N-MAX Tablet (Ibuprofen and Paracetamol)

Indications

N-MAX is a Dual Action medicine containing Ibuprofen (an NSAID) and Paracetamol (an analgesic). It is used for the temporary relief of mild to moderate pain and fever in adults over 18 years old.

Uses include: 

• Migraine, Headache, Backache, Period Pain, Dental Pain, Rheumatic and Muscular Pain. 

• Cold and Flu symptoms, Sore throat, and Fever. 

Note: This medicine should only be used after trying ibuprofen or paracetamol individually.

Pharmacology (Mechanism of Action)

• Ibuprofen (NSAID): Works by reducing pain, swelling, and high temperatures. It is a potent inhibitor of the enzyme cyclooxygenase, resulting in a marked reduction in prostaglandin synthesis (responsible for pain and inflammation). 

• Paracetamol (Analgesic): Primarily acts in the Central Nervous System (CNS) by inhibiting cyclooxygenase enzymes, which increases the pain threshold and inhibits the hypothalamic heat-regulating center to produce antipyresis (fever reduction). 

Dosage and Administration (Adults $\ge 18$ years)

• Initial Dose:1 tablet with water and food, up to 3 times a day. 

• Spacing: Leave at least 6 hours between doses. 

• Maximum Dose: If one tablet does not control symptoms, a maximum of 2 tablets may be taken up to three times a day. 

• 24-Hour Limit: Do not take more than 6 tablets within 24 hours (equivalent to $3000 \text{ mg}$Paracetamol and $1200 \text{ mg}$Ibuprofen). 

• Children/Adolescents:Not for use by children and adolescents under 18 years of age. 

Contraindications and Warnings

• Do NOT take this medicine if you:

  • Are already taking any other product containing Paracetamol or other NSAIDs (including high dose aspirin or COX-2 inhibitors). 

  • Are allergic to ibuprofen, paracetamol, aspirin, or any other ingredients. 

  • Have or ever had an ulcer or bleeding in your stomach or duodenum. 

  • Suffer from heart, liver, or kidney failure. 

  • Are in the last 3 months of pregnancy. 

• Precautions (Consult a doctor if you have): Asthma, kidney/heart/liver/bowel problems, Systemic Lupus Erythematosus (SLE), chronic inflammatory bowel disease (e.g., Crohn's disease), or are elderly. 

Pregnancy & Lactation:

• Last 3 months of Pregnancy:CONTRAINDICATED (risk of harm to the unborn child, kidney/heart problems, and delayed labor). 

• Breastfeeding: May be taken if used at the recommended dose and for the shortest possible time, as only small amounts pass into breast-milk. 

Side Effects: Potential side effects include heartburn, indigestion, signs of intestinal bleeding, signs of inflammation of the brain lining, and signs of a severe allergic reaction. 

Storage: Keep out of the sight and reach of children. No special storage conditions are required.