Paracetamol/ Mephenesin

Registered South African indications:

• Pain

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Impaired kidney function
• Impaired liver function

Cautions

Caution in the following patient groups

• Pregnancy
• Breastfeeding
• Elderly

Duration of use

• Do not use continuously for more than 10 days without consulting a doctor

Risk of liver damage

• Dosage in excess of those recommended may cause severe liver damage

Drug interactions

• Mephenesin may enhance the effects of barbiturates and opioids

Effects on ability to drive and use machines

• Mephenesin may cause drowsiness; patients that are affected should not drive or operate machinery

Forms avail. in SA and covered in this monograph: tab

Generalised pain associated with tension

Mephenesin/ Paracetamol
150/500 (mg)

• Oral (tab): 1-2 tab, 4hrly; Max: 8 tab/24hrs

No information available

Recommendations for this combination product as per highest risk category when comparing individual active ingredients

Pregnancy

• Caution (Mephenesin)
  Refer to the single agent monograph for Mephenesin
  Refer to the single agent monograph for Paracetamol

Breastfeeding

• Caution; not recommended (Mephenesin)
  Refer to the single agent monograph for Mephenesin
  Refer to the single agent monograph for Paracetamol

Renal Impairment

• Contraindicated

Hepatic Impairment

• Contraindicated

Elderly

• Caution; no dose adjustment recommended (Mephenesin)
  Refer to the single agent monograph for Mephenesin
  Refer to the single agent monograph for Paracetamol

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Mephenesin is not available as a single agent preparation

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Mephenesin
Central Nervous System Disorders

• Dizziness
• Drowsiness

Gastrointestinal Disorders

• Nausea and vomiting

Skin and Subcutaneous Tissue Disorders

• Urticaria
• Pruritus
• Rash

Immune, Blood and Lymphatic System Disorders

• Fever

Sensory Disorders

• Blurred vision

Paracetamol
Respiratory Disorders

• Bronchospasm

Hepatobiliary Disorders

• Hepatic dysfunction

Immune, Blood and Lymphatic System Disorders

• Anaphylaxis
• Cutaneous hypersensitivity reactions
• Angioedema
• Stevens Johnson syndrome
• Thrombocytopenia  
• Agranulocytosis
• Methaemoglobinaemia

Gastrointestinal Disorders 

• Acute pancreatitis

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Mephenesin

• No information available

Paracetamol

• Metoclopramide
• Domperidone
• Cholestyramine
• Oral anticoagulants
• Chloramphenicol
• Alcohol

None routine

Mephenesin
Mephenesin is a centrally acting skeletal muscle relaxant used for the symptomatic treatment of painful muscle spasm. Its clinical usefulness is limited by its short duration of action, and does not relieve the spasticity associated with chronic neurological disorders. 

Paracetamol
Paracetamol increases the pain threshold by inhibiting both isoforms of cyclooxygenase, COX-1, COX-2, and COX-3 enzymes involved in prostaglandin synthesis. It does not inhibit cyclooxygenase in peripheral tissues and, thus, has no peripheral anti-inflammatory affects.

COMBINATION PREPARATIONS

Paracetamol/ Mephenesin

Tablet 500mg/150mg

• Spasmend (Adcock)