CURE-MRDICLOFENAC POT. 50 MG + CHLORZOXAZONE 250MG + PARACETAMOL 500MG.

CURE-DSPDiclofenac potassium 50mg, and serratiopeptidase 10mg Paracetamol 500mg

CURE-MR / CURE-DSP/CURE-60 is very potent analgesic, anti-pyretic, anti-inflammatory drug

Pharmacodynamics: Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that shows preferential inhibition of the cyclooxygenase-2 (COX-2) enzyme. Antipyretic effects may be due to action on the hypothalamus, resulting in peripheral dilation, increased cutaneous blood flow, and subsequent heat dissipation. It is ideally suited for patients on sodium free diet, hypertensive patients and those on diuretic therapy.Chlorzoxazone: Chlorzoxazone is a centrally acting agent for painful musculoskeletal conditions chlorzoxazone acts primarily at the level of the spinal cord and subcortical areas of the brain where it inhibits multisynaptic reflex arcs involved in producing and maintaining skeletal muscle spasm of varied etiology.  Paracetamol: Paracetamol is a clinically proven analgesic and antipyretic agent with weak anti-inflammatory effect. Analgesic action: It produces analgesia by raising pain threshold. Serratiopeptidase  is a centrally acting agent for painful musculoskeletal conditions. It deactivates plasmin inhibitors, hydrolyses pain mediators like bradykinin, histamine, etc, accelerates liquefaction & elimination of sputum, pus & haematoma, reduces inflammation and improves microcirculation. It helps the body to breakdown pus & debris of dead microbes & thus increases penetration of antibiotics at the site of infection. On oral administration serratiopeptidase binds to α2-macroglobulin in the blood in a 1:1 ratio. This helps to mask its antigenicity but retains its enzymatic activity. Levels of serratiopeptidase are slowly transferred to the exudates at the site of infection and inflammation and gradually blood levels decline.

Pharmacokinetics: Serratiopeptidase has been shown to be absorbed from the digestive tract. On oral administration, it is absorbed unchanged into the systemic circulation, from where it penetrates into all the tissues. It reaches higher concentrations in the inflamed tissues. It attains peak levels in one hour. Metabolism takes place in liver and the metabolites are excreted through urine and faeces. Diclofenac potassium:Absorption : Diclofenac is 100% absorbed after oral administration compared to IV administration as measured by urine recovery. However, due to first-pass metabolism, only about 50% of the absorbed dose is systemically available. In some fasting volunteers, measurable plasma levels are observed within 10 minutes of dosing with diclofenac potassium tablets. Peak plasma levels are achieved approximately 1 hour in fasting normal volunteers, with a range of .33 to 2 hours. Food has no significant effect on the extent of diclofenac absorption. However, there is usually a delay in the onset of absorption and a reduction in peak plasma levels of approximately 30%.Distribution: The apparent volume of distribution (V/F) of diclofenac potassium is 1.3 L/kg. Diclofenac is more than 99% bound to human serum proteins, primarily to albumin. Serum protein binding is constant over the concentration range (0.15-105 µg/mL) achieved with recommended doses. Diclofenac diffuses into and out of the synovial fluid. Diffusion into the joint occurs when plasma levels are higher than those in the synovial fluid, after which the process reverses and synovial fluid levels are higher than plasma levels. Metabolism: Five diclofenac metabolites have been identified in human plasma and urine. Excretion: Diclofenac is eliminated through metabolism and subsequent urinary and biliary excretion of the glucuronide and the sulfate conjugates of the metabolites. Chlorzoxazone: is reported to be completely absorbed after oral administration and distributed through the body. The peak plasma concentration is achieved after 1 to 2 hours. It is rapidly metabolized in the liver, mainly 6-hydroxy chlorzoxazone and excreted in the urine primarily as the glucuronide. INDICATIONS AND USAGE : Cure-DSP; Cure-60: For treatment of primary dysmenorrhea ; For relief of mild to moderate pain ; For relief of the signs and symptoms of osteoarthritis ; For relief of the signs and symptoms of rheumatoid arthritis. CURE-MR: Symptomatic treatment of muscle spasm and pain associated with acute musculoskeletal conditionsDOSAGE : CURE-MR: 1 tablet 3-4times a day after meals. Cure-60:1 tablet thrice a day after meals. Cure-DSP: 1 tablet thrice a day after mealsWARNINGS: Hypertension, Congestive Heart Failure and Edema,serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine, which can be fatal. Renal Effects:Caution should be used when initiating treatment .

Pregnancy Category CDrug Interactions: Aspirin, Methotrexate, Cyclosporine, ACE-inhibitors, Diuretics, Lithium, Warfarin.OVERDOSAGE: Symptoms following acute NSAID overdoses are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Patients should be managed by symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose). Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.