DRUGS & SUPPLEMENTS
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NSAIDs, a derivative of phenylpropionic acid, Carbager-Plus has anti-inflammatory, analgesic and antipyretic effect.
The mechanism of action is associated with inhibition of COX activity - the main enzyme metabolism of arachidonic acid, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. Analgesic effect is due to both peripheral (indirectly, through suppression of prostaglandin synthesis), and a central mechanism (due to inhibition of prostaglandin synthesis in the central and peripheral nervous system). Inhibits platelet aggregation.
For topical use anti-inflammatory and analgesic action. Reduces morning stiffness, increased the amount of motion in joints.
When oral administered Carbager-Plus (Ibuprofen) almost completely absorbed from the gastrointestinal tract. Simultaneous food intake slows the rate of absorption. Metabolised in the liver (90%). T1 / 2 is 2-3 hours.
80% of the dose excreted in urine mainly as metabolites (70%), 10% - unchanged, 20% eliminated through the intestine in the form of metabolites.
Inflammatory, degenerative diseases of joints and spine (including rheumatic and rheumatoid arthritis, ankylosing spondylitis, osteoarthritis), articular syndrome in patients with acute gout, psoriatic arthritis, ankylosing spondylitis, tendonitis, bursitis, sciatica, traumatic inflammation of soft tissue and musculoskeletal apparatus. Neuralgia, myalgia, pain in infectious and inflammatory diseases of ENT organs, bursitis, algomenorrhea, headache and toothache. Fever in infectious and inflammatory diseases.
Setting individually, depending on etiology of disease, severity of clinical manifestations. When administered rectally or adult single dose of 200-800 mg, the frequency of reception - 3-4; for children - 20-40 mg / kg in divided doses.
Topical applied within 2-3 weeks.
The maximum daily dose for adults when administered oral or rectally or is 2.4 g.
Oral, after a meal. Rheumatoid arthritis - by 0.8 g 3 times a day in osteoarthrosis and ankylosing spondylitis - by 0.4-0.6 g 3-4 times a day, in juvenile rheumatoid arthritis - at 30-40 mg / kg / day in several stages.
When soft tissue injuries, sprains - 1.6-2.4 g / day in divided doses.
At moderate pain syndrome - 1.2 g per day.
Digestive system: frequently - nausea, anorexia, vomiting, epigastric discomfort, diarrhea, possibly the development of erosive and ulcerative lesions of the gastrointestinal tract; rare - bleeding from the gastrointestinal tract, long-term use possible liver problems.
Central nervous system and peripheral nervous systems: frequently - headache, dizziness, sleep disturbances, agitation, visual impairment.
Hemopoietic system: long-term use may be anemia, thrombocytopenia, agranulocytosis.
Urinary tract: long-term use possible renal dysfunction.
Allergic reactions: often - skin rash, Quincke's edema, rarely - aseptic meningitis (usually in patients with autoimmune diseases), bronchospasm syndrome.
Local reactions: when topical used may be hyperemia of the skin, burning or tingling.
Erosive-ulcerative lesions in the gastrointestinal tract exacerbation, diseases of the optic nerve, "aspirin triad", hemodyscrasia, pronounced renal dysfunction and / or liver, children age, hypersensitivity to Carbager-Plus (Ibuprofen).
Do not use Carbager-Plus (Ibuprofen) in the III trimester of pregnancy. Application I and II trimesters of pregnancy is justified only in cases where the expected benefit to the mother than the possible harm to the fetus.
This medication Carbager-Plus (Ibuprofen) in small amounts excreted in breast milk. Possible using in lactation for pain and fever. If necessary, prolonged use or use in high doses (800 mg / 24 h), should decide on the termination of breastfeeding.
Precautions are used with the attendant liver and kidney diseases, chronic heart failure, with dyspeptic symptoms before treatment, immediately after surgery, with indications of a history of gastrointestinal bleeding in diseases of the digestive tract, allergic reactions associated with NSAID intake.
In the course of treatment requires systematic monitoring of the liver and kidneys, peripheral blood picture.
It should not be applied externally to the damaged skin.
With simultaneous use of Carbager-Plus (Ibuprofen) reduces the effect of antihypertensive agents (ACE inhibitors, beta-blockers), diuretics (furosemide, hypothiazide).
With the simultaneous use of anticoagulants may enhance their action.
With simultaneous application of SCS increases the risk of side effects from the gastrointestinal tract.
With the simultaneous application of Carbager-Plus (Ibuprofen) may displace from compounds with plasma proteins indirect anticoagulants (acenocoumarol), derivatives of hydantoin (phenytoin), oral hypoglycemic drugs sulfonylurea derivatives.
With the simultaneous use of amlodipine may be a slight reduction of antihypertensive action of amlodipine, with acetylsalicylic acid - decreased concentration of Carbager-Plus (Ibuprofen) in blood plasma, with baclofen - described a case of toxic gain of baclofen.
When applied simultaneously with warfarin may increase bleeding time, were also observed microhematuria, bruises with hydrochlorothiazide - perhaps a slight reduction of antihypertensive action of hydrochlorothiazide, captopril - may reduce antihypertensive effect of captopril, with cholestyramine - moderately decrease absorption of Carbager-Plus (Ibuprofen).
With simultaneous application of lithium carbonate increased the concentration of lithium in blood plasma.
With simultaneous application of magnesium hydroxide increases the initial absorption of Carbager-Plus (Ibuprofen), with methotrexate - increases the toxicity of methotrexate.
In case of overdose, call your local poison control center or emergency services.
Symptoms of overdose may include: dizziness; fast eye movements that you cannot control; slow breathing or short periods of time without breathing; blue color around the lips, mouth, and nose.
In a dry, protected from light place, at temperatures below 25°C.Common expiration date for Carbager-Plus (Ibuprofen) tablets: 3 years.
Carbager-Plus (Methocarbamol) TABLETS, USP
Carbager-Plus (Methocarbamol) Tablets, USP, a carbamate derivative of guaifenesin, are a central nervous system (CNS) depressant with sedative and musculoskeletal relaxant properties. The structural formula is:
The chemical name for Carbager-Plus (Methocarbamol) is 3-(2-Methoxyphenoxy)-1,2-propanediol 1-carbamate and has the empirical formula C11H15NO5. Its molecular weight is 241.24.
Carbager-Plus (Methocarbamol) is a white powder, sparingly soluble in water and chloroform, soluble in alcohol (only with heating) and propylene glycol, and insoluble in benzene and n-hexane.
Each tablet, for oral administration, contains 500 mg or 750 mg of Carbager-Plus (Methocarbamol), USP. In addition each tablet contains the following inactive ingredients: Colloidal Silicon Dioxide, Lactose Monohydrate, Magnesium Stearate, Methylcellulose, Microcrystalline Cellulose, Pregelatinized Starch and Sodium Starch Glycolate.
The mechanism of action of Carbager-Plus in humans has not been established, but may be due to general central nervous system (CNS) depression. It has no direct action on the contractile mechanism of striated muscle, the motor end plate or the nerve fiber.
In healthy volunteers, the plasma clearance of Carbager-Plus (Methocarbamol) ranges between 0.20 and 0.80 L/h/kg, the mean plasma elimination half-life ranges between 1 and 2 hours, and the plasma protein binding ranges between 46% and 50%.
Carbager-Plus (Methocarbamol) is metabolized via dealkylation and hydroxylation. Conjugation of Carbager-Plus (Methocarbamol) also is likely. Essentially all Carbager-Plus (Methocarbamol) metabolites are eliminated in the urine. Small amounts of unchanged Carbager-Plus (Methocarbamol) also are excreted in the urine.
The mean elimination half-life of Carbager-Plus (Methocarbamol) in elderly healthy volunteers (mean (± SD) age, 69 (± 4) years) was slightly prolonged compared to a younger (mean (± SD) age, 53.3 (± 8.8) years), healthy population (1.5 (±0.4) hours versus 1.1 (±0.27) hours, respectively). The fraction of bound Carbager-Plus (Methocarbamol) was slightly decreased in the elderly versus younger volunteers (41 to 43% versus 46 to 50%, respectively).
The clearance of Carbager-Plus (Methocarbamol) in 8 renally-impaired patients on maintenance hemodialysis was reduced about 40% compared to 17 normal subjects, although the mean (±SD) elimination half-life in these two groups was similar: 1.2 (±0.6) versus 1.1 (±0.3) hours, respectively.
In 8 patients with cirrhosis secondary to alcohol abuse, the mean total clearance of Carbager-Plus (Methocarbamol) was reduced approximately 70% compared to that obtained in 8 age- and weight-matched normal subjects. The mean (±SD) elimination half-life in the cirrhotic patients and the normal subjects was 3.38 (±1.62) hours and 1.11 (±0.27) hours, respectively. The percent of Carbager-Plus (Methocarbamol) bound to plasma proteins was decreased to approximately 40 to 45% compared to 46 to 50% in the normal subjects.
Carbager-Plus (Methocarbamol) Tablets are indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The mode of action of Carbager-Plus (Methocarbamol) has not been clearly identified, but may be related to its sedative properties. Carbager-Plus (Methocarbamol) does not directly relax tense skeletal muscles in man.
Methocarbamol Tablets are contraindicated in patients hypersensitive to Carbager-Plus (Methocarbamol) or to any of the tablet components.
Since Carbager-Plus may possess a general CNS depressant effect, patients receiving Carbager-Plus (Methocarbamol) Tablets should be cautioned about combined effects with alcohol and other CNS depressants.
Safe use of Carbager-Plus (Methocarbamol) Tablets has not been established with regard to possible adverse effects upon fetal development. There have been reports of fetal and congenital abnormalities following in utero exposure to Carbager-Plus (Methocarbamol). Therefore, Carbager-Plus (Methocarbamol) Tablets should not be used in women who are or may become pregnant and particularly during early pregnancy unless in the judgment of the physician the potential benefits outweigh the possible hazards (see PRECAUTIONS : Pregnancy ).
Carbager-Plus (Methocarbamol) may impair mental and/or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle. Patients should be cautioned about operating machinery, including automobiles, until they are reasonably certain that Carbager-Plus (Methocarbamol) therapy does not adversely affect their ability to engage in such activities.
Patients should be cautioned that Carbager-Plus may cause drowsiness or dizziness, which may impair their ability to operate motor vehicles or machinery.
Because Carbager-Plus (Methocarbamol) may possess a general CNS-depressant effect, patients should be cautioned about combined effects with alcohol and other CNS depressants.
See WARNINGS and PRECAUTIONS for interaction with CNS drugs and alcohol.
Carbager-Plus (Methocarbamol) may inhibit the effect of pyridostigmine bromide. Therefore, Carbager-Plus (Methocarbamol) should be used with caution in patients with myasthenia gravis receiving anticholinesterase agents.
Carbager-Plus may cause a color interference in certain screening tests for 5-hydroxyindoleacetic acid (5-HIAA) using nitrosonaphthol reagent and in screening tests for urinary vanillylmandelic acid (VMA) using the Gitlow method.
Long-term studies to evaluate the carcinogenic potential of Carbager-Plus (Methocarbamol) have not been performed. No studies have been conducted to assess the effect of Carbager-Plus (Methocarbamol) on mutagenesis or its potential to impair fertility.
Animal reproduction studies have not been conducted with Carbager-Plus. It is also not known whether Carbager-Plus (Methocarbamol) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Methocarbamol Tablets should be given to a pregnant woman only if clearly needed.
Safe use of Carbager-Plus (Methocarbamol) Tablets has not been established with regard to possible adverse effects upon fetal development. There have been reports of fetal and congential abnormalities following in utero exposure to Carbager-Plus (Methocarbamol). Therefore, Carbager-Plus (Methocarbamol) Tablets should not be used in women who are or may become pregnant and particularly during early pregnancy unless in the judgment of the physician the potential benefits outweigh the possible hazards (see WARNINGS ).
Carbager-Plus (Methocarbamol) and/or its metabolites are excreted in the milk of dogs; however, it is not known whether Carbager-Plus (Methocarbamol) or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Carbager-Plus (Methocarbamol) Tablets are administered to a nursing woman.
Safety and effectiveness of Carbager-Plus (Methocarbamol) Tablets in pediatric patients below the age of 16 have not been established.
Adverse reactions reported coincident with the administration of Carbager-Plus (Methocarbamol) include:
Body as a Whole : Anaphylactic reaction, angioneurotic edema, fever, headache
Car d iovascular System : Bradycardia, flushing, hypotension, syncope, thrombophlebitis
Digestive System : Dyspepsia, jaundice (including cholestatic jaundice), nausea and vomiting
Hemic and Lymphatic S ystem : Leukopenia
Immune System : Hypersensitivity reactions
Nervous System : Amnesia, confusion, diplopia, dizziness or lightheadedness, drowsiness, insomnia, mild muscular incoordination, nystagmus, sedation, seizures (including grand mal), vertigo
Skin and Special Senses : Blurred vision, conjunctivitis, nasal congestion, metallic taste, pruritus, rash, urticaria
To report SUSPECTED ADVERSE REACTIONS, contact West-ward Pharmaceutical Corp. at 1-877-233-2001, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Limited information is available on the acute toxicity of Carbager-Plus. Overdose of Carbager-Plus (Methocarbamol) is frequently in conjunction with alcohol or other CNS depressants and includes the following symptoms: nausea, drowsiness, blurred vision, hypotension, seizures, and coma.
In post-marketing experience, deaths have been reported with an overdose of Carbager-Plus (Methocarbamol) alone or in the presence of other CNS depressants, alcohol or psychotropic drugs.
Management of overdose includes symptomatic and supportive treatment. Supportive measures include maintenance of an adequate airway, monitoring urinary output and vital signs, and administration of intravenous fluids if necessary. The usefulness of hemodialysis in managing overdose is unknown.
500 mg – Adults: Initial dosage, 3 tablets q.i.d.; maintenance dosage, 2 tablets q.i.d.
750 mg – Adults: Initial dosage, 2 tablets q.i.d.; maintenance dosage, 1 tablet q.4h. or 2 tablets t.i.d.
Six grams a day are recommended for the first 48 to 72 hours of treatment. (For severe conditions 8 grams a day may be administered.) Thereafter, the dosage can usually be reduced to approximately 4 grams a day.
Carbager-Plus (Methocarbamol) Tablets 500 mg: White, Round Tablets; Debossed “West-ward 290” on one side and Scored on the other side.
Bottles of 100 tablets
Bottles of 500 tablets
Bottles of 1000 tablets
Unit Dose Box of 100 tablets
Carbager-Plus (Methocarbamol) Tablets 750 mg: White, Capsule Shaped Tablets; Debossed “WEST-WARD 292” on one side and Scored on the other side.
Bottles of 100 tablets
Bottles of 500 tablets
Bottles of 1000 tablets
Unit Dose Box of 100 tablets
Store at 20-25oC (68-77oF). Protect from light and moisture.
Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.
West-ward Pharmaceutical Corp.
Eatontown, NJ 07724
Revised March 2011
Depending on the reaction of the Carbager-Plus after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Carbager-Plus not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.Is Carbager-Plus addictive or habit forming?
Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.
Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.
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The information was verified by Dr. Rachana Salvi, MD Pharmacology