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Overview

Welcome to Dwaey, specifically on NUTRYELT page.
This medicine contains an important and useful components, as it consists of
Zinc gluconate , Copper gluconate, Manganese gluconate, Sodium fluoride, Potassium iodide, Sodium selenite, Sodium molybdate, Chromium chloride, Ferrous gluconate, is available in the market in concentration

Name

Acemetacin

Precaution

Acemetacin is a nonsteroidal anti-inflammatory drug (NSAID) used to manage pain and inflammation in conditions such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. While it is effective for managing these conditions, there are several precautions to consider: - **Gastrointestinal (GI) risk**: Like all NSAIDs, acemetacin can cause gastrointestinal irritation, ulcers, bleeding, or perforation. The risk of these issues increases in patients with a history of peptic ulcers, gastrointestinal bleeding, or those who consume alcohol or tobacco. Patients should be monitored for signs of GI distress, and concomitant use of proton pump inhibitors (PPIs) may help mitigate some of these risks. - **Cardiovascular (CV) risk**: Chronic use of acemetacin can increase the risk of cardiovascular events such as heart attack and stroke, especially in patients with pre-existing cardiovascular diseases, hypertension, or those with risk factors like smoking or diabetes. Blood pressure should be monitored during treatment, and patients with known heart disease should use the drug cautiously. - **Renal impairment**: Acemetacin is metabolized by the liver and excreted by the kidneys, so it can affect renal function, especially in patients with pre-existing kidney disease. It may cause fluid retention or renal failure in sensitive individuals. Renal function should be closely monitored in elderly patients or those with kidney problems. - **Liver disease**: Patients with liver disorders should use acemetacin cautiously, as NSAIDs can worsen liver function. Liver function tests should be regularly performed during therapy to detect any signs of hepatotoxicity. - **Pregnancy and breastfeeding**: Acemetacin is contraindicated during the third trimester of pregnancy due to the potential risk of premature closure of the ductus arteriosus in the fetus. It should be used with caution in the first and second trimesters only when the potential benefit justifies the potential risk. Additionally, acemetacin may pass into breast milk, and its use is not recommended during breastfeeding. - **Asthma and allergic reactions**: Acemetacin can exacerbate asthma or cause allergic reactions in patients with a known sensitivity to NSAIDs or aspirin. Patients with a history of asthma, rhinitis, or other allergic conditions should be closely monitored during treatment.

Indication

Acemetacin is indicated for the management of pain and inflammation associated with several musculoskeletal and inflammatory conditions: - **Osteoarthritis**: A degenerative joint disease characterized by the breakdown of cartilage in the joints, acemetacin helps reduce inflammation and pain associated with this condition. - **Rheumatoid arthritis**: Acemetacin is used to manage pain and inflammation in patients with rheumatoid arthritis, an autoimmune disease that causes chronic inflammation and damage to the joints. - **Ankylosing spondylitis**: Acemetacin is also used for the treatment of ankylosing spondylitis, a chronic inflammatory condition that affects the spine and large joints, causing pain and stiffness. - **Other inflammatory conditions**: Acemetacin may be used to treat other conditions where inflammation is a significant component, such as soft tissue injuries or musculoskeletal pain. Acemetacin is primarily used to treat chronic inflammatory conditions but can also be used for short-term pain relief in acute musculoskeletal injuries. Its use in acute gout or similar conditions is less common, as other NSAIDs may be preferred.

Contra indication

There are several conditions that contraindicate the use of acemetacin due to the potential for serious adverse effects: - **Hypersensitivity**: Acemetacin should not be used in patients who have a known hypersensitivity to the drug or other NSAIDs, including aspirin. Hypersensitivity reactions can lead to anaphylaxis, severe rash, or angioedema. - **Active gastrointestinal bleeding or ulcers**: Acemetacin is contraindicated in individuals with active gastrointestinal bleeding, peptic ulcers, or a history of gastrointestinal perforation. As an NSAID, it can exacerbate these conditions by inhibiting prostaglandins that protect the gastrointestinal lining. - **Severe renal or hepatic impairment**: Acemetacin is contraindicated in patients with severe renal or hepatic dysfunction due to its reliance on renal and liver metabolism for clearance. In cases of severe impairment, it can worsen kidney or liver function. - **Pregnancy (third trimester)**: Acemetacin should not be used during the third trimester of pregnancy due to the risk of premature closure of the ductus arteriosus, which can lead to fetal complications. It should only be used in pregnancy during the first or second trimester if absolutely necessary. - **Asthma or history of NSAID-induced asthma**: Acemetacin is contraindicated in patients with asthma triggered by NSAIDs or aspirin due to the potential for exacerbating asthma symptoms or causing other respiratory issues. - **Heart failure**: In patients with heart failure or significant cardiovascular disease, acemetacin should be avoided due to the risk of fluid retention, increased blood pressure, and potential exacerbation of heart failure.

Side Effect

Acemetacin can cause a range of side effects, some of which may be severe. Side effects generally depend on the dose and duration of therapy. - **Common side effects**: - **Gastrointestinal disturbances**: These include nausea, dyspepsia, abdominal pain, and heartburn. Gastrointestinal discomfort is the most frequently reported side effect. - **Headache and dizziness**: Some patients may experience mild headache, dizziness, or lightheadedness. - **Skin rash**: A rash or itching may occur, although this is less common. - **Serious side effects**: - **Gastrointestinal bleeding or ulcers**: Long-term use of acemetacin can lead to gastric ulcers, bleeding, or perforation. Symptoms of severe gastrointestinal side effects include black or bloody stools, vomiting blood, or severe abdominal pain. - **Renal issues**: Acemetacin may lead to fluid retention, kidney dysfunction, or acute renal failure, especially in patients with pre-existing kidney disease. - **Cardiovascular events**: Prolonged use of acemetacin increases the risk of cardiovascular events like heart attack, stroke, and hypertension. Symptoms like chest pain, shortness of breath, or severe dizziness should be taken seriously. - **Management**: To reduce gastrointestinal side effects, acemetacin should be taken with food. If serious side effects like bleeding, renal failure, or cardiovascular issues occur, the drug should be discontinued, and the patient should seek immediate medical attention.

Pregnancy Category ID

0

Mode of Action

Acemetacin exerts its therapeutic effects by inhibiting the enzyme **cyclooxygenase (COX)**, specifically **COX-2**, which plays a key role in the synthesis of prostaglandins. Prostaglandins are inflammatory mediators that cause pain, fever, and swelling. By inhibiting COX-2, acemetacin reduces the production of these inflammatory mediators, thus alleviating pain, inflammation, and fever. - **Pharmacodynamics**: As an NSAID, acemetacin's primary effects are anti-inflammatory, analgesic, and antipyretic. It selectively inhibits COX-2, which is predominantly involved in inflammatory processes. This selective inhibition helps reduce the gastrointestinal side effects often associated with non-selective COX inhibitors. - **Pharmacokinetics**: Acemetacin is rapidly absorbed after oral administration and is metabolized by the liver into active metabolites. It has a half-life of approximately 4-5 hours, and the drug is primarily excreted in the urine.

Interaction

Acemetacin can interact with various medications, which may alter its effectiveness or lead to adverse effects: - **Anticoagulants (warfarin)**: Concomitant use of acemetacin and anticoagulants increases the risk of bleeding due to the inhibition of platelet aggregation by both drugs. Patients should be monitored for signs of bleeding, and dose adjustments may be needed for anticoagulant therapy. - **Other NSAIDs or corticosteroids**: Combining acemetacin with other NSAIDs or corticosteroids increases the risk of gastrointestinal ulcers, bleeding, and perforation. It is generally recommended not to use these drugs together. - **Antihypertensive medications (ACE inhibitors, diuretics)**: Acemetacin can reduce the effectiveness of antihypertensive medications, especially ACE inhibitors and diuretics, by causing fluid retention and reducing renal blood flow. Blood pressure should be monitored closely when using these combinations. - **Lithium**: Acemetacin can increase lithium levels, leading to potential lithium toxicity. If both drugs are used, regular monitoring of lithium levels is recommended. - **Methotrexate**: Acemetacin can increase the toxicity of methotrexate by inhibiting its renal excretion, leading to elevated methotrexate plasma concentrations. This combination should be avoided or closely monitored. - **Alcohol**: Alcohol consumption during acemetacin therapy increases the risk of gastrointestinal bleeding and ulcers. It is recommended to limit alcohol intake while using this drug.

Pregnancy Category Note

Information not available

Adult Dose

The usual dose of acemetacin for adults depends on the condition being treated: - **Osteoarthritis or rheumatoid arthritis**: The typical dose is **60–120 mg** per day, divided into two or three doses. The dose can be adjusted based on the severity of symptoms. - **Ankylosing spondylitis**: A dose of **120 mg per day** is commonly prescribed, usually divided into two doses. - **Acute pain or musculoskeletal pain**: Higher doses may be used for acute conditions, up to a maximum of **150 mg per day**, divided into two or three doses.

Child Dose

Acemetacin is generally not recommended for use in children under 18 due to a lack of safety and efficacy data in pediatric populations. Alternative medications should be considered for children requiring pain or anti-inflammatory treatment.

Renal Dose

In patients with mild to moderate renal impairment, acemetacin can still be used, but the dose may need to be reduced, and renal function should be closely monitored. In patients with severe renal dysfunction (creatinine clearance <30 mL/min), acemetacin should be avoided, as it can worsen kidney function.

Administration

Information not available