Ace 250 mg Suppository

Description

Indications
Ace is used for the relief of fever, common cold, and influenza. It is also effective in treating headaches, toothaches, earaches, body aches, muscle pain, neuralgia, menstrual cramps, sprains, colic pain, back pain, post-operative and postpartum pain, inflammatory pain, and pain following vaccinations in children. Additionally, it is indicated for rheumatic and osteoarthritic pain, as well as stiffness in joints.
Use under the guidance of a registered physician.

Pharmacology
Paracetamol provides pain relief by blocking the peripheral transmission of pain impulses. It reduces fever by acting on the hypothalamic heat-regulating center. Although it has weak anti-inflammatory effects, these are linked to its inhibition of prostaglandin synthesis in the central nervous system (CNS). Unlike NSAIDs, paracetamol does not inhibit cyclooxygenase (COX) enzymes in peripheral tissues, thus lacking significant anti-inflammatory properties. Research suggests that paracetamol selectively blocks a variant of the COX enzyme (COX-3), which may explain its effectiveness in the CNS while being ineffective in immune cells with high peroxide levels. Its antipyretic effects are due to its influence on hypothalamic temperature regulation, leading to vasodilation and sweating.

Dosage & Administration

Tablet:

• Adults: 1-2 tablets every 4 to 6 hours, not exceeding 4g (8 tablets) per day.
• Children (6-12 years): ½ to 1 tablet 3 to 4 times daily. Long-term use should not exceed 2.6g/day.

Extended Release Tablet:

• Adults & Children over 12 years: Two tablets swallowed whole every 6 to 8 hours (maximum 6 tablets in 24 hours). Do not crush the tablet.

Syrup/Suspension:

• Children under 3 months: 10 mg/kg body weight, reduced to 5 mg/kg if jaundiced, 3 to 4 times daily.
• 3 months – below 1 year: ½ to 1 teaspoonful 3 to 4 times daily.
• 1-5 years: 1-2 teaspoonfuls 3 to 4 times daily.
• 6-12 years: 2-4 teaspoonfuls 3 to 4 times daily.
• Adults: 4-8 teaspoonfuls 3 to 4 times daily.

Suppository:

• Children 3-12 months: 60-120 mg, 4 times daily.
• Children 1-5 years: 125-250 mg, 4 times daily.
• Children 6-12 years: 250-500 mg, 4 times daily.
• Adults & Children over 12 years: 0.5-1g, 4 times daily.

Paediatric Drops:

• Children up to 3 months: 0.5 ml (40 mg).
• 4 to 11 months: 1.0 ml (80 mg).
• 7 months to 2 years: 1.5 ml (120 mg).
  Do not exceed 5 doses per day for a maximum of 5 days.

IV Infusion:

• Adults & adolescents (50 kg and over): 1000 mg every 6 hours or 650 mg every 4 hours (max 1000 mg per dose and 4000 mg per day).
• Adults & adolescents (under 50 kg): 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours (max daily dose 75 mg/kg).
• Children (2-12 years): 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours (max daily dose 75 mg/kg).
  Use under the guidance of a registered physician.

Interactions
Patients taking barbiturates, tricyclic antidepressants, or alcohol may have reduced ability to metabolize large doses of Ace. Chronic alcohol consumption increases the risk of liver toxicity. Anticonvulsants or oral contraceptives may accelerate Ace metabolism, reducing its effectiveness.

Contraindications

• Known hypersensitivity to Paracetamol.

Side Effects
Most side effects are mild but may include hematological reactions such as thrombocytopenia, leucopenia, pancytopenia, neutropenia, and agranulocytosis. Other possible reactions include pancreatitis, skin rashes, and allergic reactions.

Pregnancy & Lactation

• Epidemiological studies have shown no adverse effects in pregnancy when used at recommended doses. However, medical advice should be followed.
• Paracetamol is excreted in breast milk in insignificant amounts and does not contraindicate breastfeeding.

Precautions & Warnings

• Use caution in patients with severe renal or hepatic impairment.
• Overdose risk is higher in those with non-cirrhotic alcoholic liver disease.
• Do not exceed the recommended dose or use other paracetamol-containing products simultaneously.
• Overuse may lead to severe liver damage, including hepatotoxicity and fatal outcomes.

Use in Special Populations

• Pediatric Use: Safe and effective for acute pain and fever in children aged 2 years and older.
• Geriatric Use: No significant safety or effectiveness differences observed between elderly and younger patients.
• Hepatic Impairment: Contraindicated in severe hepatic disease; dose adjustments may be required.
• Renal Impairment: In severe cases (creatinine clearance < 30 ml/min), longer dosing intervals and dose reduction may be necessary.

Overdose Effects
Liver damage is possible in adults consuming more than 10g of Ace. Ingestion of 5g or more may cause toxicity in individuals with risk factors such as chronic alcohol use, enzyme-inducing drugs, or malnutrition. Overdose symptoms include nausea, vomiting, pallor, abdominal pain, metabolic acidosis, and hepatic failure. Treatment includes activated charcoal and N-acetylcysteine within 8 hours of overdose. Late-stage management requires specialized medical intervention.

Therapeutic Class
Non-opioid analgesics.

Storage Conditions

• Store in a dry place away from light and heat.
• Keep out of reach of children.

Common Questions

• What is Ace 250 mg Suppository used for? It is used to relieve pain and fever, including post-immunization fever and menstrual cramps.
• Can Ace 250 mg Suppository be taken on an empty stomach? It works effectively when taken with food.
• Is Ace 250 mg Suppository an NSAID? No, it is classified as an analgesic and antipyretic.
• Can Ace 250 mg Suppository be taken with antibiotics? Consult your doctor before combining with other medications.

Quick Tips

• Take Ace 250 mg Suppository with food or milk to avoid stomach irritation.
• Long-term use can lead to complications; follow prescribed dosage strictly.
• Avoid alcohol while using Ace to prevent liver damage.
• Inform your doctor if you have liver disease, as dose adjustments may be necessary.