SANZOX

Nimesulide 100 mg + Paracetamol 325 mg + Chlorzoxazone 375 mg

Nimesulide is NSAID non steroidal antinflammatory drug reported to be selective inhibitor of cyclooxygenase2 COX2 it has been given by mouth or rectally for inflammatory condition fever and pain. Its multifactorial mode of action gives it a unique and broad action on inflammatory processes.

Paracetamol has analgesic and antipyretic action. It is more active on cyclo-oxygenase enzyme in brain. It raises the pain threshold and produces analgesic effect. It lowers fever by direct action on the thermoregulatory centre in the Hypothalamus and block the effects of endogenous pyrogen.

Chlorzoxazone is a Centrally acting Muscle relaxant and mild sedative. It works by blocking nerve impulses (or pain sensations) that are sent to the brain. It inhibits degranulation of mast cells, subsequently preventing the release of histamine and slow-reacting substance of anaphylaxis (SRS-A), mediators of type I allergic reactions. It may also reduce the release of inflammatory leukotrienes. Chlorzoxazone may act by inhibiting calcium influx.

Indications

• Low back pain
• Muscle spasm
• Muscle cramping
• Fibromyalgia

Dosage

One tablet two times daily

Contraindications

Hypersensitivity to the drug
Contraindicated in patients with the history of Active peptic ulcer, Hepatic impairment

Precautions

• Caution should be exercised in patients with history of stomach problem, high blood pressure, fluid retention, elderly, during pregnancy and breast-feeding.
• Do not drink alcohol while taking this medication.
• Monitor liver function regularly.
• This drug may make you drowsy. Do not drive a car or operate machinery while you are taking this medication.
• During pregnancy and breast-feeding

Side effects

Drowsiness, dizziness, light headedness, headache, excitement, restlessness, Jaundice, liver damage, GI disturbances, irritability, allergic reactions (skin rash), Orange or reddish-purple urine, Abdominal discomfort, heartburn, abdominal cramps, nausea, vomiting and diarrhea, Headache, dizziness and drowsiness, decrease in urination and kidney failure.

Drug interactions

• Fenofibrate, Salicyclic acid, Valproic acid and Tolbutamide: These drugs displace nimesulide from the plasma binding sites.
• Methotrexate and Frusemide: These drugs may be displaced from plasma proteins by nimesulide.
• Warfarin: Exercise caution since efficacy may be increased.
• Theophylline: Efficacy of slow release theophylline preparations reduced.
• Cholestyramine: Reduces absorption of paracetamol.
• Charcoal: Activated, administered immediately reduces absorption of paracetamol.
• Domperidone and metochlopramide: Enhance absorption of paracetamol.
• Alcohol: Chronic excessive ingestion of alcohol potentiates hepatotoxicity of paracetamol.
• Zidovudine: Effects zidovudine may be decreased.
• Alcohol or other CNS depressants: Additive effect if used concomitantly