Uses of Kotisol

Kotisol medicine contains the active ingredient Paracetamol (325mg) in combination with Tramadol (37.5mg). The analgesic effect of Kotisol combines the peripheral analgesic effect of Paracetamol and the central analgesic effect of Tramadol. Therefore, Kotisol is indicated in the treatment of moderate to severe pain in the following cases:
Headache, toothache, muscle aches, joint pain; Pain after sports injuries, accident injuries.

Kotisol is prepared in the form of film-coated tablets to be taken orally. Kotisol is not affected by food, so it can be taken with or without food. The dose of the drug used depends on the severity and condition of the patient. The recommended dose of Kotisol is as follows:
Adults and children older than 12 years: Take 1-2 tablets / time, repeat the dose after 4-6 hours without pain control. Note not to use more than 8 tablets/day; Children under 12 years of age: There are no studies proving the effectiveness and safety of treatment with Kotisol in children under 12 years of age. Therefore, do not use drugs in the treatment of this subject; Elderly (over 65 years of age): There were no differences in safety, efficacy and efficacy in the elderly. Therefore, no dose adjustment is required in the elderly. Overdose of Kotisol leads to symptoms of Paracetamol and Tramadol poisoning as follows:
Tramadol: Coma, respiratory failure, cardiac arrest, convulsions and possibly death; Paracetamol: Very high doses may lead to hepatotoxicity in some patients, loss of appetite, gastrointestinal irritation, vomiting, nausea, paleness, malaise, sweating. Symptoms of hepatotoxicity due to drug overdose may appear 48-72 hours after taking the drug.

Kotisol can cause some side effects as follows:
Common:
Body as a whole: Fatigue, weakness, strong emotions; Central nervous system, peripheral nervous system: Shivering, headache; Digestive system: Constipation, abdominal pain, diarrhea, flatulence, dyspepsia, vomiting, dry mouth; Psychiatric system: Anxiety, anorexia, irritability, insomnia, restlessness; Skin and soft tissues: Rash, skin itching, increased sweating. Rare:
Whole body: Chills, chest pain, syncope, withdrawal syndrome; Cardiovascular disorders: Severe hypertension, hypotension; Central nervous system, peripheral nervous system: Convulsions, loss of balance, migraine, muscle tension, involuntary muscle contractions, dizziness, stupor, paresthesias; Digestive system: Black stool due to gastrointestinal bleeding, difficulty swallowing, tongue edema; Vestibular - cochlear disorders: Tinnitus; Psychiatric system: Depression, forgetfulness, loss of consciousness, mood swings, drug abuse, hallucinations, nightmares, impotence, abnormal ideas; Lymphatic system: Anemia ; Respiratory system: Shortness of breath; Urinary system: Urinary disorders, albuminuria, urinary retention, little urine; Vision disorders: Abnormal vision.

Contraindicated to use Kotisol drug in the following cases:
People who are sensitive to Paracetamol, Tramadol or to any ingredient of Kotisol drug; Pregnant women, lactating women, because there are no specific studies proving the safety of Kotisol in these subjects; People with G6PD enzyme deficiency, people with anemia many times or being treated with MAO inhibitors; Precautions when using Kotisol:
Caution when using Kotisol concomitantly with serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, MAO inhibitors (MAOIs), opioids, drugs reduced seizure threshold, sedation or epileptic patients with a history of epileptic seizures. Caution should be exercised when treating with Kotisol in patients with respiratory failure, because the drug has a high risk of respiratory failure. Caution should be exercised when co-administering Kotisol with CNS depressants such as drugs, alcohol, Opioids, anesthetics, sedatives and hypnotics. Use caution when using Kotisol in patients with increased intracranial pressure or head injury, alcohol abusers because it is easy to increase liver toxicity. The use of Naxolon in the management of an overdose of Tramadol may increase the risk of convulsions. For patients with creatinine clearance less than 30ml/min, it is recommended not to take more than 2 Kotisol tablets in 12 hours. Use caution when using Kotisol in patients with severe liver failure, or using it with other drugs containing Tramadol or Paracetamol.

Kotisol may cause some interactions as follows:
MAO inhibitors, Serotonin reuptake inhibitors: Increased risk of side effects (including seizures, Serotonin syndrome); Carbamazepine: Increases the metabolism of tramadol, thereby reducing the effectiveness of Kotisol; Quinidine: Increases the concentration of Tramadol in the blood plasma; Oral Anticoagulants: Concomitant use of Kotisol and oral anticoagulants requires periodic assessment of the extracoagulation time, as several studies have demonstrated an increased INR in some patients. ; CYP2D6 Inhibitors: Concomitant use of Kotisol and CYP2D6 inhibitors such as Paroxetine, Fluoxetine and Amitriptyline reduces the metabolism of Tramadol; The above is information about the uses, dosage and usage of Kotisol. Patients should carefully read the instructions for use, consult a doctor / pharmacist before use. Absolutely do not arbitrarily buy drugs to treat at home because there may be unwanted side effects.