Napa Suppository 250 mg

Napa Suppository is a rectal formulation containing 250 mg Paracetamol, manufactured by Beximco Pharmaceuticals Ltd. Primarily used for pain and fever management, this suppository offers an alternative for patients who cannot take oral medications. Priced at ৳5.00 per unit, it provides cost-effective relief for diverse conditions like headaches, post-vaccination pain, and osteoarthritis.

The suppository works by inhibiting prostaglandin synthesis through COX enzyme pathways in the CNS. Unlike NSAIDs, it has minimal anti-inflammatory effects but remains safer for gastric health. Its rapid action makes it ideal for acute pain episodes. Always store in a cool, dry place away from children’s reach.

Key indications include:

• Fever (viral, flu-related)
• Musculoskeletal pain
• Post-surgical and postpartum pain
• Dental/earaches

Dosage varies by age:

• Adults: 0.5–1 gm every 4–6 hours
• Children (6–12 years): 250–500 mg per dose

Potential side effects like skin rashes or pancreatitis are rare. Avoid concurrent use with alcohol or enzyme-inducing drugs (e.g., rifampicin) to prevent liver toxicity. Pregnant/lactating women should consult doctors despite its general safety profile.

Suppository Dosage:
3 months-1 year: 60-120 mg 4 times daily.
1-5 years: 125-250 mg 4 times daily.
6-12 years: 250-500 mg 4 times daily.
Adults: 500 mg-1 g 4 times daily. Maintain 4-6 hour intervals between doses. Adjust dose in hepatic/renal impairment.

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.

Use during pregnancy under medical supervision. Safe during lactation at recommended doses.

Monitor patients with hepatic/renal impairment or chronic alcoholism. Consult doctor if used beyond 7 days. Wash hands before administering suppository.

Pediatric: Follow age-specific dosing. Geriatric: No dose adjustment needed. Hepatic impairment: Reduce dose. Renal impairment: Extend dosing interval if creatinine clearance <30 mL/min.

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.