Napa Syrup 120 mg/5 ml

Napa Syrup is a widely-used analgesic containing Paracetamol (120mg/5ml) manufactured by Beximco Pharmaceuticals Ltd. Priced at ৳35.00 per unit, this syrup formulation effectively manages fever, flu symptoms, and various pain conditions including headaches, dental pain, and post-vaccination discomfort in children.

The medication inhibits prostaglandin synthesis by targeting COX enzymes in the CNS, providing rapid pain relief with minimal anti-inflammatory effects. As Bangladesh’s most trusted Paracetamol brand, Napa Syrup offers better tolerance compared to NSAIDs, making it suitable for patients with aspirin sensitivity.

Dosage varies by age:

• Infants (below 3 months): 10mg/dose
• Children (1-5 years): 1-2 teaspoons
• Adults: 4-8 teaspoons every 4-6 hours

Always use the provided measuring cup for accurate dosing.

While generally safe, potential side effects include skin rashes and pancreatic inflammation. Avoid alcohol consumption and concurrent use with barbiturates or anticonvulsants to prevent liver toxicity. Store in dry conditions away from children.

For overdose cases (>10g), immediate medical attention is crucial. Treatment includes activated charcoal within 1 hour or N-acetylcysteine therapy. Napa Syrup remains pregnancy/lactation-friendly when used as directed, with minimal transfer to breast milk.

Syrup: Adults 4-8 teaspoons (240-480 mg) every 6-8 hours. Pediatric doses (1-5 years: 1-2 teaspoons). Max daily dose 4g. Reduce dose in hepatic impairment. Take after meals. Consult doctor if used beyond 3-5 days.

Side effects of Napa are usually mild, though haematological reactions including thrombocytopenia, leucopenia, pancytopenia, neutropenia, and agranulocytosis have been reported. Pancreatitis, skin rashes, and other allergic reactions occur occasionally.

Pregnancy Category B. Excreted minimally in breast milk. Max 4g/day dose advised.

Monitor liver function in hepatic/renal patients. Avoid concurrent alcohol. Check for hidden paracetamol sources.

Pediatric: Use under medical supervision <3 months. Geriatric: Dose adjustment may needed. Hepatic/Renal: Extended dosing intervals.

Liver damage is possible in adults who have taken 10 g or more of Napa. Ingestion of 5 g or more of Napa may lead to liver damage if the patient has following risk factors: If the patient is on long term treatment with Carbamazepine, Phenobarbitone, Phenytoin, Primidone, Rifampicin, St John’s Wort or other drugs that induce liver enzymes, or regularly consumes Ethanol in excess of recommended amounts, or is likely to be Glutathione deplete e.g. eating disorders, cystic fibrosis, HIV infection, starvation, cachexia.

Symptoms: Symptoms of Napa overdose 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. In severe poisoning, hepatic failure may progress to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema and death. Acute renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria and proteinuria, may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported. Immediate treatment is essential in the management of Napa overdose. Treatment with activated charcoal should be considered if the overdose has been taken within 1 hour. Plasma Napa concentration should be measured at 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of Napa. However, the maximum protective effect is obtained up to 8 hours post-ingestion. The effectiveness of the antidote declines sharply after this time. If required the patient should be given intravenous N-acetylcysteine, in line with the established dosage schedule. If vomiting is not a problem, oral Methionine may be a suitable alternative for remote areas, outside hospital. Management of patients who present with serious hepatic dysfunction beyond 24 hours from ingestion should be discussed with the NPIS or a liver unit.