Atopen-Plus
Generic Name
Cyproheptadine Hydrochloride and Paracetamol
Manufacturer
Medipharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| atopen plus 500 mg tablet | ৳ 2.51 | N/A |
Description
Overview of the medicine
Atopen-Plus 500 mg Tablet is a combination medicine used to relieve symptoms associated with allergic conditions, common cold, and flu, such as sneezing, runny nose, watery eyes, body aches, and fever. It contains an antihistamine (Cyproheptadine) for allergy relief and an analgesic/antipyretic (Paracetamol) for pain and fever.
Uses & Indications
Dosage
Adults
1 tablet every 6-8 hours as needed, or as directed by a physician. Maximum daily dose should not exceed 4 tablets.
Elderly
Use with caution. Dosage may need to be adjusted based on renal/hepatic function and overall health. Consult a physician.
Renal_impairment
Use with caution. Dosage adjustment may be necessary. Consult a physician.
How to Take
Take the tablet orally with water, with or without food. Do not crush or chew the tablet.
Mechanism of Action
Cyproheptadine acts as an H1-receptor antagonist, blocking histamine's effects that cause allergic symptoms. Paracetamol is an analgesic and antipyretic; its exact mechanism is not fully understood but is thought to involve inhibition of prostaglandin synthesis in the central nervous system.
Pharmacokinetics
Onset
Onset of action for Cyproheptadine is typically 15-30 minutes, with peak effects within 1-2 hours. Paracetamol's onset is 30-60 minutes, with peak effects within 1 hour.
Excretion
Both drugs are primarily excreted in the urine, with a small portion of Cyproheptadine excreted in feces.
Half life
Cyproheptadine has a half-life of 8-16 hours. Paracetamol has a half-life of 1.5-3 hours.
Absorption
Both Cyproheptadine and Paracetamol are rapidly and well absorbed from the gastrointestinal tract following oral administration.
Metabolism
Cyproheptadine is extensively metabolized in the liver, primarily via glucuronidation. Paracetamol is mainly metabolized in the liver to inactive glucuronide and sulfate conjugates.
Side Effects
Contraindications
- Hypersensitivity to Cyproheptadine, Paracetamol, or any component of the formulation
- Acute asthma attack
- Newborns or premature infants
- Glaucoma (narrow-angle)
- Symptomatic prostatic hypertrophy
- Stenosing peptic ulcer
- Pyloroduodenal obstruction
- Bladder neck obstruction
- Patients taking MAO inhibitors or within 14 days of stopping them
- Severe hepatic or renal impairment
Drug Interactions
Warfarin
Paracetamol, especially at high doses or prolonged use, may potentiate the anticoagulant effect of warfarin, increasing bleeding risk.
MAO Inhibitors
May prolong and intensify the anticholinergic effects of Cyproheptadine. Contraindicated.
Other Hepatotoxic Drugs
Increased risk of liver toxicity with Paracetamol.
Anticholinergic Drugs (e.g., tricyclic antidepressants, atropine)
Potentiated anticholinergic effects (dry mouth, urinary retention).
CNS Depressants (e.g., alcohol, sedatives, hypnotics, tranquilizers, anxiolytics)
Increased CNS depression, drowsiness. Avoid concurrent use.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of Cyproheptadine can cause somnolence, dizziness, dry mouth, dilated pupils, excitement, ataxia, and hallucinations. Overdose of Paracetamol can lead to severe hepatic damage, which may be fatal. Management includes gastric lavage, activated charcoal, and supportive measures. N-acetylcysteine is the antidote for Paracetamol overdose.
Pregnancy & Lactation
Use in pregnancy and lactation only if clearly needed and the potential benefits outweigh the potential risks to the fetus/infant. Cyproheptadine is Pregnancy Category B, Paracetamol is Pregnancy Category B. Consult a physician.
Side Effects
Contraindications
- Hypersensitivity to Cyproheptadine, Paracetamol, or any component of the formulation
- Acute asthma attack
- Newborns or premature infants
- Glaucoma (narrow-angle)
- Symptomatic prostatic hypertrophy
- Stenosing peptic ulcer
- Pyloroduodenal obstruction
- Bladder neck obstruction
- Patients taking MAO inhibitors or within 14 days of stopping them
- Severe hepatic or renal impairment
Drug Interactions
Warfarin
Paracetamol, especially at high doses or prolonged use, may potentiate the anticoagulant effect of warfarin, increasing bleeding risk.
MAO Inhibitors
May prolong and intensify the anticholinergic effects of Cyproheptadine. Contraindicated.
Other Hepatotoxic Drugs
Increased risk of liver toxicity with Paracetamol.
Anticholinergic Drugs (e.g., tricyclic antidepressants, atropine)
Potentiated anticholinergic effects (dry mouth, urinary retention).
CNS Depressants (e.g., alcohol, sedatives, hypnotics, tranquilizers, anxiolytics)
Increased CNS depression, drowsiness. Avoid concurrent use.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of Cyproheptadine can cause somnolence, dizziness, dry mouth, dilated pupils, excitement, ataxia, and hallucinations. Overdose of Paracetamol can lead to severe hepatic damage, which may be fatal. Management includes gastric lavage, activated charcoal, and supportive measures. N-acetylcysteine is the antidote for Paracetamol overdose.
Pregnancy & Lactation
Use in pregnancy and lactation only if clearly needed and the potential benefits outweigh the potential risks to the fetus/infant. Cyproheptadine is Pregnancy Category B, Paracetamol is Pregnancy Category B. Consult a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generic
Clinical Trials
As a combination of well-established generic drugs, specific large-scale clinical trials for this particular brand formulation are generally not published. Efficacy and safety are derived from individual component studies.
Lab Monitoring
- Liver function tests (especially with prolonged use or in patients with liver disease due to Paracetamol component)
- Renal function tests (in patients with kidney impairment)
Doctor Notes
- Advise patients on potential drowsiness and caution against driving/operating machinery.
- Emphasize strict adherence to dosage to avoid Paracetamol hepatotoxicity.
- Consider alternative antihistamines if prominent anticholinergic effects are undesired.
Patient Guidelines
- Do not exceed the recommended dose.
- Avoid driving or operating heavy machinery if you experience drowsiness or dizziness.
- Avoid alcohol consumption while taking this medicine.
- Inform your doctor about all other medicines you are taking, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause drowsiness or dizziness. Patients should be advised not to drive or operate machinery until they are aware of how the medicine affects them.
Lifestyle Advice
- Ensure adequate hydration by drinking plenty of fluids.
- Get sufficient rest to aid recovery from illness.
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