ADOL 500mg Rectal Suppositories

What is ADOL 500mg

ADOL 500 mg rectal suppositories are a single-ingredient, non-opioid analgesic and antipyretic preparation containing paracetamol (acetaminophen) 500 mg in a hydrogenated fat base. Formulated for rectal administration, they provide an alternative route when oral intake is impractical—such as in vomiting, peri-operative patients, or children who refuse tablets.

• Therapeutic class: Analgesic/antipyretic (ATC code N02BE01).
• Indications:
  • Symptomatic relief of mild-to-moderate pain (headache, dental pain, musculoskeletal aches, dysmenorrhoea, post-operative pain).
  • Reduction of fever of any aetiology (viral infections, post-immunisation pyrexia, etc.).
• Onset & duration: Analgesia begins ~30–60 min after insertion; antipyresis peaks by 2 h. Effect lasts 4–6 h.
• Why rectal? Bypasses gastric irritation and first-pass variability, offers steady absorption, and is valuable when IV access is unavailable.
• Packaging: Each carton contains two PVC-Alu blisters, five suppositories per strip (10 suppositories total).
• Regulatory status: OTC in many jurisdictions; schedule may vary—check local laws.

How to use ADOL 500mg

Correct insertion maximises efficacy and minimises mucosal trauma. Follow these evidence-based steps:

• Preparation
  • Wash hands with soap and warm water; dry thoroughly.
  • If the suppository feels soft (ambient > 30 °C), chill in a refrigerator for 5–10 min or run cold water over the foil to harden it.
• Positioning
  • Lateral (Sim’s) or dorsal recumbent with knees flexed is ideal. Children can be placed prone across the caregiver’s lap.
• Insertion technique
  • Peel the foil from the suppository—never cut with scissors, which may scratch the surface.
  • Moisten the tapered end with a drop of water or a water-based lubricant if necessary.
  • With gentle pressure, introduce the pointed end past the internal sphincter (~2.5 cm in adults, ~1.5 cm in children) to prevent expulsion.
  • Maintain position for 2–3 min; encourage children to lie still for 5 min.
• Hygiene – Rewash hands; discard packaging responsibly.
• Missed dose – Insert as soon as remembered if pain/fever persists, respecting minimum 4-h interval; never double doses.
• Special populations
  • Liver disease: Consult a physician before use; cumulative dose often limited to ≤ 2 g/day.
  • Renal impairment: Dosing interval may be extended to 6–8 h if eGFR < 30 mL/min.

Mode of Action ADOL 500mg

Although paracetamol has been in therapeutic use since 1893, its pharmacodynamics remain only partially elucidated. Current consensus highlights a centrally mediated, multifactorial mechanism:

• Cyclo-oxygenase (COX) inhibition
  • Selectively inhibits a brain-specific COX-2 variant (sometimes termed COX-3), reducing synthesis of prostaglandin E₂—key in fever and pain transmission.
  • Spares peripheral prostaglandins, explaining minimal anti-inflammatory and platelet effects.
• Serotonergic modulation
  • Enhances descending 5-HT3 anti-nociceptive pathways in the spinal cord.
• Endocannabinoid interaction
  • Metabolite p-aminophenol conjugates with arachidonic acid forming AM404, an anandamide re-uptake inhibitor acting on CB₁ receptors—attenuates central pain perception.
• TRPA1 channel blockade – Reduces transmission in pain-sensitive neurons.

This composite action lowers the hypothalamic set-point in fever and elevates pain threshold without gastrointestinal or renal vascular compromise typical of NSAIDs.

ADOL 500mg Interactions ADOL 500mg

While paracetamol is generally well tolerated, certain pharmacokinetic or pharmacodynamic interactions warrant caution:

• Hepatic enzyme inducers (e.g., rifampicin, carbamazepine, phenytoin, phenobarbital, St John’s wort)
  • Accelerate CYP2E1-mediated conversion to the hepatotoxic metabolite NAPQI → ↑ risk of liver injury at therapeutic doses.
• Warfarin & other coumarin anticoagulants
  • Regular paracetamol (> 2 g/day for ≥ 3 days) potentiates INR; monitor clotting or adjust warfarin dose.
• Isoniazid – Competitive metabolism heightens hepatotoxicity.
• Alcohol (chronic ´)
  • Chronic intake induces CYP2E1; acute heavy drinking depletes glutathione → both increase susceptibility to hepatotoxicity.
• Probenecid – Nearly doubles paracetamol AUC by inhibiting glucuronidation; halve paracetamol dose if long-term concomitance.
• Metoclopramide or domperidone – Accelerate gastric emptying; not relevant to rectal route but may alter systemic exposure if alternating with oral forms.
• Cholestyramine – Binds drug in the gut; negligible effect rectally but avoid giving orally within 1 h.
• Lamotrigine – Paracetamol may enhance glucuronidation, lowering lamotrigine levels; monitor seizure control.

Always review full medication profiles, including OTC and herbal agents, before prolonged paracetamol therapy.

Dosage of ADOL 500mg

Below are evidence-based rectal dosing regimens; adapt to local guidelines and patient factors:

• Adults & adolescents ≥ 12 y
  • 500 mg–1 g every 4–6 h as needed.
  • Maximum 4 g in 24 h (8 suppositories).
• Children 6–11 y – 250–500 mg every 6 h; max 60 mg/kg/day.
• Children 3–5 y – 250 mg every 6 h; max 60 mg/kg/day.
• Children 1–2 y – 125 mg every 6 h; max 60 mg/kg/day (use appropriately dosed paediatric suppository).
• Infants 3–11 mo – 60–125 mg every 6–8 h; specialist advice required.
• Elderly – No dose adjustment if liver & renal function normal; consider reduced frequency if frail or low body weight.
• Hepatic impairment – Reduce total daily dose to ≤ 2 g and extend dosing interval to 6–8 h.
• Renal impairment (CrCl < 30 mL/min) – Standard single dose but interval ≥ 6 h; avoid consecutive high doses.
• Dose calculation tip – In paediatrics, base on weight: 15 mg/kg per dose up to 60 mg/kg/day.

Important: Do not exceed recommended limits; cumulative paracetamol from combination cold/flu products counts toward the daily ceiling.

Possible side effects of ADOL 500mg

At therapeutic doses, paracetamol’s adverse-event profile is benign, yet no drug is risk-free. Monitor for:

• Common (< 1 %)
  • Local rectal discomfort, transient burning, or urge to defecate.
• Uncommon (0.1–1 %)
  • Pruritus, erythema, urticaria.
  • Nausea or abdominal cramps (rare, often dose-related).
• Rare (< 0.1 %)
  • Hypersensitivity reactions: angio-oedema, bronchospasm—higher risk in NSAID-asthma triad.
  • Hepatic enzyme elevation after prolonged high doses.
  • Thrombocytopenia, neutropenia, pancytopenia—idiosyncratic, reversible on withdrawal.
• Very rare (< 0.01 %)
  • Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN); discontinue immediately if mucocutaneous lesions appear.
  • Acute generalized exanthematous pustulosis (AGEP).
• Toxicity (overdose)
  • Phase I (0–24 h): anorexia, nausea, diaphoresis → often mild.
  • Phase II (24–72 h): RUQ pain, rising ALT/AST.
  • Phase III (72–96 h): fulminant hepatic failure, coagulopathy, encephalopathy.
  • Phase IV (4–14 d): recovery or death/transplant.

Any jaundice, dark urine, or severe abdominal pain warrants urgent medical review, regardless of dose taken.

ADOL 500mg Contraindications ADOL 500mg

Although broad safety supports widespread OTC use, treatment is contraindicated in the following circumstances:

• Known hypersensitivity to paracetamol or any excipients (e.g., hard fat suppository base).
• Severe hepatic impairment (Child-Pugh C), active liver disease, or acute viral hepatitis.
• Severe haemolytic anaemia or G6PD deficiency where oxidative stress may precipitate crisis.
• Rectal pathology – Anal fissures, proctitis, recent colorectal surgery, or active haemorrhoids causing pain/bleeding.
• Repeated high-dose alcohol misuse because of depleted glutathione stores.
• Dehydration & malnutrition (e.g., anorexia, eating disorders, cachexia) where glutathione reserves are low.
• Premature neonates (< 37 weeks gestation) without specialist supervision due to immature hepatic enzymes.

Clinicians should weigh risk–benefit in moderate hepatic or renal impairment and consider lower total daily doses.

Storage of ADOL 500mg

Proper storage preserves potency and microbial integrity:

• Temperature: Store below 25 °C (77 °F). Short excursions to 30 °C tolerated, but avoid prolonged heat that may soften suppositories.
• Humidity: Keep in original heat-sealed blister until use; moisture may erode the suppository base.
• Light: Paracetamol is photo-stable, yet opaque packaging shields from oxidation.
• Handling hints
  • Do not refrigerate for extended periods (> 1 month) to prevent fat bloom and brittleness.
  • For travel, transport in an insulated pouch if ambient > 35 °C.
• Child safety: Store out of sight and reach; rectal suppositories resemble confectionery.
• Shelf-life: Typically 36 months unopened. Check expiry date; discard if discoloured, rancid-smelling, or fissured.
• Disposal: Return unused or expired medicines to a pharmacy take-back program; do not flush or burn.

Following these guidelines ensures each suppository delivers its full therapeutic promise when required.