Tydol Plus 500/65mg OPV medicine relieves and reduces fever (10 blisters x 10 tablets)

Dosage form Film bag tablets
Specifications Box of 10 blisters x 10 tablets
Ingredient Acetaminophen, caffeine
Indication Sinusitis, fever, dysmenorrhea, cold, headache, migraine, body aches
Contraindication Anemia

Ingredient

Composition information	Content
Acetaminophen	500mg
Caffeine	65mg

Uses

Indications

Tydol Plus 565 mg drug is indicated in the following cases:

Mild analgesic in the following cases:

headache, toothache, muscle aches, sinusitis.

Pain of rheumatism.

Dysmenorrhea.

Cold usual.

A reduction of fever.

Pharmacy

Pharmacological group: pain relief, fever.

ATC code: N02be51.

Acetaminophen is a substance that is active in phenacetin.

Pain relief

Mechanism of pain relief effect of acetaminophen has not been fully determined.

Acetaminophen mainly acts mainly by inhibiting prostaglandin synthesis in the central nervous system and to a lower level by preventing painful impulses through peripheral effects.

Peripheral effects may also be due to prostaglandin synthesis inhibitors or synthesis inhibitors or inhibition of active active substances in mechanical or chemical pain receptors.

A reduction of fever

The drug has an antipyretic effect by inhibiting the central regional thermal area.

Acetaminophen is an analgesic - antipyretic that can replace aspirin, but acetaminophen does not work to treat inflammation.

At the same dose, acetaminophen has the same fever -reducing pain effect as aspirin.

Acetaminophen reduces body temperature in fever but rarely reduces body temperature in normal people.

acetaminophen, with treatment, less impact on the cardiovascular and respiratory system, does not replace base, does not cause irritation, scratches or stomach bleeding as when using salicylate.

When overdose of acetaminophen, n-acetyl-P-benzoquinonimin metabolites cause heavy toxicity to the liver.

Cafeine is a Xanthin derivative extracted from coffee, cocoa or synthesized from uric acid. Cafeine has the effect of increasing analgesic effect of acetaminophen.

pharmacokinetic pharmacokinetics

acetaminophen

Acetaminophen is absorbed quickly and almost completely through the gastrointestinal tract.

Carbon hydrate -rich foods reduce acetaminophen's absorption rate. The peak concentration of plasma is within 30 to 60 minutes after drinking with the dose of treatment.

Acetaminophen is distributed quickly and evenly in most body tissues. About 25% acetaminophen in the blood combined with plasma proteins. The semi -discharged time in the plasma of acetaminophen is 1.25 - 3 hours, can last.

With 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%); also detected a small amount of hydroxyl metabolites - chemicals and reducing acetyl.

Children are less likely to glucuronic in line with drugs than adults. Acetaminophen is n-hydroxylation by cytochrom P450 to create N-acetyl-Benzoquinonimin (NAPQ), a highly reactive intermediate.

This metabolic substance normally reacts with sulfhydryl groups in glutathion and is dedicated.

However, if taking high doses of acetaminophen, this metabolic is formed in sufficient amount to exhaust the glutathion of the liver; In that situation, NAPQ is not connected with glutathion toxic to liver cells, leading to inflammation and can lead to liver necrosis.

caffein

Cafeine is easily absorbed after drinking and is widely distributed throughout the body. Caffeine easily through central nervous system and saliva; Low concentration in breast milk. Caffeine through the placenta.

In adults, caffeine is metabolized almost entirely in the liver through oxidation, demethylation, acetylation and excreted in urine in the form of 1-methyluric acid, 1-methylxanthin, 7-methylxanthin, 1.7 dimethylxanthin (paraxanthin), 5-acetylamino-6-formylamino-3-methyluriciluriciluriciluriciluriciluriciluriclamino-3-methyluriciluricilamino-3-methyluriclamino. (Akmu) and other metabolites, only about 1% of constant form.

Cafe is metabolized in the liver thanks to isenzyme cytochrom P450 CYP1A2. The sale time is about 3-7 hours in adults but about 3-4 days of babies.

Before taking Tydol Plus 500/65mg OPV medicine relieves and reduces fever (10 blisters x 10 tablets)

How to use

Tydol Plus 565 mg is used orally.

Dosage

Adults and children over 12 years: Take 1-2 tablets every 6 hours when the symptoms are prolonged. Do not use more than 8 tablets/24 hours or according to the doctor's instructions.

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

Nausea, vomiting, and abdominal pain usually occur within 2-3 hours after taking the poison of the drug.

Blood methemoglobin, leading to skin purple, mucosal 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 acetaminophen.

When severe poisoning, it may initially stimulate the central nervous system, agitation and delusion.

Next can be inhibiting the central nervous system: stunned, 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 death suddenly or after a few days of coma.

Clinical signs of liver lesions become clearly within 2 to 4 days after taking toxic doses.

Aminotransferase plasma increases (sometimes very high) and plasma bilirubin levels may also increase. In addition, when the liver lesions spread, prothrombin time will last. Maybe 10% of patients with untreated poisoning have serious damage among them 10% to 20% last death from liver failure.

Acute renal failure also occurs in some patients. Liver biopsy detects thoracic central necrosis except the area around the portal vein.

In cases of non -death, liver lesions recover after weeks or months.

Handling

Early diagnosis is very important in the treatment of overdose acetaminophen.

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-acetylcysteine works when taken or intravenously. It must be used to detoxify immediately, as soon as possible if less than 36 hours from taking acetaminophen. Treatment with n-acetylcysteine is more effective when giving the drug for less than 10 hours after taking acetaminophen.

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 with 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 acetaminophen test in plasma shows the risk of low liver toxicity.

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.

Also can use activated carbon and/or salt bleach because they have the ability to reduce acetaminophen absorption.

caffein

Symptoms

Stomach pain - intestines, mild paranoia, insomnia, urination, dehydration, fever.

The more serious symptoms of caffeine overdose include arrhythmia, spastic seizures.

Handling

Cafe overdose is mainly symptomatic and supportive treatment.

In the overdose of acute oral caffeine, it must be done in the stomach immediately by causing vomiting or gastric lavage, can drink activated carbon and supportive measures that need to be started.

Taking soothing drugs like aluminum Hydroxyd gel can reduce digestion. Treatment of epilepsy by intravenous diazepam or barbiturat as sodium pentobarbital.

What to do when forgetting 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 drink twice as prescribed.

Side Effects

When using Tydol Plus 565 mg, you may experience unwanted effects (ADR).

Serious skin reactions such as Steven-Johnson syndrome, Lyell syndrome, poisoned epidermal necrotic, acne-based erythema pustules rarely occur, but likely to cause death. If the ban or other skin manifestations are found, the medication must be stopped and examined.

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, you should think of Steven-Johnson syndrome, to stop the drug immediately.

Acetaminophen overdose can lead to severe liver damage and sometimes acute renal necrosis. Patients with susceptibility to salicylate rarely hypersensitivity to acetaminophen and related drugs. In a few individual cases, acetaminophen has caused neutropenia, thrombocytopenia and hypoglycemia.

Central nerve: agitation, dizziness.

Uncommon, 1/1000

DA: Ban.

Stomach - intestines: Nausea, vomiting.

Hematology: Hemorrhagic disorders (neutropenia, all bloody hemocyst, leukopenia), anemia.

Kidney: Kidney disease, kidney toxicity when abused for a long time.

Rare, ADR

Skin: Steven-Johnson syndrome, poisoned epidermal necrosis, Lyell syndrome, acute foreign body pustules.

Other: Hypersensitivity reaction.

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

Tydol Plus 565 mg is contraindicated in the following cases:

Patients with hypersensitivity to any ingredients of the drug.

Patients with severe liver failure.

Patients with glucose-6-phosphate dehydrogenase deficiency.

Children under 12 years old.

Precautions when using

Caution and special warning when using drugs containing active ingredients Acetaminophen: The doctor needs to warn the patient about the signs of serious skin reactions, which are likely to cause death including Steven-Johnson syndrome, toxic epidermal necrosis (Ten), Lyell syndrome, acne syndrome (AGEP).

Patients need to stop taking acetaminophen and see a doctor as soon as they see rash or other manifestations in the skin or sensitive reactions during treatment. Patients with a history of such reactions should not use acetaminophen -containing preparations.

Sometimes there are skin reactions including itchy and urticaria, other sensitive reactions including larynx edema, angioedema and anti -segment 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 acetaminophen. Rarely loss of granulocytes in patients using acetaminophen.

Using many preparations containing acetaminophen and can lead to harmful consequences (such as overdose acetaminophen).

Be cautious when using acetaminophen for patients with anemia before, liver failure, kidney failure, alcoholic, chronic malnutrition or dehydration. Avoid high doses, prolonged use for people with liver failure.

Drinking plenty of alcohol can cause toxicity to the liver of acetaminophen, should avoid or limit drinking.

Avoid drinking more caffeine (coffee, tea) while taking the drug.

This drug contains:

Lactose: Patients with rare genetic problems are galactose intolerance, Lactose Lapp deficiency or Glucose-Galactose poor absorption should not be taken.

ponaceau 4r lake, can cause allergic reactions.

The ability to drive and operate machinery

Because dizziness may occur, it is cautious in activities such as driving, operating machinery, working on high and other cases.

Pregnancy

Acetaminophen-Cafein is not recommended for use during pregnancy due to an increase in the risk of low child weight and natural miscarriage related to caffeine. Therefore, this drug should not be used for pregnant women.

Breastfeeding period

caffein in breast milk is likely to stimulate infant breastfeeding. Therefore, this drug should not be used for breastfeeding women.

Drug interaction

Acetaminophen's absorption speed may be increased by metoclopramid or domperidon and absorbing decreased by Colestyramin.

Long -doses of high -dose acetaminophen increases the anticoagulant effects of cooumarin and conducting indandion.

It is necessary to pay attention to the possibility of serious heat lowering in patients using simultaneously phenothiazine and cooling therapy (such as acetaminophen).

Drinking too much alcohol and long -term increases the risk of acetaminophen's liver toxicity.

Anti -seizure drugs (including Phenytoin, Barbiturat, Carbamazepin), Isoniazid, anti -tuberculosis drugs that can increase the toxicity of acetaminophen on the liver.

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

Cafeine has the ability to interact with drugs metabolized by CYP1A2 (such as clozapin) or with this induction or inhibition drugs.

Storage

At temperatures below 30 ° C, in a dry place, avoiding light.

Expiry date: 36 months from the date of manufacture. Do not use overdue drugs stated on the packaging.

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