Pyrexin Extra

Pyrexin Extra

tramadol + paracetamol




Full Prescribing Info
Paracetamol 325 mg, tramadol HCl 37.5 mg.
Tramadol is a synthetic opioid analgesic that works in the center. Even though a work cannot be agreed upon, exposure to animals, more than two who are mutually arrogant if they arise and apply; complex bonds and metabolism II on p-opioid receptors and inhibition of weak norepinephrine and serotonin reuptake. Opioid activity results from both low affinity binding of the parent composition and higher affinity for the metabolism of O-demethylation of MI against the p-Opioid receptor. Tramadol has been shown to inhibit in-vitro norepinephrine and serotonin reuptake, such as only a few other opioid analgesics. This mechanism can contribute freely to the overall profile of tramadol analgesics. In addition to the analgesia effect, use of tramadol can produce symptoms of the constellation (including dizziness, drowsiness, nausea, constipation, sweating, and pruritus same as the effects of other opioids.
Short-time therapy for acute pain.
Dosage/Direction for Use
Adults and children over 16 years: Maximum single dose: 1 to 2 tablets every 4 to 6 hours, as needed for pain relief for up to 8 tablets daily, or as prescribed by the physician.
The clinical presentation of overdose may include tramadol toxicity signs and symptoms, paracetamol toxicity or both. Early symptoms seen in the first 24 hours, after paracetamol overdose: anorexia, nausea, vomiting, malaise, pallor and diaphoresis.
Tramadol: Potential and serious consequences of overdose of paracetamol components are respiratory depression, lethargy, coma, convulsions, cardiac arrest, and death.
Paracetamol: Severe cases of paracetamol overdoses may lead to liver toxicity in some patients. The initial symptoms after a potential overdose can result in hepatotoxic can include: gastrointestinal irritation, anorexia, nausea, vomiting, malaise, pallor and diaphoresis. Clinical and laboratory evidence of liver toxicity may not be apparent until 48-72 hours after ingestion.
Treatment: Maintain adequate ventilation together with supportive therapy. Steps must be taken to reduce drug absorption. Vomiting must be induced mechanically or with Ipecac syrup, if the patient is conscious (adequate pharyngeal and pharyngeal reflexes). Activated charcoal is given orally (1 g / kg should be carried out after gastric emptying). The first dose should be accompanied by appropriate catharsis. If repeated doses are used, catharsis may be included with alternative doses as needed. Hypotension is usually caused by hypovolemic conditions and must be treated with fluids Vasopressor and other supportive measures must be used as indicated: The endotracheal tube with a balloon must be inserted before gastric rinse in patients who are unconscious and if needed, to provide relief breathing.
In adult and child patients, every individual who comes with swallowed paracetamol whose number is unknown or with a history that is unclear or unpredictable about when it occurs should be sought for plasma paracetamol levels determined and treated with acetylcysteine.
If a measurement cannot be obtained and it is estimated that paracetamol consumption exceeds 7.5-10 gr for adults and adolescents or 150 mg / kg for children, then the administration of N-acetylcysteine should be initiated then continue with overall therapy.
Special Precautions
Risk of seizure (in co-administration with SSRI and TCA or others opioid). Tramadol usage may increase the risk of seizure in patients who also take therapy with MAO inhibitor, serotonin and reuptake inhibitor, neuroleptic and other drug that reduce the threshold of seizures.
Anaphylactoid reaction and respiratory depression. Increase intracranial pressure or head injury. Alcohol. Patients with hepatic impairment. Taken with another medicine contains paracetamol may increase the potential of toxicity. Withdrawal syndrome (discontinue this product gradually). Pregnancy & lactation. Elders.
Adverse Reactions
The most commonly reported events are nausea, dizziness, and drowsiness; asthenia, fatigue, blushing; CNS & PNS disorder (headache, tremor); GI disorder; Psychiatric disorders; pruritus, rash, excessive sweating; mental disorder; anemia; dyspnea; albuminuria, urinary disorders, oliguria, urinary retention; vision disorder. Withdrawal syndrome.
Drug Interactions
Use with MOA inhibitors and Serotonin Reuptake Inhibitors.
Carbamazepine: Concomitant use with carbamazepine may cause a significant increase in tramadol metabolism.
Quinidine: Concomitant use with quinidine with tramadol results in an increase in the concentration of tramadol.
Substances that similar to warfarin: close examination of prothrombin time must be carried out in co-administration with warfarin-like compounds, because there are reports of an increase in INR in some patients.
Inhibitor CYP2D6: In vitro studies shows that concomitant use with CYP2D6 inhibitors such as fluoxetine, paroxetine and amitriptyline may cause inhibition in tramadol metabolism.
Store in the temperature 30°C or below. Protected from the sunlight.
MIMS Class
Analgesics (Opioid)
ATC Classification
N02AJ13 - tramadol and paracetamol ; Belongs to the class of opioids in combination with other non-opioid analgesics. Used to relieve pain.
FC caplet 3 x 10's.
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