Tempra forte is an anilide group medication that has analgesic, anti-inflammatory, antipyretic effects. Refers to non-narcotic analgesics. The chemical formula is C8H9NO2.
Appointment Tempra forte
Tempra forte is prescribed in the following conditions:
• Headache and toothache;
• Pain after injury;
• Influenza, which is accompanied by muscle and headache, fever;
• Inflammatory processes;
• Neuralgic pains;
• Postoperative pain;
• Oncological pain.
Absorption - high, maximum concentration (Cmax) 5–20 μg / ml, time to reach maximum concentration (TCmax) 0.5–2 hours. It binds to plasma proteins by 15%. Penetrates through the blood-brain barrier. During lactation, less than 1% of the active substance passes into breast milk.
About 97% of the medication is metabolized in the liver: 80% undergoes a conjugation reaction with glucuronic acid and sulfates to form inactive metabolites (glucuronide and paracetamol sulfate), 17% undergoes hydroxylation with the formation of eight active metabolites that conjugate with glutathione to form already inactive metabolites. With a lack of glutathione, these metabolites can block the hepatocyte enzyme systems and cause their necrosis. The isoenzyme of CYP2E1 is also involved in the metabolism of the medication.
The elimination half-life (T½) is 1–4 hours. It is excreted by the kidneys in the form of metabolites, about 3% - unchanged. In elderly patients, the clearance of the medication decreases and T½ increases.
It is not recommended to take Tempra forte in the following cases:
• Individual sensitivity to the components of the medication;
• Together with alcohol;
• Children up to 1 month.
With extreme caution Tempra forte should be used in cases of renal or hepatic insufficiency, benign hyperbilirubinemia (including Gilbert’s syndrome), viral hepatitis, alcoholic liver damage, alcoholism, pregnancy, lactation, old age, early infancy (about 1 to 3 months), glucose-6-phosphate dehydrogenase deficiency.
Tempra forte may cause the following side effects:
1. From the skin: itching, rash on the skin and mucous membranes (usually erythematous, urticaria), angioedema, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).
2. From the side of the central nervous system (usually develops when taking high doses): dizziness, psychomotor agitation and disorientation.
3. From the digestive system: nausea, epigastric pain, increased activity of "liver" enzymes, usually without the development of jaundice, hepatonecrosis (dose-dependent effect).
4. From the endocrine system: hypoglycemia, up to hypoglycemic coma.
5. Hematopoietic organs: anemia, sulfhemoglobinemia and methemoglobinemia (cyanosis, shortness of breath, heart pain), hemolytic anemia (especially for patients with glucose-6-phosphate dehydrogenase deficiency). With prolonged use in large doses - aplastic anemia, thrombocytopenia, pancytopenia, leukopenia, agranulocytosis, neutropenia.
6. From the urinary system: (when taking large doses) - nephrotoxicity (renal colic, interstitial nephritis, papillary necrosis).
Symptoms (an acute overdose develops 6-14 hours after taking paracetamol, chronic 2-4 days after the dose is taken) of an acute overdose: gastrointestinal tract dysfunction (diarrhea, decreased appetite, nausea and vomiting. Overdose cause discomfort and pain in abdomen, increased sweating.
Symptoms of a chronic overdose: a hepatotoxic effect develops, characterized by general symptoms (pain, weakness, adynamia, increased sweating) and specific, characterizing liver damage. As a result, hepatonecrosis may develop. The hepatotoxic effect of paracetamol can be complicated by the development of hepatic encephalopathy (impaired thinking, CNS depression, stupor), convulsions, respiratory depression, coma, cerebral edema, hypocoagulation, the development of DIC, hypoglycemia, metabolic acidosis, arrhythmia, collapse. Rarely, liver dysfunction develops at lightning speed and can be complicated by renal failure (renal tubular necrosis).
Treatment: administration of SH-group donors and precursors of glutathione-methionine synthesis 8-9 hours after an overdose and N-acetylcysteine 12 hours later.The need for additional therapeutic measures (further administration of methionine, iv administration of N-acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as on the time elapsed after its administration.
Dosage and administration
Tempra forte is taken orally, drinking a tablet with plenty of water 1-2 hours after a meal.
For adults with a body weight of more than 40 kg, a single dose is 1 tablet (650 mg). The maximum single dose is 1 g. The medication is prescribed up to 3-4 times a day. The maximum daily dose is 4g.
The interval between doses should be increased in patients with renal and hepatic insufficiency, in the elderly.
The maximum duration of treatment without consulting a doctor is 3 days (when taken as an antipyretic medication) and 5 days (as an analgesic).
Treatment reduces the effectiveness of uricosuric medications. Concomitant use in high doses increases the effect of anticoagulant medications (a decrease in the synthesis of procoagulant factors in the liver).
Inducers of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic medications increase the production of hydroxylated active metabolites, which makes it possible to develop severe intoxications even with a small overdose.
Prolonged use of barbiturates reduces the effectiveness of the medication.
Ethanol contributes to the development of acute pancreatitis.
Microsomal oxidation inhibitors (including cimetidine) reduce the risk of hepatotoxicity.
Prolonged sharing and other NSAIDs increases the risk of developing “analgesic” nephropathy and renal papillary necrosis, the onset of end-stage renal failure.
Diflunisal increases plasma concentration by 50% - the risk of hepatotoxicity.
Myelotoxic medications increase the manifestations of hematotoxicity of the medication.
Expected delivery time
10-15 business days ( or even faster depending on your location)
- Credit Card
- Money Transfer (WESTERN UNION)
- Domestic Bank Wire ( Special discount with this payment method)