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Horgesic

Description
Round, white uncoated tablet, bevel-edged, flat faces, 'HD' embossed and scored on the same face.

 

Composition
Per tablet : Paracetamol 450 mg, Orphenadrine citrate 35 mg

Actions and Pharmacology
Paracetamol has analgesic and antipyretic actions. It may act by inhibiting prostaglandin synthesis in the central nervous system and through a peripheral action by blocking pain-impulse generation. The peripheral action may also be due to inhibition of the synthesis or actions of other substances which sensitize pain receptors to mechanical or chemical stimulation. Its antipyretic property may be due to its action on the hypothalamic heat-regulating center to produce peripheral vasodilation resulting in increased blood flow through the skin, sweating and heat loss.

Orphenadrine may act on the central nervous system to depress polysynaptic reflexes. Its skeletal muscle relaxant properties may be related to its CNS depressant (sedative) or to its analgesic effects.

This medication is well absorbed after oral administration, metabolized in the liver and excreted in the urine.

Indications
For the relief of mild to moderate pain of acute musculoskeletal disorders and tension headache.

Contraindications
This medication should not be used in the following conditions :
Patients with acute porphyria-aspirin-sensitive asthmatics
Patients with conditions in which anticholinergic effects are undesirable

Precautions
This medication should be given with care to patients with hepatic or renal function impairment, glaucoma, cardiac arrhythmias, coronary insufficiency or peptic ulceration.
Chronic use should be avoided, unless otherwise directed by physician.
Safety for use during pregnancy and lactation has not been established.
The usual precautions and contraindications associated with antimuscarinics should be observed with orphenadrine.

Main Side/Adverse Effect
Side-effects of this medication include dry mouth, mydriasis, cyclopegia, urinary urgency, constipation and mental confusion.
Other side-effects which occur rarely include blood dyscrasias, hepatitis, hypersensitivity reactions such as skin rash, hives or itching, increased intraocular pressure, tachycardia, CNS stimulation usually manifested by restlessness, insomnia and hallucinations, transient episodes of lightheadedness, dizziness or syncope.

Drug Interactions
This medication should not be used with the following drugs :
Hepatic enzyme-inducing agents such as barbiturates or other anticonvulsants, general anaesthetics, CNS depressants, monoamine oxidase (MAO) inhibitors, tricyclic antidepressants.

Overdosage
Clinical features : Nausea, vomiting or epigastric discomfort for the first two days. Hepatic and renal failure may occur after 3 - 5 days. Other symptoms include metabolic acidosis in severe poisoning, hypoglycaemia, hypotension, sinus tachycardia, cardiac arrhythmias, coma, dry mouth, disturbance of visual accomodation and micturition, tachycardia, hyperthermia, dizziness, confusion, hallucinations, excitement, ataxia and convulsions.

Treatment includes emesis or gastric lavage if appropriate. Activated charcoal may interfere with absorption of the antidote, N-acetylcysteine. If the 4 hour plasma paracetamol level exceeds 150 ug/ml, administer N-acetylcysteine orally, 140 mg of 20 solution per kg as a loading dose, followed by 70 mg/kg every 4 hours for 3 days (best given within 10 hours after ingestion). Others include symptomatic and supportive treatment.

Dosage and Administration
Adult : Oral, 1 to 2 tablets three to four times daily up to a maximum of 8 tablets per day.
Children : Not recommended in children.

Note : The information given here is limited. For further information consult your doctor or pharmacist.

Shelf-life : 3 years from the date of manufacture.
Storage : Store below 25C. Protect from light and moisture.

Presentation/Packing : Tablet x 500's, 1000's.

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