CYNAC – SP

CYNAC - SP

Aceclofenac is a non-steroidalanti-inflammatory drug (NSAID) analog of Diclofenac. It is used for the relief of pain and inflammation in rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. The dose is 100 mg twice daily.
It should not be given to people with porphyria or breast-feeding mothers, and is not recommended for children.

Mechanism Of Action: Aceclofenac has higher anti-inflammatory action than conventional NSAIDs. It is a cytokine inhibitor. Aceclofenac works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in the production of prostaglandins (chemicals in the body) which cause pain, swelling and inflammation. Aceclofenac is the glycolic acid ester of diclofenac.

Pharmacokinetics of Aceclofenac:
Absorption- It is rapidly and completely absorbed after oral administration
Distribution- Widely distributed in the body as protein-bound form. It is highly protein-bound (>99.7%). Aceclofenac penetrates into the synovial fluid, where the concentrations reach approximately 60% of those in plasma.
Metabolism- Metabolized into metabolites in the liver. Main metabolite is 4-hydroxyaceclofenac
Excretion- It is excreted through urine mainly as conjugated hydroxymetabolites

Half Life of Aceclofenac:
The mean plasma elimination half-life is 4 – 4.3 hours

Side Effects of Aceclofenac:
1. Dyspepsia
2. Abdominal pain
3. Dizziness
4. Vertigo
5. Pruritis
6. Rash
7. Dermatitis
8. Nausea
9. Diarrhoea
10. Flatulence
11. Gastritis
12. Constipation
13. Vomiting
14. Ulcerative stomatitis
15. Elevation of circulating levels of hepatic enzymes.

Contra-indications of Aceclofenac:
1. Hypersensitivity to the drug
2. Bleeding from the stomach or intestines
3. Moderate to severely decreased kidney function
4. Hypersensitivity to other NSAIDs
5. Active peptic ulcer

Special Precautions while taking Aceclofenac:
1. Hepatic porphyria
2. Bleeding tendencies
3. Blood disorders
4. Crohn`s disease
5. Decreased heart function
6. History of peptic ulcers
7. Inflammation of the bowel and back passage
8. Mildly decreased kidney function
9. Recent major surgery
10. Stomach disorders
11. Decreased liver function
12. Intestinal disorders

Pregnancy Related Information:
Contraindicated.

Breast Feeding Related Information:

Contraindicated.

Children Related Information:
Use with caution

Indications for Aceclofenac:
1. Ankylosing spondylitis
2. Osteoarthritis
3. Symptomatic treatment of pain and inflammation in Post-Traumatic pain
4. Cervical pain
5. Low back pain
6. Acute gout

Interactions for Aceclofenac:
Lithium, digoxin and methotrexate: Aceclofenac may increase plasma concentrations of lithium, digoxin and methotrexate.
Anticoagulants: Activity of anticoagulants may be increased.
Diuretics : Aceclofenac inhibits the activity of diuretics. When concomitantly administrated with potassium sparing diuretics, serum potassium should be monitored.
Cyclosporin: Aceclofenac may enhance cyclosporin nephrotoxicity.
Quinolones : Aceclofenac may precipitate convulsions when coadministered with quinolone antibiotics.

Paracetamol
About Paracetamol:
Acetanilide derivative, Non narcotic Analgesic,Antipyretic.

Mechanism of Action of Paracetamol:
Paracetamol 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.

Pharmacokinetics of Paracetamol:
Absorption: 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 Paracetamol:
30 – 60 minutes

Duration of Action for Paracetamol:
6 hours

Half Life of Paracetamol:
1-4 hours

Side Effects of Paracetamol:
1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash

Contra-indications of Paracetamol:
1. Hypersensitivity to Paracetamol

Special Precautions while taking Paracetamol:
1. Hepatic impairment
2. Renal impairment
3. Hypertension

Pregnancy Related Information:
Use with caution

Breast Feeding Related Information:
Use with caution

Indications for Paracetamol:
1. To relieve pain and fever
2. Acute gout
3. Migraine

Typical Dosage for Paracetamol:
Adult:
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.

Serratiopeptidase
About Serratiopeptidase
A proteolytic enzyme, A powerful anti-inflammatory, anti-edemic.

Mechanism of Action of Serratiopeptidase:
This anti-inflammatory proteolytic enzyme bind to the alpha-2-macroglobulin in the blood, which helps to mask its antigenicity.Then it is slowly transferred to the site of inflammation. Serratiopeptidase hydrolyze bradykinin, histamine, serotoxin responsible for oedema.It reduces swelling improves microcirculation and expectoration of sputum. Due to this action Serratiopeptidase has anti-inflammatory, antioedemic and fibrinolytic activity and act rapidly on localized inflammation.

Pharmacokinetics of Serratiopeptidase:
Orally absorbed. In the case of enteric coated tablet absorption take place in the intestine. After absorption it is directly enter in to the bloodstream. It is excreted via urine and bile.

Duration of Action for Serratiopeptidase:
8 to 10 hrs

Side Effects of Serratiopeptidase:
1. Hypersensitivity
2. Anorexia
3. Gastric discomfort
4. Nausea
5. Vomiting
6. Epistaxis
7. Diarrhoea
8. Skin rash

Contra-indications of Serratiopeptidase:
1. Hypersensitivity to this drug
2. Blood coagulation disorder

 Special Precautions while taking Serratiopeptidase:
1. In patients with renal failure or hepatic failure

Pregnancy Related Information:
Contraindicated

Breast Feeding Related Information:
Contraindicated
Indications for Serratiopeptidase:
1. Antiinflammatory
2. Antiswelling
3. Anti- rheumatoid
4. To promote transfer of antibiotics to the site of action
5. To promote lysis and discharge of sputum and pus
6. Bronchitis
7. Fibrocystic breast swelling
8. Sinusitis
9. Cough
10. Laryngitis
11. Fibromyalgia
12. Emphysema
13. Gout