Do not use Chinese and Western medicines together at will.

Short story

Xinhuang Tablets are a good medicine for clearing away heat, detoxifying, reducing swelling and relieving pain. Mr. Zhang uses it as a household medicine. Mr. Zhang was diagnosed with gastric ulcer some time ago. Recently, he took Xinhuang Tablets for toothache, which caused gastric ulcer bleeding.

Xinhuang Tablets is a somewhat mysterious drug. Its approval number starts with "Z". From the perspective of drug attribute classification, Xinhuang Tablets is a Chinese patent medicine. But is this really the case? Sometimes even doctors or pharmacists can be easily misled and fall into the risk of drug use.

Why do you say that?

Let's first look at the drug composition of Xinhuang Tablets: Radix Lycopodiellae, Radix Notoginseng, Artificial Bezoar, Rhizoma Cibotii, Pearl Layer Powder, Indomethacin, etc. The first five drugs are traditional Chinese medicines, and the last indomethacin is a Western analgesic.

A doctor once prescribed Xinhuang tablets and western medicine painkillers to a patient at the same time. The pharmacist told the doctor that they should not be taken at the same time. The answer he got was, "According to the theory of 'monarch, minister, assistant, and messenger' in traditional Chinese medicine, indomethacin is ranked last and should be an assistant and messenger drug with low content and secondary effect."

Is this really the truth?

Let's take a look at what the Chinese Pharmacopoeia stipulates about the content of indomethacin in Xinhuang Tablets. The Pharmacopoeia stipulates that each tablet of this product contains 5.8 to 7.8 mg of indomethacin. The following calculations all take the median of 6.8 mg.

The recommended dosage of Xinhuang Tablets in the drug instructions is: oral, 2 to 4 tablets at a time, 3 times a day. The dosage converted into indomethacin is: 13.6 to 27.2 mg at a time, and the daily dose is 40.8 to 81.6 mg.

Next, let's take a look at the recommended adult dosage for the Western medicine indomethacin instructions:

① Anti-rheumatic: the initial dose is 25-50 mg once, 2-3 times a day, and the maximum daily dose should not exceed 150 mg;

② For analgesia, the first dose is 25-50 mg, followed by 25 mg three times a day until the pain is relieved, then the drug can be stopped;

③For fever reduction, 6.25-12.5 mg at a time, not more than 3 times a day.

Here comes the point! As a compound preparation of Chinese and Western medicine, Xinhuang Tablets has the effect of reducing swelling and relieving pain. If the dosage of Xinhuang Tablets is 3 times a day, 3 tablets at a time, the daily dose of indomethacin intake is 61.2 mg; if the dosage of Xinhuang Tablets is 3 times a day, 4 tablets at a time, the daily dose of indomethacin intake is 81.6 mg; and when pure Western medicine indomethacin is used as an analgesic, its common daily dose is 75-100 mg. Through data comparison, we found that the usage of Xinhuang Tablets 3 to 4 tablets at a time, the indomethacin it contains has basically met the treatment needs of analgesia, so when monitoring medication, we have reason to treat Xinhuang Tablets as Western medicine analgesics.

When we treat Xinhuang Tablets as Western analgesics, we have reason to avoid some risks of medication. For example: ⑴ Avoid using it together with other similar analgesics and antipyretics; ⑵ Take the initiative to avoid contraindications: patients with active ulcer disease, gastrointestinal bleeding and medical history, ulcerative colitis and medical history, epilepsy, Parkinson's disease and mental illness, bronchial asthma, angioedema, liver and kidney dysfunction, and those who are allergic to indomethacin, aspirin or other non-steroidal anti-inflammatory drugs are prohibited from using it.

Mr. Zhang in the story had a new gastric ulcer and took Xinhuang tablets containing indomethacin, which induced gastric ulcer bleeding.

Life Tips

*When taking Xinhuang Tablets, avoid taking them with other similar analgesics and antipyretics, such as ibuprofen, celecoxib, etoricoxib, acetaminophen, loxoprofen sodium, nabumetone, naproxen, etc.

*Avoid taking if you have contraindications; avoid drinking alcohol while taking the medicine.

Author: Chen Ye