Termalgin: Indications, Contraindications And Side Effects

Termalgin is a trademark of the active ingredient paracetamol. It is a drug used both in the treatment of fever and to reduce pain. Paracetamol was discovered in 1877 in Germany. Today it is the most widely used drug to combat the aforementioned situations on our continent and in the United States.

Paracetamol is on the list of basic medicines that any health system must have excess of. This list of essential medicines is compiled by the World Health Organization (WHO).

On the other hand, in developing countries the price of Termalgin is lower than in developed countries. Next, we will see the following aspects of Termalgin:

• Mechanism of action.
• Indications and contraindications.
• Pharmacokinetics.
• Adverse reactions.

Mechanism of action of Termalgin

Because Termalgin has two main indications, which are the treatment of pain and the treatment of fever, it is necessary to differentiate the two mechanisms by which it carries out these effects.

It should be said that, despite not knowing exactly the mechanism of this drug, it is known that to trigger the analgesic effect it interrupts the synthesis of prostaglandins in our body. But do we know what prostaglandins are? Prostaglandins are lipid molecules that participate in many processes in our body. Among them the production of fever, pain and in the inflammatory response.

Therefore, to inhibit the synthesis of these molecules, Termalgin blocks an enzyme called cyclooxygenase (COX) in the central nervous system (CNS). Thus, as prostaglandins are responsible for the sensation of pain, as their synthesis is inhibited, this sensation disappears.

On the other hand, fever releases a molecule called cytokines (IL-1β, IL-6, INFα and beta and TNfα. These molecules enhance the synthesis of prostagalndin E2 in the hypothalamus. This increase leads to another increase in another substance, el CAMP, which raises body temperature.

Thus, by inhibiting the synthesis of prostaglandins at this level, Termalgin manages to lower body temperature and thus fever, triggering its antipyretic effect.

Indications and contraindications of Termalgin

As mentioned above, Termalgin is used in adults and adolescents from 14 years of age for the symptomatic relief of occasional mild or moderate pain such as:

• Headache.
• Dental pain.
• Muscle pain such as contractures or back pain as in lumbago.
• Fever.

In the event that the fever worsens or persists after 3 days of treatment or pain for 5 days using Termalgin, you should notify a doctor.

On the other hand, there are a number of situations in which the administration of Termalgin is contraindicated. If the patient has liver disease or is allergic to this drug, the use of the drug is absolutely contraindicated. In addition, special caution must be exercised in these situations, among others:

• Anemia, heart or lung problems.
• Asthma and allergy to acetylsalicylic acid.
• Patients who consume alcohol.
• Pregnant women should consult a doctor before taking Termalgin as it can be dangerous.
• Elderly people may need a dosage adjustment.

Pharmacokinetics

The metabolism of this drug is of special importance. It is administered orally, and once absorbed it is metabolized in the liver, into cytochrome P-450 by 95%. The remaining 5% is excreted in the urine without biotransformation.

In the liver, it undergoes glucuronation and sulfuconjugation reactions, producing a metabolite called phenacetin. Most of the metabolites of paracetamol (active principle of Termalgin) are not toxic, except NAPQI (N-acetyl-p-benzoquinoneimine), which is the cause of toxicity.

When the doses of this drug are therapeutic, this toxic metabolite is neutralized by another route and is eliminated, like the rest, by the kidney. However, when the doses are toxic, the neutralization pathway becomes saturated and toxic effects appear. That is why this drug should not be abused.

Adverse reactions

Due to what was explained in the previous section, the most important adverse reaction of Termalgin is related to the hepatotoxicity it presents. However, it can also trigger other reactions such as kidney function problems, headaches, and confusion. In addition to those mentioned, some of the following side effects may occur, although very rarely:

• Nose or gum hemorrhages.
• Decrease in some of the components of the blood.
• Anaphylactic shock.