarbamol. Do not take the dose higher than the recommended dose unless the doctor is specified. Should use the smallest dose effectively. Maximum overdose can cause serious liver damage leading to death.

Stop the medication immediately and notify the doctor if the allergic reactions appear such as wheezing, rash and itching appear; Or if symptoms last more than 5 days or fever lasting more than 3 days.

Notify the doctor if the person is addicted to alcohol, liver or kidney failure, the patient is a pregnant or nursing woman.

Do not use Savimetoc while using Mao inhibitors (monoamine oxidase) or have stopped the Mao inhibitors within the previous 2 weeks.

related to paracetamol

Paracetamol is relatively non -toxic to treatment. Sometimes there are skin reactions including rashes 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.

Be cautious when using paracetamol for people with liver failure, kidney failure, alcoholic, chronic malnutrition or dehydration. Drinking plenty of alcohol can cause toxicity to the liver of paracetamol, should avoid and limit drinking.

Use paracetamol caution in patients with anemia before, because purple blue may not manifest clearly, although there is a dangerous high concentration of methemoglobin in the blood.

Serious side effects on the skin: The doctor needs to warn the patient about the signs of serious skin reactions. Although the incidence is not high but serious, even life-threatening includes Steven-Johnson (SJS) syndrome, toxic skin necrosis syndrome: Toxic Epidermal Necrolysis (Ten) or Lyell syndrome, acute all-body pustular syndrome: Acute Generalized Exanthematous (AGEP).

Stevens-Johnson syndrome (SJS): is a puffiness, puffiness allergy around the natural eye sockets: eyes, nose, mouth, ears, genitals and anus. In addition, it may be accompanied by high fever, pneumonia, liver dysfunction. Diagnosis of Stevens-Johnson syndrome (SJS) when at least 2 natural holes are damaged.

Poisoned skin necrosis syndrome (Ten): is the most severe allergic, including: eye seal lesions (keratitis, blind conjunctivitis, corneal ulcer); Damage to the gastrointestinal tract (stomatitis, mouth mucosa, pharyngitis, esophagus, stomach, intestines); damage to the mucous membranes of genital tract, urinary tract; In addition, there are serious systemic symptoms such as gastrointestinal dengue, pneumonia, glomerulonephritis, hepatitis ... high mortality rate of 15 - 30%.

Excellent pustules syndrome (AGEP): Small sterile pustules arise on the spreading roses. Damage often appears in folds such as armpits, groin and face, then can spread the whole body. Systemic symptoms often have fever, high neutrophils testing.

related to methocarbamol

Be cautious when using methocarbamol in people with liver failure, kidney failure.

methocarbamol can change the color of urine to brown, black, blue or green.

methocarbamol gives a false positive result (may be caused by a metabolic substance) in 5-HIAA test (5-hydroxyindolacetic acid) using nitrosonaphtol reagents (quantitative methods of uDenfriend) and VMA testing (vanillylmandelic acid) in urine methods of Gitlow (quantitative method enjoy).

Methocarbamol can inhibit central neurological inhibitors, so be careful when drinking alcohol and combined with other central neurological inhibitors.

The effect of the drug on driving and operating machinery

Paracetamol does not affect the ability to drive and operate machinery. However, methocarbamol may be stunned and drowsy. Therefore, Savimetoc should not be used when driving and operating machines, especially when drinking alcohol or being used with other drugs that can cause drowsiness.

Use drugs for women during pregnancy and lactation

Pregnant women

Do not use Savimetoc in pregnant women unless the benefits are completely risk.

Related to paracetamol

Human epidemiological studies show that paracetamol does not have a bad effect when using the recommended dose, but patients should not use themselves but must follow the doctor's instructions. A large amount of data on pregnant women shows that paracetamol does not cause deformities, not toxic to the fetus or infant.

Paracetamol can be used during pregnancy if necessary, but the lowest dose should be used in the shortest time and at the lowest frequency possible.

Regarding methocarbamol

Not determined the safety of methocarbamol has not been used during pregnancy related to unwanted effects that may be available to the development of the fetus. There have been abnormal rare reports in the fetus after exposure to methocarbamol. Therefore, methocarbamol should not be used in women who are likely to be pregnant and pregnant women unless the benefits are completely risk.

breastfeeding women

Research in nursing mothers, using paracetamol does not see unwanted effects in breastfed children. However, it is unknown whether methocarbamol is secreted into breast milk or not. Therefore, caution should be used in women who are breastfeeding.

Drug interaction

methocarbamol may interact with the following drugs

Methocarbamol increases the effects of some central nervous inhibitors and stimulants including alcohol, barbiturates, anesthetic and craving inhibitors.

methocarbamol also increases the effects of anti -cholinergic drugs (such as atropine) and psychotropic drugs.

methocarbamol inhibits the effect of pyridostigminbromid. Therefore, it is necessary to be cautious when using methocarbamol in patients with myasthenia gravis that uses cholinesterase inhibiting agents.

paracetamol can interact with the following drugs

Anti -dynamic cooumarin and indandion: long -term drinking of high doses of paracetamol increases the effect of anti -dynamics of COMAARIN and indandion.

Simultaneous use of phenothiazine and cooling therapy with paracetamol: It is necessary to pay attention to the possibility of causing serious heat lowering in patients.

Alcohol: Excessive and long drinking can increase the risk of Paracetamol's liver toxicity.

Anti -convulsions (including Phenytoin, Barbiturat, Carbamazepin - Causing enzyme induction in the liver microsom): can increase the toxicity of the liver toxicity of paracetamol due to increased drug conversion into toxic substances to the liver.

Simultaneous use of isoniazid with paracetamol: can also lead to an increased risk of toxicity to the liver, but has not determined this exact mechanism of interaction.

Probenecid: can reduce paracetamol elimination and increase half -life elimination in the plasma of paracetamol.

Anti -tuberculosis drugs: Increasing the toxicity of paracetamol for the liver.

The absorption rate of paracetamol increases when used simultaneously with metoclopramid or domperidon, the absorption rate of paracetamol decreases when used simultaneously with Colestyramine.

Tyeum of drugs

Due to the absence of studies on the correlation of the drug, not mixing this drug with other drugs.

Storage

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

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.