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- Pharmacology For Paracetamol + Diclofenac Sodium + Famotidine
Paracetamol + Diclofenac Sodium + Famotidine Pharmacology
Paracetamol + Diclofenac Sodium + Famotidine
About Paracetamol + Diclofenac Sodium + FamotidineN/AMechanism of Action of Paracetamol + Diclofenac Sodium + FamotidineDiclofenac is a NSAID (NSAID). Paracetamol is an analgesic and antipyretic. When used together, the actions of paracetamol set in earlier and provides pain relief before the effects of diclofenac Na set in.Famotidine is added to reduce gastric irritation.
Pharmacokinets of Paracetamol + Diclofenac Sodium + FamotidineN/AOnset of Action for Paracetamol + Diclofenac Sodium + FamotidineN/ADuration of Action for Paracetamol + Diclofenac Sodium + FamotidineN/AHalf Life of Paracetamol + Diclofenac Sodium + FamotidineN/ASide Effects of Paracetamol + Diclofenac Sodium + Famotidine1.GI disturbances
2.Nephrotic syndrome
3.Epigastric pain
4.Nausea
5.Vomiting
6.Diarrhea
7.Hepatitis
8.Rash
9.Pruritus
10.Wheezing
11.Bronchospasm
12.Prolonged bleeding time
13.Dangerous: Bleeding or perforation through peptic ulcer, rarely blood dyscrasia or anaphylaxis, acute renal failure.
Contra-indications of Paracetamol + Diclofenac Sodium + Famotidine1.Hypersensitivity
2.Active peptic ulcer or GI bleeding
3.History of allergic responses to aspirin or other nsaids
4.Acute porphyria
Special Precautions while taking Paracetamol + Diclofenac Sodium + Famotidine1.Analgesic nephropathy
2.Renal or hepatic impairment
3.Hypertension
4.Cardiac failure
5.Bronchospasm
6.Patients taking diuretics
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Paracetamol + Diclofenac Sodium + FamotidinePain and inflammation associated with musculoskeletal and joint disorders.Interactions for Paracetamol + Diclofenac Sodium + FamotidineN/ATypical Dosage for Paracetamol + Diclofenac Sodium + FamotidineN/ASchedule of Paracetamol + Diclofenac Sodium + FamotidineN/AStorage Requirements for Paracetamol + Diclofenac Sodium + FamotidineN/AEffects of Missed Dosage of Paracetamol + Diclofenac Sodium + FamotidineN/AEffects of Overdose of Paracetamol + Diclofenac Sodium + FamotidineN/AParacetamol
About ParacetamolAcetanilide derivative, Non narcotic Analgesic,Antipyretic.Mechanism of Action of ParacetamolParacetamol has analgesic and antipyretic action.
It is more active on cyclo-oxygenase enzyme in brain. Peripherally it is a poor inhibitor of prostaglandin synthesis.
Analgesic action: Paracetamol raises the pain threshold and produces analgesic effect.
Antipyretic action: Paracetamol lowers fever by direct action on the thermoregulatory centre in the Hypothalamus and block the effects of endogenous pyrogen.
Pharmacokinets of ParacetamolAbsorption: Paracetamol is rapidly and completely absorbed after oral administration.
Distribution: It is distributed mostly in the body in unbound form.
Metabolism: It is extensively metabolised in the liver.
Excretion: Excreted in the urine.
Onset of Action for Paracetamol30 - 60 minutesDuration of Action for Paracetamol6 hoursHalf Life of Paracetamol1-4 hoursSide Effects of Paracetamol1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash
Contra-indications of Paracetamol1. Hypersensitivity to ParacetamolSpecial Precautions while taking Paracetamol1. Hepatic impairment
2. Renal impairment
3. Hypertension
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES : Contraindicated
Indications for Paracetamol1. To relieve pain and fever
2. Acute gout
3. Migraine
Interactions for ParacetamolCholestyramine: Reduces absorption of paracetamol.
Charcoal: Activated, administered immediately reduces absorption of paracetamol.
Domperidone and metochlopramide: Enhance absorption of paracetamol.
Alcohol: Chronic excessive ingestion of alcohol potentiates hepatotoxicity of paracetamol.
Zidovudine: Effects zidovudine may be decreased.Typical Dosage for ParacetamolAdult:
500 - 1000 mg in 3 times daily
Maximum dose: 4 g / day
For migraine: 500 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
60 mg / kg body weight /day in 4 divided doses.
Schedule of ParacetamolHStorage Requirements for ParacetamolStore at 15-30 degree C in a tightly closed container. Protect from heat and moisture. Keep out of the reach of children.Effects of Missed Dosage of ParacetamolTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of ParacetamolGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. N-acetylcysteine is the specific antidote for Paracetamol poisoning. Dose: 150 mg /kg body weight as IV infusion over 15 minutes followed by same dose over 20 hours.
Maintenance dose: 75 mg / kg orally every 4 - 6 hours for 2 - 3 days. Haemodialysis can be done in emergency conditions.
Diclofenac Sodium
About Diclofenac SodiumN/AMechanism of Action of Diclofenac SodiumDiclofenac possess analgesic, anti-inflammatory and antipyretic action. It inhibits the enzyme cyclo-oxygenase and there by inhibits the synthesis of Prostaglandins (PGs). It is more potent against cyclo-oxygenase-2 enzyme as compared to other NSAIDs like Indomethacin, Naproxen etc. It reduces intracellular concentrations of free arachidonic acid in leukocyte by altering its release or uptake. .Pharmacokinets of Diclofenac SodiumAbsorption: Diclofenac sodium is rapidly absorbed after oral administration. It undergoes first pass metabolism and its bioavailability is 50 % only. Distribution: It is distributed in highly protein bound form. Metabolism: Diclofenac sodium is metabolised in the liver. Excretion: Drug and metabolites are primarily excreted in urine and some amount in the bile.Onset of Action for Diclofenac Sodium1- 4.5 hoursDuration of Action for Diclofenac SodiumHoursHalf Life of Diclofenac Sodium2 hoursSide Effects of Diclofenac Sodium1.Nausea
2.Vomiting
3.Anorexia
4.Diarrhoea
5.Gastrointestinal bleeding
6.Abdominal distress
7.Constipation
8.Flatulence
9.Ulceration of the stomach or intestine
10.Dyspepsia
11.Headache
12.Dizziness
13. Rash
Contra-indications of Diclofenac Sodium1.Hypersensitivity to Indomethacin and other Non steroidal anti inflammatory drugs(NSAID)
2.Peptic ulcer
3.Asthma
Special Precautions while taking Diclofenac Sodium1.Hepatic impairment
2.Renal impairment
3.Hypertension
4.Blood clotting disorders
5.Gastrointestinal diseases
6.Proctitis
7.Asthma
8.Cautioned against driving, operating or activities requiring concentration
9.Avoid alcohol
10.Heart failure
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with caution
CHILDREN below 14: contraindicatedIndications for Diclofenac Sodium1.Ankylosing spondylitis
2.Acute gout
3.Joint disorders e.g. inflammatory disease in joints, crystal deposition in the joints
4.Osteoarthritis
5.For the relief of pain and inflammation in dental minor surgery and orthopedic
6.Dysmenorrhoea
7.Juvenile chronic arthritis
8.Migraine
Interactions for Diclofenac SodiumLithium & Digoxin : Blood levels of lithium and digoxin increased leading to enhanced efficacy and posible toxicity.
Diuretics : Inhibits diuretics but efficacy of potassium sparing diuretics enhanced.
Methotrexate : Toxicity enhanced.
Salicylates : Efficacy of salicylates reduced.
Cyclosporine : Increases nephrotoxicity of both agents.
Hydantoins : Increases serum levels resulting in toxicity.
Typical Dosage for Diclofenac SodiumAdult: 100 - 150 mg / day in 2 - 3 divided doses.
For the relief of pain, Migraine, Dysmenorrhoea: 150 mg / day in 3 divided doses.
Osteoarthritis: 50 mg 2 - 3 times daily
Rheumatoid arthritis: 150 - 200 mg / day in 3 - 4 divided doses.
Ankylosing spondylitis: 25 mg 4 times daily give an extra dose of 25 mg at bed time if necessary.
Children Juvenile rheumatoid arthritis: 0.5 - 2 mg / kg body weight / day in divided doses.
Maximum dose: 3 mg / kg body weight / day in divided doses
Schedule of Diclofenac SodiumHStorage Requirements for Diclofenac SodiumStore Diclofenac sodium at room temperature in a tightly closed light resistant container.Effects of Missed Dosage of Diclofenac SodiumTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of Diclofenac SodiumGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal.Famotidine
About FamotidineGuanidine:Thiazole derivative,a histamine H2-receptor antagonist, Anti-secretory,Antiulcer.Mechanism of Action of FamotidineFamotidine is a H2 (Histamine) receptor antagonist. Histamine is the most potent stimulus of acid secretion and acts as the common mediator. H2 receptor is a G-protein coupled receptor. It induces adenylate cyclase which converts ATP to cyclic AMP. This cyclic AMP acts on proton pump and exchange extracellular potassium ion for intracellular hydrogen ion across the parietal cell membrane. Famotidine reversibly competes with Histamine for binding to H2 receptors on the parietal cells and predominantly inhibits basal acid secretion.
Anaesthetic adjuncts: It is used in patients undergoing prolonged operations, caesarian section; obese patients are at increased risk of gastric regurgitation and aspiration pneumonia. It raises pH of gastric juice and also reduces its volume and thus chances of regurgitation. It is now routinely used before prolonged surgery.
Pharmacokinets of FamotidineAbsorption: Famotidine is 40 - 45 % absorbed after oral administration. Distribution: Distributed mainly in unbound form. Metabolism: Famotidine undergoes metabolism in the liver. Excretion: It is excreted mainly in urine and in the faeces.Onset of Action for Famotidine60 minutesDuration of Action for Famotidine2.5-3.5 hoursHalf Life of Famotidine2.5 - 3.5 hoursSide Effects of Famotidine1.Headache
2.Dizziness
3.Constipation
4.Diarrhoea
5.Nausea
6.Vertigo
7.Confusion
8.Rash
9.Thrombocytopenia
10.Leukopenia
Contra-indications of Famotidine1. Hypersensitivity to FamotidineSpecial Precautions while taking Famotidine1.Hepatic impairment
2.Renal impairment
3.Acute Porphyria
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationUse with caution.Children Related InformationUse with caution.
NEONATES: contraindicatedIndications for Famotidine1.Duodenal ulcer
2.Benign gastric ulcer
3.Zollinger- Ellison syndrome
4.Gastroesophageal reflux diseases
5.Acid indigestion
6.Heart burn
7.Sour stomach
8.Preanaesthetic medication (PAM)
Interactions for FamotidineAntacids: Bioavailability of Famotidine slightly decreased, hence antacids in small doses can be given concomitantly.Typical Dosage for FamotidineAdult: 40mg / day
Duodenal ulcer, benign gastric ulcer: 40 mg /day as single dose at bed time or in 2 divided dose (morning and bed time) for 1 - 2 months. Maintenance dose: 20 mg / day at bed time.
Zollinger- Ellison syndrome: 80mg / day in 4 divided doses; dose can be increased if necessary to a maximum up to 800 mg / day
Gastroesophageal reflux disease: 40 mg / day as single dose at bed time or in 2 divided doses (morning and bed time) for maximum 2-3 months, dose can be increased to 80 mg / day in 2 divided doses if needed.
Acid indigestion, Heart burn, Sour stomach: Dose: 20mg/day in 2 divided doses.
PAM: 20mg given night before and in the morning before surgical procedure.
Schedule of FamotidineHStorage Requirements for FamotidineStore at 15 - 30 degree C in a tightly closed container. Protect from light.Effects of Missed Dosage of FamotidineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of FamotidineGive supportive measures and symptomatic treatment. Drug can be removed from the body by inducing emesis and or by gastric lavage. Activated charcoal is given to reduce the absorption of the drug. Haemodialysis can be done if necessary.Home Delivery for Paracetamol + Diclofenac Sodium + Famotidine in Your City
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Paracetamol + Diclofenac Sodium + Famotidine is a generic medicine name and there are several brands available for it. Some of the brands for paracetamol + diclofenac sodium + famotidine might be better known than paracetamol + diclofenac sodium + famotidine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have paracetamol + diclofenac sodium + famotidine in stock, you can ask for one of the branded alternatives for paracetamol + diclofenac sodium + famotidine.
