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Paracetamol is an extremely popular drug used to relieve pain, reduce fever and increase effectiveness when combined with caffeine. This combination is found in the product Phaanedol Plus Extra Strength from USA-NIC Pharmaceuticals.
1. What is Phaanedol Plus Extra Strength?
Phaanedol Plus Extra Strength 500/65 is manufactured by USA-NIC Pharmaceutical Co., Ltd (USA - NIC Pharma). Phaanedol Plus Extra Strength ingredients include Paracetamol and Caffeine, respectively 500mg and 65mg with antipyretic and mild to moderate pain relief.
2. Uses of Phaanedol Plus Extra Strength
Phaanedol Plus Extra Strength 500/65 is indicated in the following cases:
Relief of mild to moderate pain, including headache or migraine, muscle pain, menstrual pain, sore throat; Pain after vaccination; Pain after tooth extraction or dental procedures, toothache; Pain associated with osteoarthritis; Antipyretic.
3. Pharmacological characteristics of Phaanedol Plus Extra Strength
3.1. Pharmacodynamics Active ingredient Paracetamol (or acetaminophen or N-acetyl-p-aminophenol) in Phaanedol Plus Extra Strength is an active metabolite of phenacetin with effective analgesic and antipyretic effects and can replace Aspirin. The biggest difference is that Paracetamol has no other effects than inflammation. According to research, the active ingredient Paracetamol has the effect of lowering body temperature for people with high fever but rarely hypothermia in normal people. Paracetamol's antipyretic mechanism is to act on the hypothalamus, causing hypothermia, while increasing thermogenesis due to vasodilation and increased peripheral blood flow. The advantage of Paracetamol over Aspirin is that it has the same therapeutic dose but has little effect on the heart and respiratory tract, does not affect the acid-base balance, does not cause irritation, scratches or gastric bleeding.
Paracetamol does not affect platelet function or bleeding time. In case of overdose, it will cause liver toxicity through a metabolite, N-acetyl-benzoquinonimin. Although in normal doses it is well tolerated and does not cause many side effects, an acute overdose of Paracetamol (over 10g) can lead to death due to severe liver toxicity.
Another active ingredient in Phaanedol Plus Extra Strength is caffeine, a xanthine derivative with effects on the central nervous system. Caffeine stimulates priority on the cerebral cortex, reduces fatigue, sleepiness, stimulates cortical excitability and sensory perception, thereby increasing the ability to work and be more alert. However, those who use caffeine continuously and for a long time, after the euphoria period, the central nervous system will be inhibited.
3.2. Pharmacokinetics The pharmacokinetics of Paracetamol:
Rapidly and almost completely absorbed from the gastrointestinal tract, peak plasma concentrations are reached after 30-60 minutes at therapeutic doses; Distribution: Paracetamol in Phaanedol Plus Extra Strength is rapidly and evenly distributed in most body tissues. The rate of binding to plasma proteins is about 25%; Elimination: The half-life is about 1.25-3 hours, which can be prolonged at toxic doses or in people with a predisposition to liver damage; Paracetamol is N-hydroxylated by the cytochrome P450 system to form N-acetyl-benzoquinonimin. Normally, this paracetamol metabolite reacts with the sulfhydryl group in glutathione, thereby being reduced to inactivation. However, at high doses, this metabolite leads to a large number of metabolites and depletes hepatic glutathione. When it does, it will increase the reaction with the sulfhydryl group of liver proteins, resulting in liver necrosis. Pharmacokinetics of Caffeine:
This active ingredient in Phaanedol Plus Extra Strength is rapidly absorbed orally or injected, with oral bioavailability of over 90%; The drug reaches maximum plasma concentrations about 1 hour after oral administration, then widely distributed throughout the body, including the placenta and breast milk; Metabolism: Caffeine is metabolised in the liver by demethylation and oxidation; Excreted mainly in the urine in the form of metabolites. The half-life is about 3-7 hours and is longer in neonates and premature infants.
4. What is the dose of Phaanedol?
4.1. How to take Phaanedol Plus Extra Strength 500/65 orally.
4.2. Phaanedol dose Adults: Take 1 tablet of Phaanedol Plus Extra Strength each time, 3-4 times a day; Children from 12 years of age and older: Take 1 tablet of Phaanedol Plus Extra Strength each time, 1-2 times a day; The interval between 2 doses of Phaanedol Plus Extra Strength needs to be at least 4-6 hours apart. 4.3. Overdose and treatment Paracetamol poisoning:
Poisoning can occur when taking a single toxic dose or taking repeated high doses of Paracetamol or using products with Paracetamol (such as Phaanedol Plus Extra Strength) for a long time; The most serious toxic effect is liver necrosis, which can be fatal, with manifestations of nausea, vomiting and abdominal pain within 2-3 hours after poisoning; Methemoglobinemia causing cyanosis of the skin and nails is considered a characteristic manifestation of acute poisoning of the p-aminophenol derivative of paracetamol, the risk of methemoglobin is high in children compared with adults; Severe paracetamol poisoning initially causes central nervous system stimulation causing agitation and delirium. This is followed by CNS depression, stupor, hypothermia, tachypnea, shallow breathing, tachycardia, mild, irregular, hypotension and circulatory failure; Clinical manifestations of liver damage are more obvious within 2-4 days from the time of ingestion of toxic doses of Paracetamol. Increased serum aminotransferases (sometimes very high) and plasma bilirubin, when extensive liver damage leads to prolonged prothrombin time; Treatment: Gastric lavage in all cases, preferably within 4 hours. The basic detoxification therapy is the use of sulfhydryl compounds, which will, in part, help replenish the liver's stores of glutathione. In addition, the use of N-acetylcysteine detoxification can be applied if the poisoning is less than 36 hours and more effective when the time of paracetamol poisoning is less than 10 hours. Caffeine poisoning: When used in high doses can cause tremors.
5. Side effects of Phaanedol Plus Extra Strength
During the use of Phaanedol Plus Extra Strength 500/65, patients may experience unwanted effects related to Paracetamol and Caffeine. Side effects of Paracetamol include:
Skin rash, some allergic symptoms such as erythema or urticaria, sometimes accompanied by fever or mucosal lesions; Hematopoietic disorders, neutropenia, thrombocytopenia and pancytopenia; Nausea, vomiting; Increased risk of kidney disease and nephrotoxicity with long-term abuse. Side effects of the active ingredient Caffeine in Phaanedol Plus Extra Strength products:
Stimulates the digestive tract; Central nervous system stimulation.
6. Contraindications of Phaanedol Plus Extra Strength
Phaanedol Plus Extra Strength is not allowed to be prescribed in the following cases:
History of sensitivity to paracetamol; People with anemia many times; Heart and lung disease; Deficiency of the enzyme glucose-6-phosphate dehydrogenase; Impaired liver and kidney function; Children under 12 years old. coronary insufficiency; Heart attack; Tachycardia, extrasystoles.
7. Some cautions when using Phaanedol Plus Extra Strength
The active ingredient Paracetamol in Phaanedol Plus Extra Strength is relatively safe at therapeutic doses. Some cases of skin reactions such as rash, maculopapular, pruritus, urticaria, some hypersensitivity reactions such as laryngeal edema, angioedema may be encountered but very rarely; Paracetamol should be used with caution in patients with a history of pre-existing anemia, as cyanosis may not be evident, despite very high blood levels of methemoglobin; Using a lot of alcohol while using Phaanedol Plus Extra Strength can increase the liver toxicity of paracetamol, so it is necessary to limit or absolutely not drink alcohol; Use with caution in people with impaired liver or kidney function; Doctors should warn patients when using Phaanedol Plus Extra Strength about signs of serious skin reactions such as Steven-Johnson syndrome, toxic skin necrosis syndrome, Lyell's syndrome, generalized pustular rash syndrome acute trunk (AGEP).8. Drug interactions of Phaanedol Plus Extra Strength
Long-term use of high doses of paracetamol slightly increases the anticoagulant effect of coumarin and indandion derivatives; Excessive and long-term alcohol use may increase the risk of hepatotoxicity of Paracetamol; Anticonvulsants (including phenytoin, barbiturates, carbamazepine) induce hepatic microsomal enzymes, which may increase the hepatotoxicity of Paracetamol by increasing its metabolism to toxic substances; Concomitant administration of Phaanedol Plus Extra Strength with Isoniazid may increase the risk of hepatotoxicity, but the mechanism of interaction is unknown. In particular, the risk of hepatotoxicity of paracetamol is significantly increased when patients take larger than recommended doses during treatment with anticonvulsants or isoniazid; The caffeine in Phaanedol Plus Extra Strength reduces blood flow to the liver, thereby prolonging the half-life and increasing the concentration of drugs eliminated by the liver.
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