Bral Tablet 10'S
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Introduction About BRAL TABLET
BRAL TABLET contains a combination of Diclofenac and Dicyclomine, which belongs to the group of medicines called Painkillers and Antispasmodics. BRAL TABLET is used to manage renal, ureteric, biliary and abdominal Colic (severe pain due to presence of a stone), post operative pain, uterine irritation during pregnancy and primary dysmenorrhoea (cramping pain that occurs before or during the menstruation).
A stone is a hard deposit of minerals formed within the body which can form anywhere along the path from kidney to urethra or gall bladder.
Your doctor may recommend you take relevant medical tests before or during the management with BRAL TABLET to understand your existing condition and may also advise you to modify your diet with fluids, fruits and vegetables rich in fibers if necessitated by your existing condition.
BRAL TABLET is not recommended for use in patients having severe liver, kidney or heart diseases, ulcer in stomach or small intestine, stomach or intestinal bleeding, problems with blood circulation, myasthenia gravis, glaucoma (increased pressure in eye), ulcerative colitis, reflux esophagitis, intestinal obstruction or urinary obstruction.
BRAL TABLET should be used with caution in patients who have lung diseases such as asthma, porphyria, diabetes, blood clots, raised cholesterol, enlarged prostate, runny nose, nasal polyps, habit of smoking or planned surgery of stomach or intestine.
BRAL TABLET is not recommended for use during last 3 months of pregnancy and should be used with caution in initial 6 months. BRAL TABLET should not be given to breastfeeding women as it passes through breast milk. Consult your doctor for advice.
In infants below 6 months of age, BRAL TABLET is not recommended for use and should be used with caution in elderly patients. Ask for your doctor’s advice before taking BRAL TABLET.
The common side effects of taking BRAL TABLET may include nausea, vomiting, diarrhea or constipation, headache, dizziness, gas-filled stomach, dry mouth and blurring of vision and nervousness etc. Contact your doctor if the symptoms worsen or doesn’t improve.
Uses Of BRAL TABLET
Manage:
- renal, ureteric, biliary and abdominal colic (severe pain due to presence of a stone)
- post operative pain
- uterine irritation during pregnancy
- primary dysmenorrhoea (cramping pain that occurs before or during the menstruation)
How BRAL TABLET Works
BRAL TABLET is a combination of Diclofenac and Dicyclomine. Diclofenac is a Non-steroidal anti-inflammatory drug that works by inhibiting the release cyclooxygenase, a chemical messenger that produces fever, discomfort and inflammation in the body (redness and swelling). Dicyclomine is an Anticholinergic that decreases and relaxes the abnormal muscle contractions in the stomach and intestine by acting on certain receptors called acetylcholine receptors and directly on smooth muscles.
How to use BRAL TABLET
Always take BRAL TABLET as directed by your physician. Swallow BRAL TABLET as a whole and do not crush or chew the medicine. Your doctor will decide the correct dose, frequency and duration depending on your age, body weight and severity of disease condition.
Side Effects Of BRAL TABLET
Common
- nausea
- vomiting
- headache
- spinning sensation
- gastrointestinal problems (loose stools, stomach ache, indigestion, heartburn)
- loss of appetite
- wind
- abnormal liver function tests
- dizziness
- nervousness
- weakness
- dry mouth
- blurred vision
Rare
- tiredness
- drowsiness
- inflammation of stomach lining
- vomiting blood
- ulcers
- nettle rash
- hypotension (faintness, light-headedness, giddiness)
- fluid-retention leading to swelling of hands, legs or feet
Stop taking BRAL TABLET and contact your doctor immediately if you experience any of the following side effects:
- severe allergic reactions (such as skin rash, itching, swelling of the face, lips, tongue and other parts of the body, difficulty in breathing or wheezing, blisters on the skin, sore throat, fever, headache etc.)
- passing blood in stools, black tarry stools
- yellowish discoloration of the skin or white part of the eye, lover disorders, inflamed liver
- vomiting blood
- ringing in ears, hearing problems
- anaemia (paleness), reduced white blood cells (fever, chills, sore throat)
- severe blistering rash causing peeling of surface layer of the skin (Lyell’s syndrome)
- irregular heartbeat, chest pain, heart attack
- blood in urine, increased amount of protein in urine, kidney failure
- pancreatitis (severe pain in abdomen and back)
- signs of aseptic meningitis (stiffness of neck, headache, nausea, vomiting)
How To Manage Side Effects
Diarrhoea:
Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor. Ask for your doctor’s advice if diarrhoea doesn’t improve.
Nausea:
Take BRAL TABLET with or after meals. Stick to simple meals while taking this medicine. Avoid eating rich or spicy food. Do not take any medication on your own. Ask for your doctor’s advice if nausea doesn’t improve.
Headache:
Try to take rest and don’t involve yourself in exertive activities. Rest in a quiet and dark room. Apply a pain-relieving balm on your forehead. Ask for your doctor’s advice if headache doesn’t improve.
Vomiting:
Drink clear or ice-cold drinks. Eat light, bland foods and avoid fried, oily or sweet foods. Avoid carbonated drinks. Ask for your doctor’s advice if vomiting doesn’t improve.
Dizziness:
Lie or sit down immediately when you feel dizzy. If you're feeling severe episode of spinning(vertigo), lie in a dark and quite place with eyes closed. Try to avoid vehicle driving. Discuss with your doctor if the symptom worsens.
Stomach pain:
Try to rest and relax. Try to have smaller and frequent meals. Keep a heat pad on your stomach. Take your physicians advice if the symptom worsens.
Flatulence/Wind:
Eat smaller and frequent meals. Eat and drink slow and exercise regularly. If it does not improve, contact your doctor.
Constipation:
Eat plenty of fiber rich foods such as vegetables, fresh fruits and cereals and drink plenty of water. Exercise more regularly. Ask for your doctor’s advice if constipation doesn’t improve.
Dry mouth:
Dry mouth can be managed by chewing sugar-free gum or sucking on sugar-free hard candies to stimulate the flow of saliva. Sip water at regular intervals of time. Do not use mouthwashes that contain alcohol because they can be drying. Consult your physician for advice.
Warning & Precautions
Pregnancy
BRAL TABLET is not recommended for use during last 3 months of pregnancy. It should be used with caution in initial 6 months. Consult your doctor before taking BRAL TABLET.
Breastfeeding
BRAL TABLET is not recommended for use in breastfeeding mothers as it passes through breast milk. Consult your doctor for advice.
Driving and Using Machines
Do not drive or operate any machines if you feel dizzy, tired, sleepy or have blurred vision after taking BRAL TABLET.
Kidney
BRAL TABLET is not recommended in patients having severe kidney diseases. BRAL TABLET should be taken with caution if you have any other kidney disease. Consult your doctor for advice.
Liver
BRAL TABLET is not recommended in patients having severe liver diseases. BRAL TABLET should be taken with caution if you have any other liver disease. Consult your doctor for advice.
Allergy
Do not take BRAL TABLET if you are allergic to Diclofenac, Dicyclomine, Aspirin, Ibuprofen and other NSAIDs or any other ingredients of BRAL TABLET.
Lungs
BRAL TABLET should be taken with caution in patients with lung diseases such as asthma, chronic obstructive pulmonary diseases (COPD) or chronic lung infection etc. Consult your doctor before taking BRAL TABLET.
Heart Disease
BRAL TABLET is not recommended for patients with severe heart diseases such as heart failure, mini-stroke, blockage in blood vessels of the heart or have recently undergone any surgical procedure for your heart (CABG/ bypass heart surgery, PTCA etc.). Consult with your doctor before taking BRAL TABLET.
Others
BRAL TABLET is not recommended for use if you have:
- ulcer in stomach or small intestine
- stomach or intestinal bleeding
- problems with blood circulation
- myasthenia gravis
- glaucoma (increased pressure in eye)
- reflux esophagitis
- intestinal obstruction
- urinary obstruction
- ulcerative colitis, Crohn’s disease
Before taking BRAL TABLET, inform your physician if you have:
- porphyria
- diabetes
- blood clots
- high blood pressure
- raised cholesterol
- enlarged prostate
- runny nose, nasal polyps
- habit of smoking
- planned surgery of stomach or intestine
- intolerance to certain sugars
Use in paediatrics:
BRAL TABLET is not recommended for use in infants below 6 months of age. Consult your child’s doctor for advice.
Use in geriatrics:
BRAL TABLET should be used with caution in elderly patients as they are more susceptible to side effects. Consult your doctor for advice.
Interactions
A. Drug-Drug interactions:
Before taking BRAL TABLET, inform your doctor if you are taking any of the following medicine:
- aspirin, ibuprofen (used to manage pain, inflammation)
- propranolol, atenolol, ramipril, digoxin (used to manage high blood pressure and other heart problems)
- gliclazide (used to manage diabetes)
- spironolactone (used to remove excess fluid from the body)
- lithium, citalopram, escitalopram (used to manage mental illness, depression)
- methotrexate (used to manage certain cancers)
- mifepristone (used to terminate pregnancy)
- prednisolone (used to manage certain allergies, inflammation, hormone imbalance)
- warfarin (used to manage blood clots)
- ciclosporin, tacrolimus (used to supress immune system e.g., after transplants)
- ciprofloxacin, ofloxacin (used to manage certain infections)
- zidovudine (used to manage HIV)
- phenytoin (used to manage epilepsy)
- colestipol, cholestyramine (used to reduce the levels of cholesterol)
- sulfinpyrazone (used to manage gout)
- voriconazole (used to manage fungal infections)
- metoclopramide (used to manage vomiting)
- omeprazole, pantoprazole (used to manage control gastric acid secretion)
Overdosage:
If you or anyone else accidentally take too much of BRAL TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose of BRAL TABLET are lethargy, drowsiness/dizziness, disorientation, nervousness, dryness of mouth, difficulty in swallowing, pupil dilation, nausea, vomiting, blurring of vision, stomach pain, muscle weakness, black or tarry stool due to bleeding in the digestive system, ringing sensation in the ear, fit or seizure, coma etc.
Synopsis
| Drug | : | Diclofenac, Dicyclomine |
| Pharmacological Category | : | Non-steroidal anti-inflammatory drugs, Anticholinergic |
| Therapeutic Indication | : | Renal, ureteric, biliary and abdominal colic, Post operative pain, Uterine irritation during pregnancy,
Primary dysmenorrhoea |
| Dosage Forms | : | Tablet |
More Information
- Keep BRAL TABLET out of reach from children
- Store BRAL TABLET at room temperature below 30°C
FAQs About BRAL TABLET
Is BRAL TABLET safe for use in patients with heart disease?
BRAL TABLET is not recommended for use if you are having certain types of heart disease. Always consult your doctor and use BRAL TABLET with caution after ensuring its safety. Also, inform your doctor if you have recently undergone heart surgery such as bypass surgery/ CABG, PTCA etc.
Is BRAL TABLET safe for use in a patient with diabetes?
BRAL TABLET should be used with caution in diabetic patients. Also, anti-diabetic medications may interact with BRAL TABLET, creating unwanted side effects. Consult your doctor for advice and get your health status checked to see whether or not BRAL TABLET is safe to use.
Can BRAL TABLET cause diarrhoea?
Diarrhoea is a common side effects of BRAL TABLET. If this happens, drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor. Ask for your doctor’s advice if diarrhoea doesn’t improve.
Is BRAL TABLET safe for use in pregnant women?
BRAL TABLET is not recommended for use during the last 3 months of pregnancy. BRAL TABLET should be used with caution in in last 6 months only if recommended by your doctor after outweighing the risks and benefits as it may interfere with the development of the baby. Consult with your doctor before taking BRAL TABLET.
Does BRAL TABLET affects my ability to drive?
Do not drive or operate any machines if you feel dizzy, tired, sleepy or have blurred vision after taking BRAL TABLET. You can continue doing your activities as soon as you feel normal again.
References
1. KD. Tripathi. NSAIDs and antipyretic-analgesics & anticholinergic drugs and drugs acting on autonomic ganglia. Essentials of medical pharmacology. 8th Edition. 2019. Page – 221 & 129.
2. Laurence Brunton, Bruce Chabner, Bjorn Knollman. Muscarinic receptor antagonist and agonist. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 12th Edition. 2006. Page- 233.
3. Tong J Gan. Diclofenac: an update on its mechanism of action and safety profile. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. July 2010. [Accessed On 21st May 2022]. https://pubmed.ncbi.nlm.nih.gov/20470236/
4. NIH National Library of Medicine, National center for biotechnology information. Dicyclomine. Pubchem. [Accessed On 21st May 2022]. https://pubchem.ncbi.nlm.nih.gov/compound/Dicyclomine
5. Magdalena Janczura, Malgorzata Kobus-Moryson, Szymon Sip, Marcin Zarowski, Agnieszka Warenczak, Judyta Cielecka-Piontek. Multidisciplinary Digital Publishing Institute journals (MDPI). Fixed-Dose Combination of NSAIDs and Spasmolytic Agents in the Treatment of Different Types of Pain. [Revised on 18th June 2021] [Accessed On 21st May 2022]. https://www.mdpi.com/2077-0383/10/14/3118/htm
6. Teva UK Limited. Diclofenac Sodium. [Revised in April 2021]. [Accessed On 21st May 2022]. https://products.tevauk.com/mediafile/id/51764.pdf
7. Teva Pharmaceuticals USA, Inc. Dicyclomine. Dailymed. [Revised in November 2020]. [Accessed On 21st May 2022]. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a5937c7b-cdfc-46e6-a0fa-541b24f91d47
8. Dexcel Ltd. Diclofenac Sodium. Dailymed. [Revised in June 2022]. [Accessed On 21st May 2022]. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=89c0abb8-31f5-4a7e-94d9-08945aa7787f
9. Ifimed Pharmaceuticals Pvt. Ltd. Ifispas (Dicyclomine + Diclofenac). [Accessed On 21st May 2022]. http://www.ifimed.com/ifispas
10. B.J. Healthcare. Spasbit Tablets (Dicyclomine + Diclofenac). [Accessed On 21st May 2022]. http://www.bjhealthcare.co.in/spasbit-tablets.htm
11. Niksan Pharmaceuticals. (Dicyclomine + Diclofenac). [Accessed On 21st May 2022]. https://www.niksanpharmaceutical.co.in/dicyclomine-10-mg-diclofenac-potassium-50-mg-tablets-5682387.html
Useful Diagnostic Tests
- Complete Blood Count
- Liver Function Test
- Kidney Function Test
- Colonoscopy
- CT scan - Abdomen
- Ultrasonography (USG) abdomen
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