INTRODUCTION

NEDOLIDE MR TABLET is a combination of Chlorzoxazone, Nimesulide and Paracetamol which belongs to the group of medicines called Muscle relaxants, Non-Steroidal Anti-inflammatory Drugs (NSAIDs) and Analgesic and Antipyretics respectively. NEDOLIDE MR TABLET is used to treat low back pain, muscle spasm or cramps and fibromyalgia.

Fibromyalgia is a condition that is characterized by widespread musculoskeletal pain associated by fatigue, sleep, memory and mood issues.

Avoid consumption of alcohol during treatment with NEDOLIDE MR TABLET as it may increase the risk of liver damage. NEDOLIDE MR TABLET is not recommended for use in patients having active peptic ulcers, severe kidney problems and liver impairment.

Inform your doctor if you have any problems related to stomach, high blood pressure, active bleeding or bleeding disorders, heart disease or fluid retention. Before taking NEDOLIDE MR TABLET inform your doctor if you are pregnant or breastfeeding.

NEDOLIDE MR TABLET is not recommended for use in children (aged 12 years and below). It should be used with caution in elderly patients.

The most common side effects of taking NEDOLIDE MR TABLET are nausea, vomiting, diarrhea, stomach upset and indigestion. Consult your doctor if any of the side effects worsen over the time.

USES OF NEDOLIDE MR TABLET

Treats:

• low back pain
• muscle spasm and cramping
• fibromyalgia

HOW NEDOLIDE MR TABLET WORKS

NEDOLIDE MR TABLET is a combination of chlorzoxazone, nimesulide and paracetamol. Chlorzoxazone is a muscle relaxant that works on the brain and spinal cord to relieve muscle stiffness or spasm and to improve pain and movement of muscles. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) and paracetamol is an analgesic and antipyretic, which works together by inhibiting the production of a chemical called prostaglandins in the body which are responsible for causing pain and swelling at the site of injury.

DIRECTIONS FOR USE

Take NEDOLIDE MR TABLET as advised by your physician. Swallow NEDOLIDE MR TABLET with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. Do not stop taking NEDOLIDE MR TABLET without informing your doctor.   

SIDE EFFECTS OF NEDOLIDE MR TABLET

HOW TO MANAGE SIDE EFFECTS

Diarrhoea:

Drink lot of fluids such as water to keep yourself hydrated. Avoid eating high-fat or spicy foods. Avoid taking any medicine on your own for treating diarrhea. Consult your doctor if the symptom did not improve.

Nausea or vomiting:

Take this medicine with or immediately after food. Stick to simple meals. Avoid eating oily, fried and spicy foods. Do not perform any strenuous activities immediately after eating. Consult your doctor if the symptom does not improve.

Dizziness:

Lie down until dizziness goes away and then move slowly and carefully. Take sufficient rest and drink plenty of fluids. Rise slowly after sitting or lying down. Be careful while going up and down stairs. Consult your doctor if the symptom worsens.

WARNING & PRECAUTIONS

PREGNANCY

NEDOLIDE MR TABLET is not recommended for use in third trimester of pregnancy as it may cause serious harm to the baby and it should be used with caution in first and second trimester of pregnancy. Consult with your doctor for advice before taking it.  

BREASTFEEDING

NEDOLIDE MR TABLET is not recommended for use in breastfeeding women, especially if your baby is a new-born or born prematurely. Consult your doctor before taking it.

DRIVING AND USING MACHINES

Do not drive or operate heavy machines if you experience drowsiness while taking NEDOLIDE MR TABLET. Consult with your doctor for advice before taking this medicine.

ALCOHOL

Consumption of alcohol is not recommended during treatment with NEDOLIDE MR TABLET as it may increase the risk of liver damage.

KIDNEY

NEDOLIDE MR TABLET is not recommended for use in patients with severe kidney problems and it should be used with caution in patients with kidney problems. Consult with your doctor for advice before taking it.

LIVER

NEDOLIDE MR TABLET is not recommended for use in patients with liver impairment. Consult with your doctor for advice before taking it.

ALLERGY

Do not take NEDOLIDE MR TABLET if you are allergic to Chlorzoxazone, Nimesulide, Paracetamol or any other ingredients of this medicine.

HEART DISEASE

NEDOLIDE MR TABLET is not recommended for use in patients with severe heart failure and it should be used with caution in patients with mild heart disease. Consult with your doctor for advice before taking it.

INTERACTIONS

A. Drug-Drug interactions:

Before taking NEDOLIDE MR TABLET inform your doctor if you are taking any of the following medicines:

• fenofibrate (used to treat cholesterol)
• salicylic acid (used to treat skin disorders)
• valproic acid (used to treat epilepsy)
• tolbutamide (used to treat diabetes)
• methotrexate (used to treat cancer)
• frusemide (used to treat fluid retention)
• warfarin (used to treat blood clots)
• theophylline (used to treat asthma)
• domperidone and metoclopramide (used to treat vomiting and nausea)
• zidovudine (used to treat HIV)

Overdosage:

If you or anyone else accidentally take too much of NEDOLIDE MR TABLET, consult your doctor immediately or visit the nearby hospital. Overdosage may cause side effects such as lethargy, epigastric pain, nausea, vomiting or diarrhea together with drowsiness, dizziness, headache or light-headedness, gastrointestinal bleeding, increased blood pressure, acute kidney failure and respiratory depression.

SYNOPSIS

MORE INFORMATION

• Keep NEDOLIDE MR TABLET out of reach of children
• Store at room temperature

FAQs ABOUT NEDOLIDE MR TABLET

Q: What to do If I forget to take a dose of NEDOLIDE MR TABLET?

A: You should take NEDOLIDE MR TABLET immediately when you remember. If it is time for the next dose skip the missed dose and follow the regular dose schedule. Do not double the dose to match up the missed dose.

Q: Does NEDOLIDE MR TABLET impair the ability to drive?

A: Do not drive or operate heavy machines if you experience drowsiness while taking NEDOLIDE MR TABLET. Consult with your doctor for advice before taking this medicine. Follow appropriate precautions before driving or you may ask someone to drive for you after consulting with your doctor.

Q: Is NEDOLIDE MR TABLET safe to use in patients with kidney problems?

A: NEDOLIDE MR TABLET is not recommended for use in patients with severe kidney problems and it should be used with caution in patients with kidney problems. Consult with your doctor for advice before taking it. 

Q: Can NEDOLIDE MR TABLET be used during pregnancy?

A: NEDOLIDE MR TABLET is not recommended for use in third trimester of pregnancy as it may cause serious harm to the baby and it should be used with caution in first and second trimester of pregnancy. Consult with your doctor for advice before taking it.    

Q: What are the common side effects of NEDOLIDE MR TABLET?

A: The most common side effects of taking NEDOLIDE MR TABLET are nausea, vomiting, diarrhea, stomach upset, dizziness, drowsiness, sleepiness and indigestion. Consult your doctor if any of the side effects worsen.

REFERENCES

1. KD. Tripathi. Skeletal Muscle Relaxants. Essentials of medical pharmacology. Seventh edition. 2013. Page – 347-359.

2. Helal Abdo Moqbel, Aliaa Nabil El Meshad & Mohamed Ahmed El-Nabarawi. A pharmaceutical study on chlorzoxazone orodispersible tablet: formulation, in-vitro and in-vivo evaluation. Journal of Drug Delivery. February 2016 [Accessed on 22nd July 2022] https://www.tandfonline.com/doi/full/10.3109/10717544.2016.1138340

3. Elizabeth Chiam, Laurence Weinberg, and Rinaldo Bellomo. Paracetamol: a review with specific focus on the haemodynamic effect of intravenous administration. Journal of Heart, Lung, and Vessels. NIH National Library of Medicine, National center for biotechnology information. Pubmed Central. 2015 [Accessed on 22nd July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476766/

4. H.G. Kress, A. Baltov, A. Basinski, F. Berghea, J. Castellsague, C. Codreanu, E. Copaciu, M.A. Giamberardino, M. Hakl, L. Hrazdira, M. Kokavec, J. Lejcko, L. Nachtnebl, R. Stancík, A. Svec, T. Toth, M.V. Vlaskovska & J. Woron. Acute pain: a multifaceted challenge – the role of nimesulide. Journal of Current Medical Research and Opinion. October 2015 [Accessed on 22nd July 2022] https://www.tandfonline.com/doi/pdf/10.1185/03007995.2015.1100986?needAccess=true

5. Leeford Healthcare Limited. Neopar MR tablet (Nimesulide, Paracetamol & Chlorzoxazone). [Accessed on 22nd July 2022] https://www.leeford.in/product/751/neopar-mr

6. Santo Medi Sciences Pvt. Ltd. Sanzox tablet (Nimesulide, Paracetamol & Chlorzoxazone). [Accessed on 22nd July 2022] https://www.santomedisciences.com/product/nimesulide-100-mg-paracetamol-325-mg-chlorzoxazone-375-mg-tablets

7. Helsinn Birex Pharmaceuticals Ltd. Nimesulide. [Accessed on 22nd July 2022] https://file.wuxuwang.com/hma/IT_H_0151_002_FinalPI.pdf

8. Remedyrepack Inc. Chlorzoxazone tablets. DailyMed; National Library of Medicine; National Institute of Health. June 2022 [Accessed on 22nd July 2022] https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5a22fa51-bab3-4b18-ab1d-f5672223c929

USEFUL DIAGNOSTIC TESTS

• Kidney function test
• Liver function test

AUTHOR DETAILS

Written By Dr. R. Dinesh John Rajkumar, Pharm.D
Last updated on 23 Jan 2023 | 06:04 PM(IST)