Parvon N Uses

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Parvon N indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or Paracetamol (Parvon N) is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of Paracetamol (Parvon N). A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Reduction of fever. Relief of aches & pains associated w/ flu, common colds, tonsilitis, teething pains & post-immunization reactions.

Parvon N description

A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of morphine. It also has a depressant action on the cough center and may be given to control intractable cough associated with terminal lung cancer. Parvon N is also used as part of the treatment of dependence on opioid drugs, although prolonged use of methadone itself may result in dependence. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)

Parvon N interactions

In vitro results suggest that methadone undergoes hepatic N-demethylation by cytochrome P450 enzymes, principally CYP3A4, CYP2B6, CYP2C19 and to a lesser extent by CYP2C9 and CYP2D6. Coadministration of methadone with CYP inducers of these enzymes may result in a more rapid metabolism and potential for decreased effects of methadone, whereas administration with CYP inhibitors may reduce metabolism and potentiate methadones effects. Although antiretroviral drugs such as efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination are known to inhibit CYPs, they are shown to reduce the plasma levels of methadone, possibly due to their CYP induction activity. Therefore, drugs administered concomitantly with methadone should be evaluated for interaction potential; clinicians are advised to evaluate individual response to drug therapy.

Opioid Antagonists, Mixed Agonist/Antagonists, and Partial Agonists

As with other mu-agonists, patients maintained on methadone may experience withdrawal symptoms when given opioid antagonists, mixed agonist/antagonists, and partial agonists. Examples of such agents are naloxone, naltrexone, pentazocine, nalbuphine, butorphanol, and buprenorphine.

Anti-retroviral Agents

Abacavir, amprenavir, efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination - Coadministration of these anti-retroviral agents resulted in increased clearance or decreased plasma levels of methadone. Parvon N-maintained patients beginning treatment with these antiretroviral drugs should be monitored for evidence of withdrawal effects and methadone dose should be adjusted accordingly.

Didanosine and Stavudine - Experimental evidence demonstrated that methadone decreased the AUC and peak levels for didanosine and stavudine, with a more significant decrease for didanosine. Parvon N disposition was not substantially altered.

Zidovudine - Experimental evidence demonstrated that methadone increased the area under the concentration-time curve (AUC) of zidovudine which could result in toxic effects.

Cytochrome P450 Inducers

Parvon N-maintained patients beginning treatment with CYP3A4 inducers should be monitored for evidence of withdrawal effects and methadone dose should be adjusted accordingly. The following drug interactions were reported following coadministration of methadone with inducers of cytochrome P450 enzymes:

Rifampin - In patients well-stabilized on methadone, concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms.

Phenytoin - In a pharmacokinetic study with patients on methadone maintenance therapy, phenytoin administration (250 mg b.i.d. initially for 1 day followed by 300 mg QD for 3 to 4 days) resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. Upon discontinuation of phenytoin, the incidence of withdrawal symptoms decreased and methadone exposure increased to a level comparable to that prior to phenytoin administration.

St. Johns Wort, Phenobarbital, Carbamazepin/strong>Administration of methadone along with other CYP3A4 inducers may result in withdrawal symptoms.

Cytochrome P450 Inhibitors

Since the metabolism of methadone is mediated primarily by CYP3A4 isozyme, coadministration of drugs that inhibit CYP3A4 activity may cause decreased clearance of methadone. The expected clinical results would be increased or prolonged opioid effects. Thus, methadone-treated patients coadministered strong inhibitors of CYP3A4, such as azole antifungal agents (e.g., ketoconazole) and macrolide antibiotics (e.g., erythromycin), with methadone should be carefully monitored and dosage adjustment should be undertaken if warranted. Some selective serotonin reuptake inhibitors (SSRIs) (e.g., sertraline, fluvoxamine) may increase methadone plasma levels upon coadministration with methadone and result in increased opiate effects and/or toxicity.

Voriconazole - Repeat dose administration of oral voriconazole (400mg Q12h for 1 day, then 200mg Q12h for 4 days) increased the Cmax and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose (30 to 100 mg QD). The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively. Increased plasma concentrations of methadone have been associated with toxicity including QT prolongation. Frequent monitoring for adverse events and toxicity related to methadone is recommended during coadministration. Dose reduction of methadone may be needed.

Others

Monoamine Oxidase (MAO) Inhibitors - Therapeutic doses of meperidine have precipitated severe reactions in patients concurrently receiving monoamine oxidase inhibitors or those who have received such agents within 14 days. Similar reactions thus far have not been reported with methadone. However, if the use of methadone is necessary in such patients, a sensitivity test should be performed in which repeated small, incremental doses of methadone are administered over the course of several hours while the patients condition and vital signs are under careful observation.

Desipramine - Blood levels of desipramine have increased with concurrent methadone administration.

Potentially Arrhythmogenic Agents

Extreme caution is necessary when any drug known to have the potential to prolong the QT interval is prescribed in conjunction with methadone. Pharmacodynamic interactions may occur with concomitant use of methadone and potentially arrhythmogenic agents such as class I and III antiarrhythmics, some neuroleptics and tricyclic antidepressants, and calcium channel blockers.

Caution should also be exercised when prescribing methadone concomitantly with drugs capable of inducing electrolyte disturbances (hypomagnesemia, hypokalemia) that may prolong the QT interval. These drugs include diuretics, laxatives, and, in rare cases, mineralocorticoid hormones.

Interactions with Alcohol and Drugs of Abuse

Parvon N may be expected to have additive effects when used in conjunction with alcohol, other opioids or CNS depressants, or with illicit drugs that cause central nervous system depression. Deaths have been reported when methadone has been abused in conjunction with benzodiazepines.

Anxiety - Since methadone as used by tolerant patients at a constant maintenance dosage does not act as a tranquilizer, patients who are maintained on this drug will react to life problems and stresses with the same symptoms of anxiety as do other individuals. The physician should not confuse such symptoms with those of narcotic abstinence and should not attempt to treat anxiety by increasing the dose of methadone. The action of methadone in maintenance treatment is limited to the control of narcotic withdrawal symptoms and is ineffective for relief of general anxiety.

Acute Pain - Maintenance patients on a stable dose of methadone who experience physical trauma, postoperative pain or other acute pain cannot be expected to derive analgesia from their existing dose of methadone. Such patients should be administered analgesics, including opioids, in doses that would otherwise be indicated for non-methadone-treated patients with similar painful conditions. Due to the opioid tolerance induced by methadone, when opioids are required for management of acute pain in methadone patients, somewhat higher and/or more frequent doses will often be required than would be the case for non-tolerant patients.

Risk of Relapse in Patients on Parvon N Maintenance Treatment of Opioid Addiction

Abrupt opioid discontinuation can lead to development of opioid withdrawal symptoms. Presentation of these symptoms have been associated with an increased risk of susceptible patients to relapse to illicit drug use and should be considered when assessing the risks and benefit of methadone use.

Tolerance and Physical Dependence

Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist. Physical dependence and/or tolerance are not unusual during chronic opioid therapy.

If methadone is abruptly discontinued in a physically dependent patient, an abstinence syndrome may occur. The opioid abstinence or withdrawal syndrome is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

In general, chronically administered methadone should not be abruptly discontinued.

Special-Risk Patients

Parvon N should be given with caution and the initial dose reduced in certain patients, such as the elderly and debilitated and those with severe impairment of hepatic or renal function, hypothyroidism, Addisons disease, prostatic hypertrophy, or urethral stricture. The usual precautions appropriate to the use of parenteral opioids should be observed and the possibility of respiratory depression should always be kept in mind.

Parvon N side effects

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Dizziness, sedation, nausea, vomiting, weakness, constipation, abdominal pain, rash, euphoria, dysphoria, visual disturbances, liver dysfunction, abuse potential.

Potentially Fatal: Hepatic necrosis (especially in chronic alcoholics).

Parvon N contraindications

Parvon N is contraindicated in patients with a known hypersensitivity to methadone hydrochloride or any other ingredient in DOLOPHINE.

Parvon N is contraindicated in any situation where opioids are contraindicated such as: patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), and in patients with acute bronchial asthma or hypercarbia.

Parvon N is contraindicated in any patient who has or is suspected of having a paralytic ileus.

Active ingredient matches for Parvon N:

Dextropropoxyphene/Paracetamol


Unit description / dosage (Manufacturer)Price, USD
PARVON N 350MG/32MG CAPSULE 1 packet / 100 capsules each (Jagsonpal Pharmaceuticals Ltd)$ 0.99
Parvon N Capsule (Jagsonpal Pharmaceuticals Ltd)$ 0.01

List of Parvon N substitutes (brand and generic names):

Lupivon Paracetamo, Dextropropoxyphene TAB / 8$ 0.17
8's$ 0.17
Lupivon Paracetamol, Dextropropoxyphene. TAB / 8$ 0.17
Lupivon Paracetamol, Dextropropoxyphene. TAB / 8$ 0.17
Lupivon Paracetamo, Dextropropoxyphene TAB / 8$ 0.17
Medonol 5 x 50's
Medonol 500's
Tablet; Oral; Acetaminophen 500 mg; Dextropropoxyphene Hydrochloride 65 mg
PAINVON CAPSULE 1 strip / 8 capsules each (Intas Pharmaceuticals Ltd)$ 0.13
Tablet; Oral; Acetaminophen; Dextropropoxyphene Hydrochloride
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100 tablet in 1 bottle
500 tablet in 1 bottle
PROXYNOVA CAPSULE 1 strip / 8 capsules each (Zydus Cadila)$ 0.26
PROXYVON Capsule/ Tablet / 65mg - 400mg / 8 units (Wockhardt)$ 0.25
Proxyvon Paracetamol 500mg, Dextropropoxyphene HCI 32.5mg FC-TAB / 10$ 0.11
Proxyvon Paracetamol 400mg, Dextropropoxyphene 65mg CAP / 8$ 0.26
8's$ 0.17
10's$ 0.11
Proxyvon 24 Tablet
Proxyvon 18 Blister x 8 Tablet
Proxyvon 24 Tablet nang 1
Proxyvon 18 Blister x 8 Tablet nang 2
Proxyvon Paracetamol 400 mg, Dextropropoxyphene napsilate100 mg. CAP / 8$ 0.26
Proxyvon Paracetamol 500 mg, Dextropropoxyphenehydrochloride 32.5 mg. FC-TAB / 10$ 0.11
PYEEVON SPAS CAPSULE 1 strip / 10 capsules each (Laborate Pharmaceuticals India Ltd)$ 0.21
SUDHINOL Capsule/ Tablet / 65mg - 650mg / 10 units (Rextar (Ranbaxy Laboratories Ltd))$ 0.32
Sudhinol Paracetamol 650mg, Dextropropoxyphene 65mg TAB / 10 (Rextar (Ranbaxy Laboratories Ltd))$ 0.32
10's (Rextar (Ranbaxy Laboratories Ltd))$ 0.32
Sudhinol Paracetamol 650 mg, dextropropoxyphene 65 mg. TAB / 10 (Rextar (Ranbaxy Laboratories Ltd))$ 0.32
Sudhinol 650+65 Tablet (Rextar (Ranbaxy Laboratories Ltd))$ 0.03
SUDHINOL 325MG/65MG TABLET 1 strip / 10 tablets each (Rextar (Ranbaxy Laboratories Ltd))$ 0.32
Sudhinol 325 mg/65 mg Tablet (Rextar (Ranbaxy Laboratories Ltd))$ 0.03
Tiphalvic 2 Blister x 10 Tablet
Tiphalvic 1 Bottle 100 Tablet
Tong-Well

References

  1. DailyMed. "PROPOXYPHENE HYDROCHLORIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "Dextropropoxyphene". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "Dextropropoxyphene". http://www.drugbank.ca/drugs/DB00647 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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