Neuropen Kit, Neuropen, One 10g Monofilament, and One Neurotip, For Peripheral Neuropathy Foot Screenings of Diabetic Patients, Pocket Size, Easy to Carry on Rounds, For Use in Clinics and Hospitals

Product Information

Testing for peripheral Neuropathy in people with Diabetes should be conducted on an Annual basis and is measured as a QoF indicator. This medicinal product can mask symptoms of infection, which may lead to delayed initiation of appropriate treatment and thereby worsening the outcome of the infection. This has been observed in bacterial community acquired pneumonia and bacterial complications to varicella. When this medicine is administered for pain or fever in relation to infection, monitoring of infection is advised. In non-hospital settings, the patient should consult a doctor if symptoms persist or worsen. For short term use only. Codeine should be used at the lowest effective dose for the shortest period of time necessary to relieve symptoms. The patient should consult a doctor if symptoms persist or worsen, or if the product is required for more than 3 days. This medicinal product can mask symptoms of infection, which may lead to delayed initiation of appropriate treatment and thereby worsening the outcome of the infection. This has been observed in bacterial community acquired pneumonia and bacterial complications to varicella. When this medicine is administered for fever or pain relief in relation to infection, monitoring of infection is advised. In non-hospital settings, the patient should consult a doctor if symptoms persist or worsen.

No special dosage modifications are required for elderly patients, unless renal or hepatic function is impaired, in which case dosage should be assessed individually.

6. Side effects of ibuprofen and codeine

Risk factors for diabetic peripheral sensory neuropathy: results of the Seattle Prospective Diabetic Foot Study. Other NSAIDs including cyclooxygenase-2 selective inhibitors: Avoid concomitant use of two or more NSAIDs as this may increase the risk of adverse effects (see section 4.4) Scores are denoted as the lowest number of rods a patient can discriminate from rod (0) and this is the threshold value of the TCD test. For example, if the patient can only discern rods (5), (6), and (7) from (0), a score of five will be denoted. A score of six or higher is significantly correlated with neuropathy ( Maser 1997; Vileikyte 1997). Caution (discussion with doctor or pharmacist) is required prior to starting treatment in patients with a history of hypertension and/or heart failure as fluid retention, hypertension and oedema have been reported in association with NSAID therapy. Reported in association with NSAID treatment. Clinical trial and epidemiological data suggest that use of ibuprofen (particularly at high doses 2400mg daily) and in long-term treatment may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke) (see section 4.4).

Increased sensitivity to pain: Hyperalgesia has been reported with the use of opioids, particularly following long-term use and/or at high doses. Hyperalgesia may resolve with opioid dose reduction, discontinuation, or switching to a different opioid Most patients who have ingested clinically important amounts of NSAIDs will develop no more than nausea, vomiting, epigastric pain, or more rarely diarrhoea. Tinnitus, headache and gastrointestinal bleeding are also possible. In more serious poisoning, toxicity is seen in the central nervous system, manifesting as drowsiness, occasionally excitation and disorientation or coma. Occasionally patients develop convulsions. In serious poisoning metabolic acidosis may occur and the prothrombin time/ INR may be prolonged, probably due to interference with the actions of circulating clotting factors. Acute renal failure and liver damage may occur. Exacerbation of asthma is possible in asthmatics. Both signalling question 1 and 3 can not be answered ‘yes’ or ‘no’ because of insufficient information.

4. How and when to take ibuprofen and codeine

Nurofen plus (which contains Codeine) should not be used in children below the age of 12 years because of the risk of opioid toxicity due to the variable and unpredictable metabolism of codeine to morphine (see sections 4.3 and 4.4).

Clinical studies suggest that use of ibuprofen, particularly at a high dose (2400 mg/day) may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke). Overall, epidemiological studies do not suggest that low dose ibuprofen (e.g. ≤1200 mg/day) is associated with an increased risk of arterial thrombotic events. Screening and prevalence of peripheral neuropathy in type 2 diabetic outpatients: a randomized multicentre survey in 12 city hospitals of China. Antimuscarinics: Concomitant use of antimuscarinics or medications with muscarinic action, e.g. atropine and some antidepressants may result in an increased risk of severe constipation which may lead to paralytic ileus and/or urinary retention. Serotonergic drugs: Serotonin syndrome has been reported during concomitant use of serotonergic drugs including triptans, selective serotonin-reuptake inhibitors (SSRIs), selective serotonin- and norepinephrine-reuptake inhibitors (SNRIs), and tricyclic antidepressants, with opioids at recommended dosages Participants: sampling (consecutive/convenience), inclusion criteria, exclusion criteria, total number and number in comparison groups, sex, age, ethnicity, BMI, type of diabetes mellitus, duration of diabetes mellitus, glycaemic control, antihyperglycaemic treatment, symptoms, severity of target condition.

Side Effects

NSAIDs should be given with care to patients with a history of gastrointestinal disease (ulcerative colitis, Crohn's disease) as these conditions may be exacerbated (See section 4.8 Undesirable effects). If you need to take this medicine continuously for more than three days you should see your doctor or pharmacist