Perinorm 20ml Inj

PERINORM 20ML INJ

Perinorm Injection is an anti-emetic and prokinetic agent manufactured by IPCA LABORATORIES LTD.

• Composition: The active ingredient in Perinorm Injection is Metoclopramide hydrochloride, typically at a concentration of 5 mg/ml. A 20ml vial therefore contains 100 mg of Metoclopramide.

• Uses: Perinorm Injection is primarily used to prevent and treat nausea and vomiting caused by various conditions, including chemotherapy, radiotherapy, migraines, and post-operative recovery. It is also effective in managing delayed gastric emptying (gastroparesis), indigestion, and heartburn. Additionally, it may be used to facilitate small bowel intubation and improve gastric emptying during radiological examinations.

• Dosage and Administration: This medicine is administered by a healthcare professional, either as a slow intravenous (into a vein) or intramuscular (into a muscle) injection. It should not be self-injected. For adults, a common dosage is 10 mg, three to four times daily. Dosage for children is calculated based on body weight. Perinorm Injection is not recommended for children under one year of age.

• Side Effects: Common side effects include drowsiness, diarrhea, weakness, low blood pressure, fatigue, dizziness, headache, and restlessness. More serious, though less common, side effects can include uncontrollable body movements (extrapyramidal symptoms, tardive dyskinesia), and depression.

• Precautions:

  • Perinorm Injection is contraindicated in individuals with an allergy to metoclopramide, gastrointestinal bleeding, mechanical obstruction or perforation of the digestive tract, pheochromocytoma, epilepsy, or Parkinson's disease.
  • It is not recommended during the first three months of pregnancy and should be used with caution later in pregnancy only if specifically advised by a doctor. It is also not recommended for breastfeeding mothers.
  • Patients should avoid driving or operating heavy machinery if they experience drowsiness, dizziness, or unusual muscle movements. Alcohol consumption should be avoided due to increased sedative effects.
  • Caution is advised for elderly patients and those with kidney or liver problems, as dose adjustments may be necessary.

• Storage: Store Perinorm Injection at a temperature not exceeding 25°C, protected from light and moisture. It should not be frozen. Keep out of reach of children. Any unused portion from opened single-dose vials should be discarded immediately.

PERINORM 20ML INJ, manufactured by IPCA LABORATORIES LTD, contains metoclopramide as its active ingredient. It is an anti-emetic and prokinetic medication primarily used to prevent and treat nausea and vomiting.

What is Perinorm Injection used for?

Perinorm Injection is primarily used to prevent and treat nausea and vomiting caused by various conditions, including chemotherapy, radiotherapy, migraine, and post-operative recovery. It also helps manage delayed gastric emptying (gastroparesis), particularly in diabetic patients, by speeding up the movement of food through the stomach. Additionally, it can be used to facilitate diagnostic procedures such as small bowel intubation and radiological examinations of the stomach or small intestine.

How does Perinorm Injection work?

Perinorm Injection works by increasing the motility or movement of the upper gastrointestinal tract, which helps to speed up gastric emptying and the transit of food. Its active ingredient, metoclopramide, acts by blocking dopamine receptors in the brain and the gastrointestinal tract. This blockage leads to an increased release of acetylcholine, a neurotransmitter that stimulates smooth muscle contractions in the digestive system. It also has antiemetic properties by blocking the chemoreceptor trigger zone (CTZ) in the brain, which is responsible for the sensation of nausea and vomiting.

What is the usual dosage of Perinorm Injection?

Perinorm Injection is administered either intramuscularly (IM) or by slow intravenous (IV) injection. For adults (20 years and over), the usual dosage is a maximum of 10 mg three times a day, with a total daily dose not exceeding 30 mg or 0.5 mg/kg bodyweight, whichever is less. The maximum recommended treatment duration is typically 5 days for all age groups, though for conditions like gastroparesis, it may be used for up to 12 weeks. For children (1-18 years), the dosage is calculated based on body weight and should only be used as a second-line therapy. Dosage adjustments may be necessary for elderly patients and individuals with kidney impairment.

What are the possible side effects of Perinorm Injection?

Common side effects include drowsiness, excessive tiredness, weakness, headache, dizziness, restlessness, nervousness, agitation, difficulty falling or staying asleep, and diarrhea. More serious but less common side effects can include tardive dyskinesia, a movement disorder characterized by involuntary movements, especially of the face, which can be potentially irreversible. The risk of tardive dyskinesia increases with treatment duration and cumulative dose, and generally, the medication should not be used for more than 12 weeks. Other serious side effects include muscle tightening (especially in the jaw or neck), speech problems, depression (including suicidal thoughts), fever, severe muscle stiffness, confusion, fast or irregular heartbeat, sweating, seizures, rash, hives, swelling of the face, lips, tongue, or limbs, difficulty breathing or swallowing, and Neuroleptic Malignant Syndrome (NMS).

Is Perinorm Injection safe during pregnancy or breastfeeding?

During pregnancy, Perinorm Injection is generally considered safe and can be used as there is no evidence suggesting harm to the baby. However, some sources advise caution during the first three months or suggest that other anti-sickness medicines with fewer side effects might be more suitable. It is crucial to consult your doctor before using this medication if you are pregnant or planning to become pregnant. Regarding breastfeeding, metoclopramide passes into breast milk in small amounts. While some sources advise against its use in breastfeeding women, others state it is generally considered safe for short-term use if advised by a doctor. It is important to monitor the baby for any side effects such as trapped wind, unusual sleepiness, or diarrhea. Metoclopramide can also be used, under specialist advice, to help increase breast milk supply.

Can Perinorm Injection be taken with other medications?

Perinorm Injection can interact with several other medications, so it is vital to inform your doctor about all prescription and non-prescription drugs, vitamins, nutritional supplements, and herbal products you are taking. It should be avoided or used with caution with:

• Levodopa and other Parkinson's disease medications: Can lead to antagonism and worsen symptoms.
• Central Nervous System (CNS) depressants: Including opioid analgesics, antipsychotics, sedatives, antidepressants, and antihistamines, as concurrent use can increase the risk of drowsiness, dizziness, confusion, and oversedation.
• Anticholinergic drugs and antidiarrheals: These can make metoclopramide less effective.
• Certain antidepressants (e.g., fluoxetine, paroxetine, bupropion): Can increase metoclopramide levels in the blood, raising the risk of side effects.
• Digoxin, cyclosporine, and tacrolimus: Metoclopramide can affect the levels of these drugs in the body.
• Ropinirole and pramipexole: Concomitant use is generally contraindicated.

What precautions should be taken while using Perinorm Injection?

Do not use Perinorm Injection for longer than 12 weeks due to the increased risk of tardive dyskinesia. It should not be used if you have gastrointestinal bleeding, obstruction, or perforation. Use with caution in elderly patients, as they may have a higher risk of side effects like tardive dyskinesia, confusion, drowsiness, and kidney problems. Dose adjustments are necessary for individuals with impaired kidney function. Avoid alcohol consumption, as it can worsen drowsiness caused by the injection. Since it may cause drowsiness and dizziness, avoid driving or operating heavy machinery until you understand how the medicine affects you. Intravenous administration should be done slowly (over at least 1-2 minutes for a 10mg dose or 15 minutes for infusions) to minimize acute adverse reactions like anxiety, restlessness, or hypotension. Patients with Parkinson's disease, epilepsy/seizures, pheochromocytoma (an adrenal gland tumor), depression, hypertension, asthma, cirrhosis, congestive heart failure, or a history of Neuroleptic Malignant Syndrome should use this medication with extreme caution or avoid it. Abruptly stopping Perinorm Injection after prolonged use can lead to withdrawal symptoms such as nausea, vomiting, anxiety, and restlessness; therefore, a gradual dose reduction is usually advised by a healthcare professional.

What happens if a dose of Perinorm Injection is missed?

If you miss a dose of Perinorm Injection, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one, as this can increase the risk of side effects.

How should Perinorm Injection be stored?

Perinorm Injection should be stored below 25°C or 30°C and protected from light. If ampoules are removed from their carton, they should be stored away from light, and any ampoules showing a yellow discolouration must be discarded. Once opened, single-dose vials should not be stored for later use as they do not contain a preservative, and any unused portion should be discarded. If diluted in compatible parenteral solutions like Sodium Chloride Injection, it can be stored for up to 48 hours when protected from light, or for up to 24 hours under normal light conditions. Some dilutions can be stored frozen for up to 4 weeks.