CYNAC – P

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.