Cypa

Clidinium Bromide (Cypa) is a synthetic anticholinergic agent which has been shown in experimental and clinical studies to have a pronounced antispasmodic and antisecretory effect on the gastrointestinal tract. It inhibits muscarinic actions of acetylcholine at postganglionic parasympathetic neuroeffector sites. It is used for the treatment of peptic ulcer disease and also to help relieve abdominal or stomach spasms or cramps due to colicky abdominal pain, diverticulitis, and irritable bowel syndrome.

A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [PubChem]

Paracetamol (Cypa) is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Paracetamol (Cypa) exists as small alkaline deliquescent crystals with a saline tasteacinol was introduced to medicine as a solvent for uric acid. When taken into the body the drug is partly oxidized and partly eliminated unchanged. Outside the body, piperazine has a remarkable power to dissolve uric acid and producing a soluble urate, but in clinical experience it has not proved equally successfulacinol was first introduced as an anthelmintic in 1953. A large number of piperazine compounds have anthelmintic Paracetamol (Cypa). Their mode of Paracetamol (Cypa) is generally by paralysing parasites, which allows the host body to easily remove or expel the invading organism.

Irritable bowel syndrome, adjuvant in peptic ulcer, spasmodic dysmenorrhoea, abdominal/biliary/ureteric colic.

For the treatment of functional disturbances of gastrointestinal motility eg, irritable bowel syndrome and renal and biliary colic. As with other antispasmodics, Dicycloverine (Cypa) has limited efficacy in the treatment of these disorders and should be used only if other measures (eg, diet) have been of little or no benefit.

Dicycloverine (Cypa) has been used alone or in combination with phenobarbital in the treatment of infant colic and acute enterocolitis but lacks substantial evidence of efficacy in these conditions. Infant colic is considered a benign and self-limiting condition.

For systemic use of Paracetamol (Cypa) Sante Naturelle: prevention and treatment of hypo- and avitaminosis of vitamin C; providing increased need for vitamin C during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Clidinium Bromide (Cypa) reduces the secretions of certain organs in the body.

Clidinium Bromide (Cypa) helps to control conditions such as peptic ulcers that involve excessive stomach acid production.

Clidinium Bromide (Cypa) may also be used for purposes other than those listed in this medication guide.

Dicycloverine (Cypa) relieves spasms of the muscles in the stomach and intestines.

Dicycloverine (Cypa) is used to treat functional bowel or irritable bowel syndrome.

Dicycloverine (Cypa) may also be used for purposes not listed in this medication guide.

Paracetamol (Cypa) (acetaminophen) is a pain reliever and a fever reducer. The exact mechanism of Paracetamol (Cypa) of is not known.

Paracetamol (Cypa) is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. It relieves pain in mild arthritis but has no effect on the underlying inflammation and swelling of the joint.

Paracetamol (Cypa) may also be used for other purposes not listed in this medication guide.

1-2 tabs, 3-4 times/day before meals.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule,

Oral, as hydrochloride:

Bentyl: 10 mg [DSC] [contains brilliant blue fcf (fd&c blue #1), corn starch, fd&c red #40]

Generic: 10 mg

Solution,

Intramuscular, as hydrochloride:

Bentyl: 10 mg/mL (2 mL) [pyrogen free]

Generic: 10 mg/mL (2 mL)

Solution,

Intramuscular, as hydrochloride [preservative free]:

Generic: 10 mg/mL (2 mL)

Solution,

Oral, as hydrochloride:

Generic: 10 mg/5 mL (473 mL)

Tablet,

Oral, as hydrochloride:

Bentyl: 20 mg [DSC] [contains brilliant blue fcf (fd&c blue #1), corn starch]

Generic: 20 mg

Dosing: Adult

Irritable bowel syndrome-associated abdominal pain:

Oral: Initial: 20 mg up to 4 times daily; some experts recommend only administering as needed or in anticipation of a stressor that triggers abdominal pain (Wald 2019); intended for short-term use; scheduled dosing for >2 weeks has not been studied (Ford 2014; manufacturer's labeling)

Note: According to the manufacturer's labeling, may titrate dose after 1 week, based on response and tolerability, up to 40 mg 4 times daily; however, some experts do not recommend doses >20 mg due to anticholinergic adverse effects (Wald 2019).

Dosing: Geriatric

Avoid use (Beers Criteria [AGS 2019]).

Dosing: Pediatric

Gastrointestinal motility disorders/irritable bowel: Limited data available (Bentylol Canadian prescribing information 2012):

Infants ≥6 months and Children <2 years:

Oral: 5 to 10 mg 3 to 4 times daily administered 15 minutes before feeding

Children ≥2 years

Oral: 10 mg 3 to 4 times daily

Adolescents:

Oral: 10 to 20 mg 3 to 4 times daily. If efficacy not achieved in 2 weeks, therapy should be discontinued.

Usual Adult Paracetamol (Cypa) Dose for Fever:

General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.

Paracetamol (Cypa) 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours

Usual Adult Paracetamol (Cypa) Dose for Pain:

General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.

Paracetamol (Cypa) 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours

Usual Pediatric Dose for Fever:

Oral or Rectal:

<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.

>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)

Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)

>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.

Usual Pediatric Dose for Pain:

Oral or Rectal:

<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.

>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)

Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)

>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.

See also:
What is the most important information I should know about Clidinium Bromide (Cypa)?

Hypersensitivity to anticholinergic agents, narrow-angle glaucoma, GI obstruction, myasthenia gravis, paralytic ileus, GI atony, toxic megacolon.

See also:
What is the most important information I should know about Dicycloverine (Cypa)?

1. Obstructive uropathy
2. Obstructive disease of the gastrointestinal tract
3. Severe ulcerative colitis
4. Reflux esophagitis
5. Unstable cardiovascular status in acute hemorrhage
6. Glaucoma
7. Myasthenia gravis
8. Evidence of prior hypersensitivity to Dicycloverine (Cypa) hydrochloride or other ingredients in this formulation
9. Infants less than 6 months of age
10. Nursing Mothers

See also:
What is the most important information I should know about Paracetamol (Cypa)?

Paracetamol (Cypa) should not be used in patients who have previously exhibited hypersensitivity to aspirin and/or nonsteroidal antiinflammatory agents. Paracetamol (Cypa) should not be given to patients with a recent history of gastrointestinal bleeding or in patients with bleeding disorders (e.g., hemophilia).

Use Dicycloverine (Cypa) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Dicycloverine (Cypa) is usually given as an injection at your doctors office, hospital, or clinic. If you will be using Dicycloverine (Cypa) at home, a health care provider will teach you how to use it. Be sure you understand how to use Dicycloverine (Cypa). Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Dicycloverine (Cypa) is for intramuscular (IM) injection only. It is NOT for intravenous (IV) use.
• Do not use Dicycloverine (Cypa) if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• The injection form of Dicycloverine (Cypa) is only given short-term when the oral form cannot be taken. Your health care provider will prescribe the oral form of Dicycloverine (Cypa) as soon as you are able to take it.
• Use Dicycloverine (Cypa) on a regular schedule around the clock, unless your doctor tells you otherwise.
• If you miss a dose of Dicycloverine (Cypa), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Dicycloverine (Cypa).

Use Paracetamol (Cypa) exactly as directed on the label, or as prescribed by your doctor.

Do not use more of this medication than is recommended. An overdose of Paracetamol (Cypa) can cause serious harm. The maximum amount for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Using more Paracetamol (Cypa) could cause damage to your liver. If you drink more than three alcoholic beverages per day, talk to your doctor before taking Paracetamol (Cypa) and never use more than 2 grams (2000 mg) per day. If you are treating a child, use a pediatric form of Paracetamol (Cypa). Carefully follow the dosing directions on the medicine label. Do not give the medication to a child younger than 2 years old without the advice of a doctor.

Measure the liquid form of Paracetamol (Cypa) with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. You may need to shake the liquid before each use. Follow the directions on the medicine label.

The Paracetamol (Cypa) chewable tablet must be chewed thoroughly before you swallow it.

Make sure your hands are dry when handling the Paracetamol (Cypa) disintegrating tablet. Place the tablet on your tongue. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

To use the Paracetamol (Cypa) effervescent granules, dissolve one packet of the granules in at least 4 ounces of water. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

Do not take a Paracetamol (Cypa) rectal suppository by mouth. It is for use only in your rectum. Wash your hands before and after inserting the suppository.

Try to empty your bowel and bladder just before using the Paracetamol (Cypa) suppository. Remove the outer wrapper from the suppository before inserting it. Avoid handling the suppository too long or it will melt in your hands.

For best results from the suppository, lie down and insert the suppository pointed tip first into the rectum. Hold in the suppository for a few minutes. It will melt quickly once inserted and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after inserting the suppository.

Stop using Paracetamol (Cypa) and call your doctor if:

• you still have a fever after 3 days of use;

• you still have pain after 7 days of use (or 5 days if treating a child);

• you have a skin rash, ongoing headache, or any redness or swelling; or

• if your symptoms get worse, or if you have any new symptoms.

Urine glucose tests may produce false results while you are taking Paracetamol (Cypa). Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.

Store Paracetamol (Cypa) at room temperature away from heat and moisture. The rectal suppositories can be stored at room temperature or in the refrigerator.

Clidinium Bromide (Cypa) is used to treat ulcers in stomach and intestine that occur due to excessive acid secretion and to relieve abdominal cramps. It can also be used in irritable bowel syndrome (disorder of the intestines that leads to cramps in the abdomen, gas, bloating and changes in bowel habits).

Dicycloverine (Cypa) is used to treat periodic spasms and pain in abdomen and stomach, intestinal cramps, irritable bowel syndrome (disorder of the intestines that leads to cramps in the abdomen, gas, bloating and changes in bowel habits) and inability to control urine (urinary incontinence).

This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.

How to use Paracetamol (Cypa)

Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

There are many brands and forms of acetaminophen available. Read the dosing instructions carefully for each product because the amount of acetaminophen may be different between products. Do not take more acetaminophen than recommended.

If you are giving acetaminophen to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.

For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.

For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.

Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.

Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.

Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.

Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.

See also:
What other drugs will affect Clidinium Bromide (Cypa)?

Amantadine, tricyclic antidepressants, and MAOIs may increase anticholinergic effect of Clidinium Bromide (Cypa). Clidinium Bromide (Cypa) may decrease the effect of phenothiazines, levodopa, and ketoconazole.

See also:
What other drugs will affect Dicycloverine (Cypa)?

As an anticholinergic drug Dicycloverine (Cypa) is likely to interact additively with other drugs acting on muscarinic cholinergic receptors. However there seems to be no evidence.

See also:
What other drugs will affect Paracetamol (Cypa)?

With the simultaneous use with inducers of microsomal liver enzymes, means having hepatotoxic effect, increasing the risk of hepatotoxic Paracetamol (Cypa) of Paracetamol (Cypa).

With the simultaneous use of anticoagulants may be slight to moderate increase in prothrombin time.

With the simultaneous use of anticholinergics may decrease absorption of Paracetamol (Cypa).

With the simultaneous use of oral contraceptives accelerated excretion of Paracetamol (Cypa) from the body and may reduce its analgesic Paracetamol (Cypa).

With the simultaneous use with urological means reduced their effectiveness.

With the simultaneous use of activated charcoal reduced bioavailability of Paracetamol (Cypa).

When Paracetamol (Cypa) Guardian applied simultaneously with diazepam may decrease excretion of diazepam.

There have been reports about the possibility of enhancing mielodepression effect of zidovudine while applying with Paracetamol (Cypa). A case of severe toxic liver injury.

Described cases of toxic effects of Paracetamol (Cypa), while the use of isoniazid.

When applied simultaneously with carbamazepine, phenytoin, phenobarbital, primidonom decreases the effectiveness of Paracetamol (Cypa), which is caused by an increase in its metabolism and excretion from the body. Cases of hepatotoxicity, while the use of Paracetamol (Cypa) and phenobarbital.

In applying cholestyramine a period of less than 1 h after administration of Paracetamol (Cypa) may decrease of its absorption.

At simultaneous application with lamotrigine moderately increased excretion of lamotrigine from the body.

With the simultaneous use of metoclopramide may increase absorption of Paracetamol (Cypa) and its increased concentration in blood plasma.

When applied simultaneously with probenecid may decrease clearance of Paracetamol (Cypa), with rifampicin, sulfinpyrazone - may increase clearance of Paracetamol (Cypa) due to increasing its metabolism in the liver.

At simultaneous application of Paracetamol (Cypa) Guardian with ethinylestradiol increases absorption of Paracetamol (Cypa) from the gut.

Enhances the effect of indirect anticoagulants (coumarin derivatives and indandione). Antipyretic and analgesic activity of caffeine increases, reduce - rifampicin, phenobarbital and alcohol (accelerated biotransformation, inducing microsomal liver enzymes).

See also:
What are the possible side effects of Clidinium Bromide (Cypa)?

Altered libido, Altered taste, Change in appetite, Altered sexual function, Constipation, Drowsiness, Dry mouth, Difficulty in urination, Excitement, Abdominal bloating, Heartburn, Insomnia, Stomach upset, Weakness

See also:
What are the possible side effects of Dicycloverine (Cypa)?

Controlled clinical trials have provided frequency information for reported adverse effects of Dicycloverine (Cypa) hydrochloride listed in a decreasing order of frequency.

Not all of the following adverse reactions have been reported with Dicycloverine (Cypa) hydrochloride. Adverse reactions are included here that have been reported for pharmacologically similar drugs with anticholinergic/antispasmodic action.

Gastrointestinal: dry mouth, nausea, vomiting, constipation, bloated feeling, abdominal pain, taste loss, anorexia.

Central Nervous System: dizziness, lightheadedness, tingling, headache, drowsiness, weakness, nervousness, numbness, mental confusion and/or excitement (especially in elderly persons), dyskinesia, lethargy, syncope, speech disturbance, insomnia.

Ophthalmologic: blurred vision, diplopia, mydriasis, cycloplegia, increased ocular tension

Dermatologic/Allergic: rash, urticaria, itching, and other dermal manifestations; severe allergic reaction or drug idiosyncrasies including anaphylaxis.

Genitourinary: urinary hesitancy, urinary retention

Cardiovascular: tachycardia, palpitations

Respiratory: Dyspnea, apnea, asphyxia

Other: decreased sweating, nasal stuffiness or congestion, sneezing, throat congestion, impotence, suppression of lactation

See also:
What are the possible side effects of Paracetamol (Cypa)?

Effects due to the presence of acetylsalicylic acid.

Accidents awareness with respiratory or skin reactions (angioedema, urticaria, asthma, anaphylactic shock);

Cross hypersensitivity reactions with NSAIDs and with tartrazine;

At low doses recommended for the use of Paracetamol (Cypa), side effects of aspirin are generally limited to some irritation of the gastro-intestinal tract.

At higher doses, side effects include gastrointestinal mucosal erosions, gastric ulcer or duodenal ulcer, occult blood loss, melena.

Acetylsalicylic acid may also increase the tendency to bleeding and bleeding time (the lengthening of bleeding continues 4-6 days after stopping the drug).

It may also worsen renal function including cases of pre-existing condition (the long-term use can cause chronic kidney disease).

The signs of salicylic overdose described under.

Effects due to the presence of Paracetamol (Cypa).

At the doses and duration of recommended treatment, side effects are usually negligible, but the prolonged use of Paracetamol (Cypa) in therapeutic doses large (2-4 g per day, or 10-20 tablets Paracetamol (Cypa)) may cause the appearance chronic hepatitis. This justifies the recommendations of caution especially in patients with liver disease prior.

Very rarely, it can produce thrombocytopenia.

The acute liver toxicity in overdose massive (doses greater than 8 g of Paracetamol (Cypa)) is described in paragraph overdose.