Penthrox

Emergency relief of moderate to severe pain in conscious adult patients w/ trauma & associated pain.

3 mL to be vaporised in an inhaler. Max dose: 6 mL in a single administration. Inhale intermittently to achieve adequate analgesia. Total dose in a wk: 15 mL.

Hypersensitivity to methoxyflurane or any fluorinated anaesth. As anaesth agent. Known genetic susceptibility to malignant hyperthermia or family history of severe drug reactions to inhaled anaesth. History of showing signs of liver damage after previous methoxyflurane use or halothane anaesth. Clinically evident CV instability; resp depression. Altered level of consciousness. Clinically significant renal impairment.

Not appropriate for providing relief of breakthrough pain/exacerbations in chronic pain conditions due to limitations on dose & duration of pain; relief of trauma related pain in closely repeated episodes for same patient. Do not administer to patients who have shown signs of liver damage, especially after previous methoxyflurane or halothane anaesth. Significant nephrotoxicity at high doses. Potential CNS effects eg, sedation, euphoria, amnesia, ability to concentrate, altered sensorimotor coordination & change in mood. Risk of resp depression & hypoxia; monitor respiration. Patients w/ genetic variations resulting to fast metabolism; underlying hepatic conditions or w/ risks for hepatic dysfunction; other known risk factors of renal disease. Elevation of liver enzymes, BUN & serum uric acid; non-serious & transient reactions (eg, dizziness, headache, nausea, malaise & hypersensitivity reactions) in healthcare professionals upon exposure. Use activated carbon chamber to reduce occupational exposure. Contains butylated hydroxytoluene (E321) which may cause local skin reactions (eg, contact dermatitis) or irritation to eyes & mucous membranes. Concomitant treatment w/ drugs inducing hepatic enzymes. May have minor influence on ability to drive & use machines. Advise patients not to drive or operate machinery if feeling drowsy or dizzy. Increased exposure in patients w/ hepatic impairment. Dose-related renal impairment. Pregnancy especially during 1st trimester. Lactation. Not to be used in childn <18 yr. Neonatal resp depression w/ high methoxyflurane levels. Elderly w/ hypotension & bradycardia.

Dizziness, somnolence; feeling drunk.

Increased rate of metabolism w/ CYP 2E1 (eg, alcohol, INH), CYP 2A6 (eg, phenobarb, rifampicin) & CYP 2B6 (eg, carbamazepine, efavirenz, rifampicin or nevirapine) enzyme inducers. Additive depressant effects w/ CNS depressants eg, opioids. Additive nephrotoxic effect w/ medicines (eg, antibiotics) known to have nephrotoxic effect including tetracycline, gentamicin, colistin, polymyxin B & amphotericin B. May raise serum fluoride levels & nephrotoxicity w/ sevoflurane.

Analgesics (Non-Opioid) & Antipyretics

N02BG09 - methoxyflurane ; Belongs to the class of other analgesics and antipyretics.

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