Napa Suppository 125 mg

Napa Suppository is a rectal formulation containing Paracetamol 125 mg, manufactured by Beximco Pharmaceuticals Ltd. Primarily used for pain and fever management, it offers an effective alternative for patients who cannot take oral medications. Priced at ৳4.00 per unit, it is economical for both short-term and long-term use.

This suppository treats diverse conditions: fever, flu, headaches, dental pain, postoperative pain, and musculoskeletal discomfort. Its analgesic and antipyretic properties inhibit prostaglandin synthesis via COX enzyme pathways. Though classified as a suppository, it ensures rapid absorption and minimal gastrointestinal irritation.

Dosage varies by age:

• 3 months–1 year: 60–120 mg every 4–6 hours
• 1–5 years: 125–250 mg every 4–6 hours
• 6–12 years: 250–500 mg every 4–6 hours
• Adults: 0.5–1 g every 4–6 hours

Never exceed 4 doses daily. Store in a cool, dry place away from light.

Common side effects include mild allergic reactions or skin rashes. Severe liver damage may occur with overdose (>10 g). Avoid combining with alcohol or enzyme-inducing drugs like phenobarbital. Pregnant/lactating women should consult doctors despite its safety profile.

As a cost-effective non-opioid analgesic, Napa Suppository complements other Paracetamol variants (e.g., Napa 250 mg/500 mg tablets). Trusted by Beximco Pharmaceuticals, it remains a staple in Bangladeshi households for pediatric and geriatric care.

Suppository dose: 3-12 months: 60-120 mg 4 times daily. 1-5 years: 125-250 mg. 6-12 years: 250-500 mg. Adults: 500-1000 mg every 4-6 hours. Reduce dose in hepatic/renal impairment. Insert rectally after hand hygiene.

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. Short-term use safe under medical supervision. Excreted minimally in breastmilk—compatible with lactation.

Caution in hepatic/renal disease. Max 4g/day. Avoid concurrent paracetamol products. Keep away from children.

Pediatrics: Contraindicated <3 months. Geriatric: Standard dose safe. Hepatic impairment: Max 2g/day. Renal impairment: Extend dosing interval if CrCl <30.

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.