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INTRODUCTION
NEXTPLUS MR TABLET is a combination of Aceclofenac, Chlorzoxazone and Paracetamol which belongs to the group of medicines called Analgesics and Muscle relaxants respectively. It is used to treat muscular pains and spasms. It can also be used to provide relief from joint pain (Ex. osteoarthritis, rheumatoid arthritis) and back pain (Ex. ankylosing spondylitis).
Take NEXTPLUS MR TABLET preferably with meals to avoid gut irritation. Avoid consumption of alcohol as it could aggravate the risk of stomach problems. Do not take NEXTPLUS MR TABLET if you have any ulcers, bleeding or perforations in the gut.
Before taking NEXTPLUS MR TABLET inform your doctor if you have any liver, kidney or heart problems. You must also inform your doctor if you have diabetes, hypertension, high blood cholesterol, any inflammation in the bowel or intestines, blood clots, bleeding problems or a previous history of stomach ulcers as a precaution.
NEXTPLUS MR TABLET is not recommended for use in patients with liver failure or stroke. It is also not suitable for use in pregnant or breastfeeding women. The most common side effects of taking NEXTPLUS MR TABLET are nausea, vomiting, indigestion, heartburn and stomach pain. Consult your doctor if any of these side effect worsens.
USES OF NEXTPLUS MR TABLET
It is used to treat:
- Muscle pain and spasms
- Joint pain and back pain
HOW NEXTPLUS MR TABLET WORKS
NEXTPLUS MR TABLET contains three medicines namely Chlorzoxazone, Aceclofenac and paracetamol. Chlorzoxazone is a muscle relaxant. It acts by increasing the effects of certain chemical messengers (such as GABA) in the brain and in spinal cord that induces muscle relaxation. As a result, it prevents muscle twitching, relieves pain caused due to muscle spasms and improves muscle movement.
Aceclofenac and paracetamol are analgesic agents. They provide pain relief by blocking the release of certain chemicals (such as prostaglandins) in the body that causes pain, inflammation and swelling. Collectively, these action helps in reducing muscle spasms, joint pain and inflammation.
DIRECTIONS FOR USE
Take NEXTPLUS MR TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. It is preferably taken with meals to avoid gastric irritation.
Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF NEXTPLUS MR TABLET
COMMON
- nausea, vomiting
- heartburn, stomach pain, diarrhea, constipation
- loss of appetite, indigestion
- tiredness, sleepiness
- dizziness, spinning sensation
UNCOMMON
- mouth ulcers
- skin rash or itching
- bloating
RARE
Stop taking NEXTPLUS MR TABLET and consult your doctor immediately if you experience any of the following:
- signs of severe allergic reactions (such as skin rash, itching, swelling of the face, lips, throat or tongue causing difficulty in breathing or swallowing, chest tightness, fever, ulcers on the mucous membrane, oral sores)
- signs of liver problem (such as fever, skin rash, lack of appetite, nausea, vomiting, fatigue, upper abdominal pain, dark urine, yellowing of skin and whites of the eye)
- severe skin reactions (such as skin rash with itching and redness, blistering and peeling of skin, skin swelling and inflammation of mucous membrane, joint pain with fever)
- bloody stools, vomits or urine
- difficulty in passing urine, painful urination
- bleeding or bruising
HOW TO MANAGE SIDE EFFECTS
Nausea and Vomiting:
Take NEXTPLUS MR TABLET with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
Constipation:
Eat plenty of fiber rich foods such as fresh fruits, vegetables and cereals and drink plenty of water. Exercise more regularly. Consult your doctor if the symptom did not improve.
Mouth ulcers:
Avoid eating spicy foods. Drink plenty of water. Apply a pain-relieving gel on the affected areas of the mouth if required. Consult your doctor if the symptom did not improve.
Diarrhea:
Drink lots of fluids, such as water to keep yourself hydrated. Try to avoid taking any medicine on your own to treat diarrhea and consult your doctor if the symptom gets worse.
Skin rash:
Avoid hot showers because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if your skin rash worsens.
WARNING & PRECAUTIONS
PREGNANCY
NEXTPLUS MR TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
BREASTFEEDING
NEXTPLUS MR TABLET is not recommended for use in breastfeeding women. Therefore, consult your doctor before taking it.
DRIVING AND USING MACHINES
Do not drive or operate any heavy tools or machines if you experience dizziness, drowsiness or vision problems after taking NEXTPLUS MR TABLET.
ALCOHOL
Avoid consumption of alcohol while taking NEXTPLUS MR TABLET as it may make you feel dizzier or drowsier.
KIDNEY
NEXTPLUS MR TABLET is not recommended for use in patients with moderate to severe kidney diseases. It should be used with caution in patients with mild kidney problems. Therefore, consult your doctor before taking it.
LIVER
NEXTPLUS MR TABLET is not recommended in patients with severe liver problems (such as liver failure). It should be used with caution in patients with mild liver problems. Therefore, consult your doctor before taking it.
ALLERGY
Do not take NEXTPLUS MR TABLET if you are allergic to Aceclofenac, Chlorzoxazone or Paracetamol.
LUNGS
NEXTPLUS MR TABLET is not recommended for use in patients who previous experienced asthma attack or breathing difficulties after taking any pain-relieving medicine.
HEART DISEASE
NEXTPLUS MR TABLET is not recommended for use in patients with severe heart problems (such as heart attack). It should be used with caution in patients with other heart problems (such as angina). Therefore, consult your doctor before taking it.
OTHERS
NEXTPLUS MR TABLET is not recommended for use if you:
- have GI bleeding (bloody stools or vomits)
- have ulcers in the stomach or intestines
- have stroke or any problems in blood circulation
- have any blood clotting disorders
Before taking NEXTPLUS MR TABLET inform your doctor if you:
- have porphyria
- have diabetes
- have high blood pressure
- have blood cholesterol levels
- have inflammation of the bowel (Ex. Ulcerative colitis, Crohn’s Disease)
- have holes or blockage in the gut
- have a history of stomach ulcers
- have any autoimmune disorders that affects the skin (Systemic lupus erythematosus)
- smoke
- have blood clots in the body
- have bleeding problems
- recently had any surgery
- have chickenpox
Use in Pediatrics:
NEXTPLUS MR TABLET is not recommended for use in children and adolescents (aged below 18 years) unless considered necessary by the physician. Therefore, consult your doctor for advice before taking it.
Use in Geriatrics:
NEXTPLUS MR TABLET should be used with caution in elderly patients. Therefore, consult your doctor for advice before taking it.
INTERACTIONS
A. Drug-Drug Interactions:
Before taking NEXTPLUS MR TABLET, inform your doctor if you are taking any of the following medicines such as:
- other medicines used to treat pain (Ex. aspirin, ibuprofen, naproxen, celecoxib, etoricoxib)
- medicines used to treat increased blood pressure (Ex. enalapril, lisinopril, losartan, candesartan, methyldopa, clonidine, propranolol)
- diuretics (used to reduce edema and blood pressure) Ex. furosemide, hydrochlorothiazide
- cardiac glycosides (used to correct heart rhythm (Ex. digoxin)
- medicines used to suppress immune system after organ transplantation (Ex. ciclosporin or tacrolimus)
- medicines used to stop blood clotting (Ex. warfarin, heparin, clopidogrel)
- cholestyramine (a medicine used to control blood cholesterol levels)
- corticosteroids (used to treat pain and inflammation) Ex. hydrocortisone, prednisolone
- medicines used to treat nausea and vomiting (Ex. domperidone, metoclopramide)
- chloramphenicol (a medicine used to treat bacterial infections)
- medicines used to treat infections (Ex. ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin)
- medicines used to treat depression (Ex. citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline)
- medicines used to treat cancer and autoimmune disorders such as arthritis and skin conditions (Ex. methotrexate)
- medicines used to treat HIV infection (Ex. zidovudine)
- medicines used to treat diabetes (Ex. glibenclamide, gliclazide, tolbutamide)
Overdosage:
If you or anyone else accidentally took more NEXTPLUS MR TABLET, visit the nearby hospital or consult your doctor immediately.
SYNOPSIS
| Drug | : | Aceclofenac, Chlorzoxazone, Paracetamol |
| Pharmacological Category | : | COX-2 inhibitor, Mephensin Congeners, Analgesics and Antipyretics |
| Therapeutic Indication | : | Muscle Pain, Joint Pain |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep NEXTPLUS MR TABLET out of reach of children
- Store NEXTPLUS MR TABLET below 25°C
FAQs ABOUT NEXTPLUS MR TABLET
What is the use of NEXTPLUS MR TABLET?
NEXTPLUS MR TABLET is used to treat muscular pains and spasms. It can also be used to provide relief from joint pain (Ex. osteoarthritis, rheumatoid arthritis) and back pain (Ex. ankylosing spondylitis).
How NEXTPLUS MR TABLET works?
NEXTPLUS MR TABLET works by reducing pain and inflammation in the muscles and bones. It increases the effects of certain chemical messengers (such as GABA) in the brain and in spinal cord that induces muscle relaxation and blocks the release of certain chemicals (such as prostaglandins) in the body that causes pain, inflammation and swelling. Collectively, these action helps in reducing muscle spasms, joint pain and inflammation.
How to take NEXTPLUS MR TABLET?
Take NEXTPLUS MR TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not chew or crush the medicine. It is preferably taken with meals to avoid gastric irritation.
What is the best time to take NEXTPLUS MR TABLET?
NEXTPLUS MR TABLET can be taken at any time of the day. However, your doctor will decide the best time to take NEXTPLUS MR TABLET.
Can I stop taking NEXTPLUS MR TABLET once I started feeling better?
No. Do not stop taking NEXTPLUS MR TABLET without consulting your doctor as it may make your symptoms re-appear once again. If you feel better during the midway of therapy, consult your doctor for advice.
Can I take NEXTPLUS MR TABLET daily?
Take NEXTPLUS MR TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take NEXTPLUS MR TABLET every day or not.
Will taking a higher dose of NEXTPLUS MR TABLET be more effective?
No. Taking a higher dose of NEXTPLUS MR TABLET will not be effective rather it would be making you drowsier. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
What to do if I forgot to take a dose of NEXTPLUS MR TABLET?
If you forgot to take a dose of NEXTPLUS MR TABLET, take it as soon as you remember. However, if it is time for the next dose of NEXTPLUS MR TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of NEXTPLUS MR TABLET to compensate the missed ones. Consult your doctor for advice.
What are the side effects of NEXTPLUS MR TABLET?
The most common side effects of taking NEXTPLUS MR TABLET are nausea, vomiting, indigestion, heartburn and stomach pain. Consult your doctor if any of these side effect worsens.
Does NEXTPLUS MR TABLET make me feel sleepy?
NEXTPLUS MR TABLET may causes sleepiness in some individuals. Therefore, restrict yourself from engaging into hazardous activities that requires complete alertness. Do not drive or handle any heavy tools or machines. Also, avoid consumption of alcohol as it may make you feel more drowsy. Consult your doctor if sleepiness worsens.
Can I consume alcohol while taking NEXTPLUS MR TABLET?
Avoid consumption of alcohol while taking NEXTPLUS MR TABLET as it might make you feel dizzier and drowsier.
Is NEXTPLUS MR TABLET safe to use in diabetic patients?
NEXTPLUS MR TABLET may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking NEXTPLUS MR TABLET as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects.
Can NEXTPLUS MR TABLET be taken during pregnancy?
NEXTPLUS MR TABLET is not recommended for use in pregnant women. Therefore, consult your doctor before taking it.
Can the use of NEXTPLUS MR TABLET affect the liver?
Yes. NEXTPLUS MR TABLET may affect the way your liver work. It can elevate the levels of certain liver enzymes in your body. Therefore, it is not recommended for use in patients with liver failure. It should be used with caution in patients with other mild liver problems. Consult your doctor before taking it.
REFERENCES
1. KD. Tripathi. Nonsteroidal Anti-Inflammatory Drugs and Antipyretic-Analgesics. Skeletal Muscle Relaxants. Seventh edition. Page – 204, 206 & 357.
2. Sanjeev Kumar, Seema Rani, Ramchander Siwach and Prem Verma. To compare the efficacy and safety of fixed dose combination of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. July-December 2014. [Accessed on 12th December 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137632/
3. Innova Captab Ltd. National Agency for Food and Drug Administration. [Accessed on 12th November 2022] https://www.nafdac.gov.ng/wp-content/uploads/Files/SMPC/Jan2_2022/Aceclofenac-Paracetamol-Chlorzoxazone-Tablets.pdf
4. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in January 2021] [Accessed on 12th November 2022] https://www.medicines.org.uk/emc/files/pil.4240.pdf
5. STAT Rx USA LLC. Chlorzoxazone Tablet. Dailymed.com. [Revised in September 2011]. [Accessed on 12th December 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ddd41f29-8c98-4fae-94e3-104a8e9365fc
6. GlaxoSmithKline. PARACETAMOL/CHLORZOXAZONE. [Accessed on 12th December 2022] https://gskpro.com/content/dam/global/hcpportal/en_TZ/PI/MYOLGIN-NCDS-v-03.pdf
7. Solubiomix, LLC. Chlorzoxazone 250 mg. Dailymed.com. [Revised in October 2022]. [Accessed on 12th December 2022] https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=c3d40a90-6df8-4b44-bc61-d7655c52bacb&type=pdf
8. Reliable 1 Laboratories LLC. Acetaminophen 325mg – Acetaminophen tablet. Dailymed.com. [Revised in October 2021]. [Accessed on 12th December 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=25626b46-78f8-7226-e054-00144ff8d46c
9. Accord. Electronic Medicines Compendium (EMC). [Revised in November 2021] [Accessed on 12th November 2022] https://www.medicines.org.uk/emc/files/pil.5916.pdf
10. Central Drugs Standard Control Organization. FDC division. Annexure A. Aceclofenac + chlorzoxazone + Paracetamol. December 2018. [Accessed on 12th November 2022] https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadPublic_NoticesFiles/fdc294saka.pdf
11. Leeford Healthcare Pvt Ltd. Acimol MR. [Accessed on 12th November 2022] https://www.leeford.in/product/533/acimol-mr
12. Hetero Healthcare Ltd. Vetory MX Tablet. [Accessed on 12th November 2022] https://www.heterohealthcare.com/vetory-mx-tablet
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