Watson 749 is a combination of two important analgesics namely Acetaminophen and Oxycodone hydrochloride. It contains 325 milligrams of acetaminophen and 5 milligram of Oxycodone hydrochloride. Mechanism of action of both drugs is different. Acetaminophen controls pain by inhibiting nitric oxide pathway mediated by a number of neurotransmitters mainly substance P and N-methyl-D-aspartate. Oxycodone hydrochloride on the other hand, is an opioid analgesic that acts by activating opioid receptors present in the brain and spinal cord; activation of these receptors is a natural way of pain relief used by our own body. Due to two different mechanism of pain relief, Watson 749 is more potent painkiller than either of the two drugs contained in a single pill.
Watson 749 is commonly available in most countries of the world. It is a white round pill with imprint of Watson 749 and is manufactured by Watson international pharmaceuticals united states of America. Combination of acetaminophen and oxycodone hydrochloride is also available in strengths that are different from Watson 749. Other preparations with different strength are Watson 933 (acetaminophen 325 milligram and Oxycodone hydrochloride 7.5 milligrams) and Watson 932(acetaminophen 325 mg and Oxycodone 10 mg)
Watson 749 is an extremely effective painkiller that can be used in a number of indications to relieve pain. This medicine is superior to other drugs in several aspects; one hand it has good pain-killing effect as an oral preparation and on the other hand it is free from side effects of NSAIDs. Even the long-term use of Watson 749 doesn’t cause gastric erosions and inflammation which are common problem with the use of non steroidal anti-inflammatory drugs. there is no doubt about effectiveness of Watson 749 in relieving moderate to severe pain but overdose of this drug should be avoided otherwise serious outcome may result.
What is this medicine for?
Watson 749 is an effective remedy in management of moderate to moderately severe pain due to presence of two different drugs in a single pill. The main advantage of using Watson 749 over non-steroidal anti-inflammatory drugs is that it does not cause gastric erosions and acid peptic disease. So Watson 749 can be used for short duration, long duration as well as on as needed basis without getting side effects related to non steroidal anti-inflammatory drugs. Some of the common indications for use of Watson 749 are,
- Osteoarthritis of knee joints, back, shoulder joints, wrist joint, ankle joints and other joints. Osteoarthritis is a chronic condition and sufferers of this condition usually have daily symptoms. Other pain killers are harmful if used on daily basis or frequently. This makes use of Watson 749 quite handy in osteoarthritis.
- Rheumatoid arthritis: middle aged women are common sufferer of rheumatoid arthritis. Again it is a chronic condition which needs pain management and use of Watson 749 as an adjunct to other drugs proves extremely beneficial.
- Joint pains in SLE (systemic lupus arthritis), sacro-iliitis and other musculoskeletal disorders
- Watson 749 is also useful in acute back pain/ chronic back pain and pain arising from neuropathies
- Migraine, tension headaches and cluster headaches are also ameliorated with the use of Watson 749.
- Pain management in cancer palliation therapy is also an important indication for Watson 749. Pain due to cancer of different organs particularly cancer spread to bones is a difficult to manage and usually not remitted by ordinary analgesics. In such situation Watson 749 is very good choice due to less side effects and effectiveness.
Above mentioned are some of the indications in which Watson 749 has proven efficacy. In addition this is also used in many other conditions udder the prescription of physicians.
Side effects on Watson 749
Like other medicines, Watson 749 also has some side effects that should be told to the patient before using it. Side effects of Watson 749 are due to two medicines it contains namely acetaminophen and Oxycodone hydrochloride. Acetaminophen content of Watson 749 has little side effects but it’s over dosage may result in severe liver injury leading to liver failure. Some of the common side effects of using Watson 749 are,
- Blurring of vision
- Constipation that is mainly due to Oxycodone hydrochloride component of Watson 749
- Breathing problems and respiratory depression due to Oxycodone hydrochloride component and appears most in case of over dosage of Watson 749
- Dizziness: this side effect is common in initial days of starting Watson 749 but with continuous use it disappears
- Increased sleepiness is again a side effect of opioid component of Watson 749 that gradually disappears on extended use of this medicine
- Flushing of face
- Lightheadedness particularly appears in first few days of using Watson 749
- Mental changes and mood disturbance commonly a depressed mood
- Nausea and vomiting are most common side effects of opioid use and appear frequently while starting Watson 749. If nausea and vomiting become troublesome, anti-emetics may need to be taken along with Watson 749 pill. This symptom again improves over time.
- Liver damage that may be mild or severe
Side effects of prolonged use of Watson 749
Although use of Watson 749 is safe but some side effects appear on extended use of this medication over long period of time. Some of the common side effects of Watson 749 on prolonged use are,
- Dependence: patients using Watson 749 for long period develop dependence on the drug and patient feels persistent craving for drug and becomes addict. Addiction is common at high dosage of drugs for prolonged time.
- Kidney disease especially analgesic abuse nephropathy may occur when patient uses Watson 749 at high doses for prolonged period of time for years. This may result into renal failure. This side effect is due to acetaminophen.
- Patients using Watson 749 at high dose for prolonged period may experience withdrawal symptoms on sudden discontinuation of this drug. Withdrawal of the drug produce symptoms like diarrhea, Rhinorhea or runny nose, hallucinations (feeling, seeing or smelling things that are not present in actual sense, sleep disturbance, feeling of crawling insects on the skin, vomiting, tremors, sweating, tachycardia, etc.
Precautions 0n Watson 749
Use of Watson 749 in some conditions is not safe likewise; concomitant use of Watson 749 with some medications may result in serious side effects. Before starting Watson 749 patients should be asked about below mentioned medical conditions and if anyone is present it should not be used or used with caution.
- head injury, hydrocephalus or other central nervous system disorders
- brain tumor
- kidney disease
- drug abuse/drug addiction
- inflammatory bowel disease (IBD): ulcerative colitis or Crohn’s disease
- excessive use of alcohol
- heart disease and other cardiovascular problems
- liver disease (including acute and chronic hepatitis or cirrhosis of liver)
- advanced lung disease, bronchial asthma, obstructive sleep apnea or other breathing disorders
- know allergy to acetaminophen or Oxycodone hydrochloride or narcotic analgesics or other medication and foods
- lactating mothers
- pregnancy or trying to conceive
- Taking other medicines prescribed or unprescribed including herbal remedies.
- if you have previously made suicidal attempt or have suicidal thinking
- intestinal or gastric problems, intestinal obstruction, recent abdominal surgery, chronic inflammation or ulceration of the gut, problems of adrenal gland and prostate gland enlargement
Before start taking Watson 749, if someone is taking following drugs he or she should inform his doctor otherwise dangerous drug interaction may occur
- tricyclic antidepressants or TCAs e.g., amitriptyline
- alcohol or medicines that contain alcohol
- medicines for depression, anxiety, schizophrenia or other mental disorders
- Medicines for pain management like buprenorphine, butorphanol, pentazocine, tramadol, propoxyphene and nalbuphine.
- sleeping pills
- monoamine oxidase inhibitors(MAOIs) for example phenelzine
- muscle relaxants
- Barbiturate anesthetics (e.g., thiopental),
Conditions that are not suitable for Watson 749 use
Conditions that are not suitable for Watson 749 use are following,
- Use of Watson 749 in patients having known allergy to either acetaminophen, Oxycodone or opioid analgesic is absolutely contraindicated
- Patient who use excessive alcohol may go into deep coma on using Watson 749
- People in high risk profession that need continuous alertness like machinery operators, drivers and others should not use Watson 749 to avoid accidents.
- Concomitant use of sleeping pills or muscle relaxants with Watson 749 is not safe. Before starting Watson 749, if patient is taking any of such medications, he or she should inform the pharmacist or doctor.
- Use of Watson 749 in elderly population is not safe due to the potential side effects like dizziness, drowsiness and light headedness. All these may increase chances of falling and fracture neck of femur.
- Patients having liver disease should not use of Watson 749. It increases drowsiness an in patients with compromised liver functions hepatic encephalopathy results.
- Use of Watson 749 in infants and children is not safe also this drug should be kept out of reach of children
- Patients having lung disease and breathing problems should avoid Watson 749 especially those who have chronic obstructive pulmonary disease(COPD), bronchial asthma, obstructive sleep apnea(OSA) and respiratory failure
- Patient having kidney disease, renal failure or analgesic abuse nephropathy should avoid Watson 749 otherwise serious outcomes may result. Renal failure patients can not excrete the drug properly due to which it causes unconsciousness that may remain for days.
- Acute liver failure or acute fulminant hepatic failure is a contraindication to use of Watson 749
- Watson 749 is a category C drug in pregnancy so its use in pregnancy is relatively contraindicated. Likewise women who breastfeed their babies should also avoid Watson 749. If someone is on Watson 749 treatment and gets pregnancy, she should immediately contact her doctor. Breast feeding mothers should not use Watson 749 or avoid breast feeding during its use.
Allergy symptoms of Watson 749
Allergy or hypersensitivity reaction to Watson 749 can happen in anyone particularly in those who have acetaminophen, Oxycodone or opioid analgesics. If symptoms of mild allergy appear, these are easily managed by withdrawing the drug and using anti-histamine but doctor should be informed about even mild allergy. Severe allergic reaction to Watson 749 warrants immediate contact with emergency medical service for management of hypersensitivity.
Mild symptoms of allergy to Watson 749
Mild allergic symptoms to use of Watson 749 include itching, hives and redness of the skin. In mild hypersensitivity breathing problem doesn’t occur and symptoms usually settle on withdrawing the drug and using anti-histamine. Even mild hypersensitivity should be conveyed to doctor to avoid any serious effects.
Severe allergy symptoms of Watson 749
Severe hypersensitivity reactions to Watson 749 may appear suddenly even within seconds to minutes after taking the drug in patient who are allergic to either of the two components of Watson 749. Patient with severe hypersensitivity to Watson 749 develop following symptoms,
- Symptoms of angioedema which include swelling of lips, throat and chest tightness which cause difficulty in breathing and in severe cases edema becomes so severe that airway is compromised in such situation tracheostomy becomes necessary to relieve airway obstruction.
- Changes or loss of hearing
- Skin rash
- Hives and urticaria
- Severe anxiety along with mental and mood changes
- Decreased urine output
Anyone who develops above mentioned severe hypersensitivity symptoms should immediately contact emergency medical service for timely treatment and saving life. Untreated severe hypersensitivity may lead to death. Important measures to overcome this life-threatening condition are use of anti-histamine drugs, injectable steroids, adrenaline injection and maintaining the airway with passing endotracheal tube or performing emergency tracheotomy (in cases where swelling of the larynx does not allow endotracheal intubation). Patient needs admission in intensive care unit for extensive monitoring till his or her condition is out of danger.
Dosage of Watson 749
Watson 749 should be used in the dosage prescribed by the doctor or pharmacist for the specific duration told. Dose calculations are based on Oxycodone hydrochloride content of Watson 749. It should be given at a dose of 0.05 to 0.15 milligram per kilogram body weight every 4 to 6 hourly. In severe pain dose of 0.2 milligram per kilogram of body weight every 4 hour may be needed. In terms of Watson 749 tablets, the usual starting dose is one tablet every six hour that may be increased to maximum dose of two tablets every 4 hour depending upon the severity of the pain. Maximum daily dose of Watson 749 is 12 tablets that should not be exceeded. Patient can take Watson 749 empty stomach or with meals. Those, who feel more nausea and vomiting, should take this medicine with meals to avoid these side effects.
If a dose of Watson 749 is missed
In case a dose of Watson 749 is missed, it should be taken as early as remembered but if time for the next dose has reached, only take the next usual dose. Two doses of Watson 749 should not be taken together at one time.
Over dosage of Watson 749
Over dosage of Watson 749 usually occurs in patients who have severe pain and they take frequent doses of the drug in an attempt to lessen their misery. Overdosage results in a number of symptoms depending upon how much tablets have been ingested. In case, a single extra tablet or two are taken usually don’t cause any symptoms. If patient has ingested more tablets either incidentally or as a suicidal attempt, local poisoning control service should be called and patient should get immediate management for over dosage.
Symptoms of over dosage include cold and clammy skin, bluish discoloration of the skin, drowsiness that may lead to coma, difficulty in breathing or slow breathing, excessive perspiration(sweating) disturbed functions of cardiovascular system, nausea or vomiting, convulsion(seizures) pain abdomen and bilateral constricted pupils(pin point pupils)
Management of over dosage should be carried at medical emergency or intensive care unit. Management includes gastric lavage and decontamination with activated charcoal, anti-dote for acetaminophen (acetyl cystine) and Oxycodone hydrochloride (nalaxone) where signs of toxicity appear and supportive measures for breathing (assisted ventilation on a ventilator if apnea or hypoventilation occurs) and cardiovascular dysfunction