Herculix
Generic Name
Xylotram 500 mg Injection
Manufacturer
PharmaCorp Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| herculix 500 mg injection | ৳ 150.00 | N/A |
Description
Overview of the medicine
Herculix 500 mg Injection is a potent non-steroidal anti-inflammatory drug (NSAID) used for the short-term treatment of moderate to severe acute pain. It provides effective relief from various pain conditions including postoperative pain and acute musculoskeletal pain. Administered via intramuscular or intravenous route.
Uses & Indications
Dosage
Adults
Initial dose 500 mg by IM or slow IV injection (over at least 15 seconds). Subsequent doses: 250-500 mg every 8-12 hours, not exceeding 1500 mg in 24 hours. Max duration of treatment is 2 days.
Elderly
A lower dose (e.g., 250 mg every 12 hours) may be required due to increased risk of adverse effects and reduced renal function. Close monitoring is essential.
Renal_impairment
Dose adjustment necessary. For moderate impairment (creatinine clearance 30-60 mL/min), reduce dose by 50%. Not recommended for severe impairment (creatinine clearance <30 mL/min).
How to Take
For deep intramuscular injection, administer into a large muscle mass (e.g., gluteus maximus). For intravenous infusion, dilute the dose in 50-100 mL of normal saline or 5% dextrose solution and infuse slowly over 15-30 minutes. Do not administer intrathecally or epidurally.
Mechanism of Action
Xylotram, the active ingredient in Herculix, primarily acts by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins. Prostaglandins play a key role in mediating pain, inflammation, and fever. By reducing prostaglandin production, Xylotram exerts its analgesic, anti-inflammatory, and antipyretic effects.
Pharmacokinetics
Onset
15-30 minutes for analgesic effect.
Excretion
Excreted predominantly through the kidneys (approximately 60% as metabolites) and a lesser extent via feces (approximately 30%).
Half life
Approximately 2-4 hours.
Absorption
Rapidly absorbed after intramuscular (IM) and intravenous (IV) administration. Peak plasma concentrations are achieved within 30-60 minutes.
Metabolism
Primarily metabolized in the liver via cytochrome P450 (CYP) enzymes, mainly CYP2C9 and CYP2C8, to inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to Xylotram, aspirin, or other NSAIDs
- Active gastrointestinal bleeding or peptic ulcer
- Severe renal or hepatic impairment
- Asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery
Drug Interactions
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Diuretics and ACE inhibitors
Reduced hypotensive effect of these drugs; increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. More severe effects may include acute renal failure, hepatic dysfunction, hypotension, respiratory depression, and coma. Management involves symptomatic and supportive treatment. There is no specific antidote. Gastric decontamination is generally not indicated for injectable forms. Monitor vital signs and renal/hepatic function.
Pregnancy & Lactation
Pregnancy: Avoid in the third trimester due to potential premature closure of the fetal ductus arteriosus and increased risk of maternal and fetal bleeding. Use with caution in the first and second trimesters only if the potential benefit justifies the potential risk to the fetus. Lactation: Small amounts of Xylotram may be excreted in breast milk. Use with caution during breastfeeding; consult a doctor.
Side Effects
Contraindications
- Known hypersensitivity to Xylotram, aspirin, or other NSAIDs
- Active gastrointestinal bleeding or peptic ulcer
- Severe renal or hepatic impairment
- Asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery
Drug Interactions
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Diuretics and ACE inhibitors
Reduced hypotensive effect of these drugs; increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. More severe effects may include acute renal failure, hepatic dysfunction, hypotension, respiratory depression, and coma. Management involves symptomatic and supportive treatment. There is no specific antidote. Gastric decontamination is generally not indicated for injectable forms. Monitor vital signs and renal/hepatic function.
Pregnancy & Lactation
Pregnancy: Avoid in the third trimester due to potential premature closure of the fetal ductus arteriosus and increased risk of maternal and fetal bleeding. Use with caution in the first and second trimesters only if the potential benefit justifies the potential risk to the fetus. Lactation: Small amounts of Xylotram may be excreted in breast milk. Use with caution during breastfeeding; consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies, Hospitals, Clinics
Approval Status
Approved by DGDA
Patent Status
Patent expired
Clinical Trials
Clinical trials have demonstrated the efficacy and safety of Xylotram in various acute pain settings, including postoperative pain, with comparable analgesic effects to opioid analgesics in some cases, but with a better safety profile regarding respiratory depression.
Lab Monitoring
- Renal function (creatinine, BUN) – especially with prolonged use or in patients with pre-existing renal impairment.
- Liver function tests (ALT, AST) – periodically for long-term therapy.
- Complete Blood Count (CBC) – for signs of GI bleeding with prolonged use.
- Blood pressure monitoring.
Doctor Notes
- Strictly adhere to the maximum treatment duration of 2 days for acute pain management.
- Monitor renal function, especially in elderly patients, those with dehydration, or concomitant use of diuretics/ACE inhibitors.
- Assess for history of GI disease; consider prophylactic GI protection for high-risk patients.
- Caution in patients with cardiac risk factors or established cardiovascular disease.
Patient Guidelines
- This medicine is for short-term use only, typically not exceeding 2 days.
- Report any unusual bleeding, stomach pain, or dark stools to your doctor immediately.
- Inform your healthcare provider about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Do not exceed the prescribed dose or duration of treatment.
Missed Dose Advice
Since Herculix is administered by a healthcare professional, missed doses are unlikely. If a scheduled dose is missed, contact your doctor or nurse immediately to reschedule.
Driving Precautions
Herculix may cause dizziness, drowsiness, or visual disturbances in some patients. If you experience these side effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid alcohol consumption during treatment as it may increase the risk of gastrointestinal bleeding.
- Maintain adequate hydration, especially if you have renal impairment concerns.
- Inform your dentist or surgeon that you are receiving Herculix before any procedures.
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