Napa Tablet 500 mg

Napa Tablet is a widely used paracetamol-based medication manufactured by Beximco Pharmaceuticals Ltd. Each 500 mg tablet effectively addresses fever, headaches, musculoskeletal pain, and post-vaccination discomfort in children. Priced at ৳1.20 per unit, it offers an affordable solution for mild-to-moderate pain management across all age groups.

This tablet formulation inhibits prostaglandin synthesis by targeting COX enzymes in the CNS. Unlike NSAIDs, it causes minimal gastric irritation, making it safer for prolonged use. The strip price of ৳12.00 (10 tablets) and bulk pack of 510 tablets (৳612.00) cater to different therapeutic needs.

Key indications include:

• Fever from cold/flu
• Dental/ear/menstrual pain
• Post-surgical discomfort
• Arthritic pain relief

Dosages vary by age:

• Adults: 1-2 tablets every 4-6 hours (max 8/day)
• Children (6-12 years): ½-1 tablet 3-4 times daily

Extended-release formulations require stricter dose monitoring to prevent hepatotoxicity.

While generally safe, potential side effects include rare skin rashes (0.01% cases) and pancreatitis. Concurrent use with alcohol or enzyme-inducing drugs like phenobarbital increases overdose risks. Patients should store tablets in dry conditions below 30°C and consult doctors when pregnant/lactating.

Tablet: Adults 500mg 1-2 tablets every 4-6hrs (Max 4g/day). Children (6-12yrs): 250-500mg 4 times daily. Suspension: 3mo-1yr: 80-160mg, 1-5yrs: 160-320mg. Hepatic/renal impairment requires 50% dose reduction. Can be taken with/without food. Consult doctor if used beyond 5-7 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): Safe in low doses; avoid prolonged use. Lactation: 0.1-1% secreted in milk – compatible. Maximum 4g/day for ≤3 days considered safe.

Limit to 3g/day in alcoholics/malnourished/HIV patients. Monthly LFT monitoring during chronic use. Avoid other paracetamol combinations. Medical supervision needed if used >72hrs continuously.

Pediatric: Contraindicated <3 months without medical supervision. Geriatric: Adjust dose based on renal function. Renal: 50% dose reduction if CrCl <30mL/min. Hepatic: Max 2g/day in Child-Pugh B/C cirrhosis.

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.