INDICATIONS     CONTRA-INDICATIONS     DOSAGE     SIDE-EFFECTS     PREGNANCY     OVERDOSE     IDENTIFICATION     PATIENT INFORMATION
MYPRODOL® SUSPENSION

SCHEDULING STATUS:
S3

PROPRIETARY NAME:
(and dosage form)

MYPRODOL^® SUSPENSION

COMPOSITION:
Each 10 mL contains:

	Ibuprofen	200 mg
	Paracetamol	250 mg
	Codeine Phosphate	10 mg
	Preservative:
	Sodium Benzoate	0,1 % m/v

(Contains Sodium Metabisulphite)

PHARMACOLOGICAL CLASSIFICATION:
A 2.8 Analgesic Combinations

PHARMACOLOGICAL ACTION:
MYPRODOL^®SUSPENSION has an analgesic, anti-inflammatory and anti-pyretic action.

INDICATIONS:
MYPRODOL^®SUSPENSION is indicated for the relief of mild to moderate pain of inflammatory origin with or without fever.

CONTRA-INDICATIONS:
Impaired hepatic and renal function, peptic ulceration or a history of such ulceration. Cardiovascular disease.
Hypersensitivity to any of the active ingredients.
Contra-indicated in respiratory depression, especially in the presence of cyanosis and excessive bronchial secretion, after operations on the biliary tract, acute alcoholism, head injuries and conditions in which intracranial pressure is raised. It should not be given during an attack of bronchial asthma or in heart failure secondary to chronic lung disease.
Contra-indicated in patients taking monoamine oxidase inhibitors or within fourteen days of stopping such treatment.
Caution is advised in those patients who are receiving coumarin anticoagulants.
Patients who are sensitive to aspirin should not be given MYPRODOL^®SUSPENSION.

WARNINGS:
MYPRODOL^®SUSPENSION is not recommended for use by pregnant or breastfeeding women.
The safety of continuous administration of MYPRODOL^®SUSPENSION has not been established for a period greater than four weeks.
Paracetamol:
Dosages in excess of those recommended may cause severe liver damage.

DOSAGE AND DIRECTIONS FOR USE:
Shake the bottle before use.
Adults :-
Two to four medicine measures (10 - 20 mL) four hourly and not more than twenty-four medicine measurefuls in twenty-four hours.
Children:-

3 - 5 years	Half to one medicine measure (2,5 - 5 mL) three to four times daily
6 - 12 years	One to two medicine measures (5 - 10 mL) three to four times daily

Consult your doctor if no relief is obtained with the recommended dosage.

SIDE-EFFECTS AND SPECIAL PRECAUTIONS:
Ibuprofen:
Peptic ulceration and gastro-intestinal bleeding have been reported. Other side-effects include dizziness, dyspepsia, nausea, nervousness, skin rash, pruritus, tinnitus, oedema, depression, drowsiness, insomnia, blurred vision and other ocular reactions. Hypersensitivity reactions, abnormalities of liver function tests, impairment of renal function, agranulocytosis and thrombocytopenia have occasionally been reported. Acute reversible renal failure has been reported. Ibuprofen should be used with care in patients with impaired renal function.
Paracetamol:
Sensitivity reactions resulting in reversible skin rash or blood disorders may occur. Haematological reactions have been reported.
Codeine Phosphate:
Codeine phosphate may cause nausea, vomiting, constipation, drowsiness, confusion, dry mouth, sweating, facial flushing, vertigo, bradycardia, palpitations, orthostatic hypotension, hypothermia, restlessness, changes of mood and miosis. Micturition may be difficult and there may be ureteric or biliary spasm. Raised intracranial pressure may occur. Reactions such as urticaria and pruritus may occur. Codeine phosphate should be given with caution to patients with hypothyroidism, adrenocortical insufficiency, impaired liver function, prostatic hypertrophy or shock. It should be used with caution in patients with inflammatory or obstructive bowel disorders. The dosage should be reduced in elderly and debilitated patients.
The depressant effects of codeine are enhanced by depressants of the central nervous system such as alcohol, anaesthetics, hypnotics and sedatives, and phenothiazines.
The prolonged use of high doses of codeine has produced dependence of the morphine type.

KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT:
Paracetamol:
Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, anorexia, and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur.
Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias have been reported. Symptoms during the first 2 days of acute poisoning do not reflect the potential seriousness of the overdosage. Nausea, vomiting, anorexia and abdominal pain may persist for a week or more. Liver injury may become manifest on the second day (or later), initially by elevation of serum transaminase and lactic dehydrogenase activity, increased serum bilirubin concentration and prolongation of prothrombin time. The liver damage may progress to encephalopathy, coma and death. Cerebral oedema and nonspecific myocardial depression have also occurred.
In the event of overdosage consult a doctor or take the patient to the nearest hospital immediately. Specialised treatment is essential as soon as possible.
Prompt treatment is essential. Any patient who has ingested about 7,5g of paracetamol in the preceding 4 hours should undergo gastric lavage. Specific therapy with an antidote such as acetylcysteine or methionine may be necessary. If decided upon, acetylcysteine should be administered IV (intravenously) as soon as possible.
Acetylcysteine : Acetylcysteine should be administered as soon as possible, preferably within 8 hours of overdosage.
IV: An initial dose of 150 mg/kg in 200 mL glucose injection, given intravenously over 15 minutes, followed by an intravenous infusion of 50 mg/kg in 500 mL of glucose injection over the next 4 hours, and then 100 mg/kg in 1000 mL over the next 16 hours. The volume of intravenous fluids should be modified for children.
Orally: 140 mg/kg as a 5% solution initially, followed by a 70 mg/kg solution every 4 hours for 17 doses. Acetylcysteine is effective if administered within 8 hours of overdosage.
Ibuprofen:
The most likely symptoms of overdosage are epigastric pain and nausea.
Codeine Phosphate:
Symptoms of overdosage include excitement and, in children, convulsions may occur. Large doses produce respiratory depression.
Treatment of overdosage is symptomatic and supportive.

IDENTIFICATION:
An opaque pink suspension with a blackcurrant taste and odour.

PRESENTATION:
Bottles of 100 mL and 200 mL.

STORAGE INSTRUCTIONS:
Store below 30°C in well-closed containers. Protect from light. Keep out of reach of children.

REGISTRATION NUMBER:
Y/2.8/119

NAME AND ADDRESS OF THE APPLICANT:
Adcock Ingram Limited
Adcock Ingram Park
17 Harrison Avenue,
Bryanston Ext. 77,
Private Bag X 69, Bryanston, 2021

DATE OF PUBLICATION OF THIS PACKAGE INSERT:
22 June 1994

New addition to this site: April 2004
Source: Pharmaceutical Industry
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