AVARIN SOFT GEL CAPSULES

Indications

• Osteoarthritis
• Rheumatoid arthritis
• Acute pain
• Chronic pain syndromes
• Musculoskeletal disorders
• Inflammatory conditions

Dosage

Children: Refer to the BNF for Children for appropriate pediatric dosing information.

Adults: Refer to the product-specific prescribing information for dosage guidance.

Mechanism of action

The mechanism of action of alvenne involves the inhibition of cyclooxygenase (COX) enzymes, leading to a decrease in the production of prostaglandins. Prostaglandins are compounds that promote inflammation, pain, and fever. By reducing their synthesis, alvenne effectively alleviates symptoms associated with inflammation and pain.

Pharmacodynamics

Alvenne exhibits anti-inflammatory, analgesic, and antipyretic effects. It works by modulating pain pathways and reducing the inflammatory response at the site of injury or disease. This results in decreased sensitivity to pain and a reduction in swelling and redness.

Pharmacokinetics

Alvenne is absorbed through the gastrointestinal tract following oral administration. Its onset of action typically occurs within a few hours, and it reaches peak plasma concentrations relatively quickly. The drug is extensively metabolized in the liver, and its metabolites are excreted primarily through the kidneys. The half-life of alvenne varies depending on the formulation and patient characteristics, but it generally allows for dosing intervals that support effective pain management.

Pregnancy

There is limited data on the use of alvenne during pregnancy. Consult a healthcare provider for advice.

Breast-feeding

Limited information is available on the excretion of alvenne in human milk. Caution is advised when administering to nursing mothers.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Indications

• Dyspepsia
• Colic
• Wind pains

Dosage

Children: For children aged 1 month to 1 year: 0.5–1 mL, to be taken before feeds. For children aged 5–11 years: 5–10 mL three times a day, alternatively as required. For children aged 12–17 years: 10–20 mL three times a day, alternatively as required.

Adults: 10–20 mL three times a day, alternatively as required, to be made up with water.

Mechanism of action

Simeticone acts as a surfactant, decreasing the surface tension of gas bubbles in the gastrointestinal tract. This action facilitates the coalescence of mucus-covered gas bubbles, leading to their expulsion. The clinical efficacy of simeticone is attributed to these antifoam properties, which help alleviate discomfort caused by trapped gas.

Pharmacodynamics

Simeticone effectively decreases the surface tension of gas bubbles within the gastrointestinal tract, thereby facilitating their expulsion. It has a short duration of action, as it is typically administered on an as-needed basis, and possesses a wide therapeutic index because it is not absorbed systemically, making it generally safe for use.

Pharmacokinetics

Simeticone is not absorbed into the systemic circulation and is excreted unchanged. It has a localized effect within the gastrointestinal tract, where it acts to alleviate symptoms related to gas. Due to its lack of systemic absorption, the pharmacokinetics of simeticone are characterized by rapid action following administration, with effects lasting only as long as the drug is present in the gastrointestinal tract.

Contra-indications

• Hypophosphataemia
• Severe renal impairment
• Hepatic coma

Adverse effects

• Diarrhoea
• Nephrolithiasis (long term use)

Interactions

• Magnesium salts may interact with other medications and should be avoided in patients with renal impairment.

Precautions

• Use with caution in patients with heart failure, hypermagnesaemia, metabolic alkalosis, or respiratory alkalosis.
• Avoid antacids containing large amounts of sodium in patients with fluid retention.

Pregnancy

Simeticone is generally considered safe during pregnancy as it is not systemically absorbed.

Breast-feeding

Simeticone is considered safe during breastfeeding as it is not systemically absorbed.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Oral suspension (Infacol 40mg/ml, Dentinox Infant colic drops)
• Chewable tablets (Dentinox)
• Liquid form (sugar-free options available)

Mechanism of action

Simethicone is a surfactant that decreases the surface tension of gas bubbles in the gastrointestinal tract, more easily allowing gas to exit the body. The clinical use of simethicone is based on its antifoam properties. Silicone antifoams spread on the surface of aqueous liquids, forming a film of low surface tension and thus causing collapse of foam bubbles. Simethicone reportedly allows mucus-surrounded gas bubbles in the GI tract to coalesce and be expelled.

Pharmacodynamics

Simethicone decreases the surface tension of gas bubbles in the gastrointestinal tract, facilitating their expulsion. It has a short duration of action as it is generally given as needed, and a wide therapeutic index as it is not systemically absorbed.