UNSAFE

• It is unsafe to consume alcohol with Xcel ER.

SAFE IF PRESCRIBED

• Xcel ER is safe to use during pregnancy. Most studies have shown low or no risk to the developing baby.

SAFE IF PRESCRIBED

• Xcel ER is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.

SAFE

• Xcel ER does not usually affect your ability to drive.

CAUTION

• Xcel ER should be used with caution in patients with kidney disease. Dose adjustment of Xcel ER may be needed. Please consult your doctor. However, Xcel ER contains paracetamol which is considered the safest painkiller for kidney disease patients.

CAUTION

• Xcel ER should be used with caution in patients with liver disease. Dose adjustment of Xcel ER may be needed. Please consult your doctor. However, the use of Xcel ER is not recommended in patients with severe liver disease and active liver disease.
• Medicine Overview of Xcel ER 665mg Tablet

Introduction

• Xcel ER 665mg is a medicine used to relieve pain and to reduce fever. It is used to treat many conditions such as headache, body ache, toothache and common cold.Xcel ER may be prescr665mg ibed alone or in combination with another medicine. You should take it regularly as advised by your doctor. It is usually best taken with food otherwise it may upset your stomach. Do not take more or use it for longer than recommended. Side effects are rare if this medicine is used correctly but this medicine may cause stomach pain, nausea, and vomiting in some people. Consult your doctor if any of these side effects bother you or do not go away.This medicine is widely prescribed and considered safe but is not suitable for everybody. Before taking it, let your doctor know if you have liver or kidney problems or are using blood-thinning medicines. It may affect the dose or suitability of this medicine. Let your doctor know about all the other medicines you are taking because they may affect, or be affected by, this medicine.

Uses of Xcel ER

• Pain relief
• Fever

Side effects of Xcel ER

• Common
• No common side effects seen

How to use Xcel ER

• Take Xcel ER 665mg medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Xcel ER 665mg is to be taken with food.

How Xcel ER works

• Xcel ER 665mg is an analgesic (pain reliever) and anti-pyretic (fever reducer). It works by blocking the release of certain chemical messengers that cause pain and fever. Xcel ER is an analgesic (pain reliever) and anti-pyretic (fever reducer). It works by blocking the release of certain chemical messengers that cause pain and fever.

What if you forget to take Xcel ER?

• If you miss a dose of Xcel ER 665mg, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Quick Tips

• Xcel ER should be taken with food or milk to prevent upset stomach.
• Take it as per the dose and duration prescribed by your doctor. Long term use may lead to serious complications such as stomach bleeding and...

Do not take indigestion remedies (antacids) within two hours of taking Xcel ER.

• Avoid consuming alcohol while taking this medicine as it can increase your risk of stomach problems.
• Inform your doctor if you have liver disease as your dose may need to be adjusted.
• Your doctor may regularly monitor your kidney function, liver function and levels of blood components if you are taking this medicine for long-term treatment.
• Brief Description

Indication

• Fever, Mild to moderate pain, osteoarthritis, rheumatoid arthritis, chronic low back pain, Renal stone pain, neuropathic pain, toothache, migraine, postoperative mild to moderate pain.

Administration

• May be taken with or without food.

Adult Dose

• Oral Mild to moderate pain and fever Tablet Adult: 1 - 2 tablets every 4 to 6 hours up to a maximum of 4 g (8 tablets) daily Extended Release (XR) Tablet Adults: 2 tablets, swallowed whole, every 6 to 8 hours (maximum of 6 tablets in any 24 hours). Syrup/Suspension: Adults: 4-8 Measuring spoonful 3-4 times daily; Rectal Suppository Adults: 500 mg-1 g every 4-6 hours to a maximum of 4 g daily.

Child Dose

• Oral Mild to moderate pain and fever Tablet Children (6 - 12 years) : 1/2 to 1 tablet 3 to 4 times daily Extended Release (XR) Tablet Children over 12 years: 2 tablets, swallowed whole, every 6 to 8 hours (maximum of 6 tablets in any 24 hours). Syrup Mild to moderate pain and fever Children: 3 months - <1 year : 60 - 120 mg (1/2 - 1 measuring spoonful), 1 - 5 years : 1 - 2 measuring spoonful 6 - 12 years : 2 - 4 measuring spoonful Children: 2 months: 60 mg (1/2 measuring spoonful) for post immunization pyrexia; Paediatric Drops Mild to moderate pain and fever Children Up to 3 months: 0.5 ml (40 mg) 4 to 11 months: 1.0 ml (80 mg) 1 to <2 years: 1.5 ml (120 mg) 2 to 3 years: 2 ml (160mg) 4 to 5 years: 3 ml (240 mg) Dose can be repeated, every 4 hours. Rectal Mild to moderate pain and fever Suppository Children: 3 months-<1 year: 60-125 mg 1-<5 years: 125-250 mg 5-12 years: 250-500 mg These doses may be repeated every 4-6 hours as necessary (maximum 4 doses in 24 hours). Children over 12 years: 500 mg-1 g every 4-6 hours to a maximum of 4 g daily. Post-immunisation pyrexia Child: 2-3 mth 60 mg. If necessary, a 2nd dose may be given after 4-6 hr.

Contraindication

Hypersensitivity.

Mode of Action

• Paracetamol exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the hypothalamic heat-regulating centre. Its weak anti-inflammatory activity is related to inhibition of prostaglandin synthesis in the CNS.

Precaution

• Patient w/ chronic alcoholism, known G6PD deficiency, severe hypovolaemia, chronic malnutrition. Renal and hepatic impairment. Pregnancy and lactation. Monitoring Parameters Monitor serum paracetamol levels esp when acute overdosage is suspected and w/ long-term use.

Side Effect

• Thrombocytopenia, leucopenia, pancytopenia, neutropenia, agranulocytosis, pain and burning sensation at inj site. Rarely, hypotension and tachycardia. Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis, acute renal tubular necrosis and hepatotoxicity.

Interaction

• May reduce serum levels w/ anticonvulsants (e.g. phenytoin, barbiturates, carbamazepine). May enhance the anticoagulant effect of warfarin and other coumarins w/ prolonged use. Accelerated absorption w/ metoclopramide and domperidone. May increase serum levels w/ probenecid. May increase serum levels of chloramphenicol. May reduce absorption w/ colestyramine w/in 1 hr of admin. May cause severe hypothermia w/ phenothiazine.