Psychotropics India Limited

Tromanil MR Tablet 10'S

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Introduction About TROMANIL MR TABLET

TROMANIL 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. TROMANIL MR TABLET is used to manage 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 management with TROMANIL MR TABLET as it may increase the risk of liver damage. TROMANIL 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 TROMANIL MR TABLET inform your doctor if you are pregnant or breastfeeding.

TROMANIL 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 TROMANIL 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 TROMANIL MR TABLET

Manage:

  • low back pain
  • muscle spasm and cramping
  • fibromyalgia

How TROMANIL MR TABLET Works

TROMANIL 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.

How to use TROMANIL MR TABLET

Take TROMANIL MR TABLET as advised by your physician. Swallow TROMANIL 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 TROMANIL MR TABLET without informing your doctor.   

Side Effects Of TROMANIL MR TABLET

Common

  • nausea, vomiting
  • diarrhea
  • stomach upset
  • sleepiness
  • dizziness, drowsiness
  • indigestion

Rare

Stop taking TROMANIL MR TABLET and contact your doctor immediately if you experience any of the following side effects:

  • hepatotoxicity (signs include fever, rash, loss of appetite, nausea, vomiting, fatigue, right upper quadrant pain, dark urine or jaundice)
  • allergic reactions (signs include rash, redness, shortness of breath or wheezing, swelling of the face, feet or legs)

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 managing 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

TROMANIL 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

TROMANIL 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 TROMANIL MR TABLET. Consult with your doctor for advice before taking this medicine.

Alcohol

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

Kidney

TROMANIL 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

TROMANIL 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 TROMANIL MR TABLET if you are allergic to Chlorzoxazone, Nimesulide, Paracetamol or any other ingredients of this medicine.

Heart Disease

TROMANIL 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.

Others

TROMANIL MR TABLET is not recommended for you, if you have:

  • active peptic ulcers

Before taking TROMANIL MR TABLET, inform your doctor if you have:

  • stomach problems
  • high blood pressure
  • active bleeding or bleeding disorders
  • fluid retention

Use in pediatrics:

TROMANIL MR TABLET is not recommended for use in children aged less than 12 years. Consult your child’s doctor for advice.

Use in geriatrics:

TROMANIL MR TABLET should be used with caution in elderly patients. Consult your doctor for advice before taking TROMANIL MR TABLET.

Interactions

A. Drug-Drug interactions:

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

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

Overdosage:

If you or anyone else accidentally take too much of TROMANIL 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

Drug :   Chlorzoxazone, Nimesulide, Paracetamol
Pharmacological Category :   Muscle relaxants, Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Analgesic and Antipyretics
Therapeutic Indication :   Low back pain, Muscle spasm, Muscle cramping and Fibromyalgia        
Dosage Forms :   Tablet

More Information

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

FAQs About TROMANIL MR TABLET

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

A: You should take TROMANIL 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 TROMANIL MR TABLET impair the ability to drive?

A: Do not drive or operate heavy machines if you experience drowsiness while taking TROMANIL 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 TROMANIL MR TABLET safe to use in patients with kidney problems?

A: TROMANIL 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 TROMANIL MR TABLET be used during pregnancy?

A: TROMANIL 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 TROMANIL MR TABLET?

A: The most common side effects of taking TROMANIL 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
Reviewed For Accuracy By Dr. Srikar Modepu - MBBS, MD (Diabetology)
Last updated on 23 Jan 2023 | 06:04 PM(IST)
Lab updated