Precautions of Acelofenac and Paracetamol with Serratiopeptidase

Acetaminophen may cause liver damage. Daily use of alcohol, especially when combined with acetaminophen, may increase your risk for liver damage. Avoid alcohol. Check with your doctor or pharmacist for more information.Liquid products, chewable tablets, or dissolving/effervescent tablets may contain sugar or aspartame. Caution is advised if you have diabetes, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. If you have any of these conditions, ask your doctor or pharmacist about using these products safely.Acetaminophen is contraindicated in patients with a known acetaminophen hypersensitivity.

Acetaminophen hypersensitivity reactions are rare, but severe sensitivity reactions are possible.Patients with alcoholic hepatic disease, viral hepatitis or alcoholism are at risk for acetaminophen-induced hepatotoxicity since glucuronide conjugation of the drug may be decreased. Depletion of hepatic glutathione reserves limits the ability of the liver to conjugate acetaminophen which predisposes the patient to further hepatic injury. Although it is always prudent to use the smallest dose of acetaminophen for the shortest duration necessary, short courses (< 5 days) of normal adult doses have been administered safely to patients with stable chronic liver disease. Acetaminophen should not be used for self-medication in patients who consume 3 or more alcoholic beverages per day. Acetaminophen-induced hepatotoxicity should be suspected in alcoholic patients with aminotransferase levels > 1000 U/L and acetaminophen blood levels should be checked in these patients.

Paracetamol is often given intravenously because onset of action is fast about 3-5 minutes when it is given intravenously. Also it gives 100% bioavailability in blood stream. This is the most reliable route, as in acutely ill patients the absorption of substances from the tissues and from the digestive tract can often be unpredictable due to altered blood flow or bowel motility.Acetaminophen should be used cautiously in patients with salicylate hypersensitivity. A patient with salicylate hypersensitivity may also be hypersensitive to acetaminophen.Symptoms of acute infection (e.g., fever, pain) can be masked during treatment with acetaminophen in patients with bone marrow suppression, especially neutropenia, or immunosuppression.Certain acetaminophen products containing aspartame (Nutrasweet®) should be avoided in patients who have phenylketonuria or who must restrict intake of phenylalanine. Nothing is 'in' paracetamol as such - it is just one molecule. It is made by nitrating phenol to produce 4-nitrophenol, which is then reduced to 4-aminophenol, from which paracetamol is made.

Concomitant treatment with aminophenazone may lead to an increase of the effects of both medicines. Paracetamol potentiates effects of the anticoagulant medicines. Phenobarbital increases the harming effect of Paracetamol on the liver. Contraceptive preparations and rifampicin reduce the effectivity of Paracetamol. Cimetidin reduces toxicity and potentiates the analgesic effect of the preparation. Paracetamol potentiates the action of the Chloramphenicol. Concomitant usage of alcohol and medicines harming the liver, enhances the risk of severe liver disorders.Patients should not use acetaminophen for more than 10 days to relieve pain (five days for children) or for more than three days to reduce fever, unless directed to do so by a physician. If symptoms do not go away or if they get worse, a physician should be contacted. Anyone who drinks three or more alcoholic beverages a day should check with a physician before using this drug and should never take more than the recommended dosage. A risk of liver damage exists from combining large amounts of alcohol and acetaminophen. People who already have kidney or liver disease or liver infections should also consult with a physician before using the drug. Women who are pregnant or breastfeeding should do the same.