Metafenex (Ibuprofen, Paracetamol)

Metafenex, containing ibuprofen and paracetamol, is used to manage conditions involving pain, fever, or inflammation.

• Mild to moderate pain: provides analgesic relief for headaches, musculoskeletal aches, dental pain and similar discomforts.
• Fever: lowers elevated body temperature in adults with febrile illnesses.
• Inflammatory conditions: reduces inflammation and associated discomfort in conditions such as mild arthritis or soft‑tissue injuries.

• Ibuprofen inhibits cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, decreasing peripheral prostaglandin synthesis and thereby reducing inflammation and pain. Paracetamol acts centrally by inhibiting prostaglandin production in the brain and modulating serotonergic pathways, which contributes to antipyretic and analgesic effects. The combined action provides complementary relief of pain and fever.

Common side effects are generally mild and reversible.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness: transient sensation of light‑headedness.
• Skin rash: mild erythema or itching.
• Elevated liver enzymes: transient increase detectable on blood tests.
• Mild renal irritation: occasional increase in serum creatinine.

Serious or Rare Side Effects

• Severe gastrointestinal bleeding: hematemesis or melena requiring medical attention.
• Allergic reactions: anaphylaxis, angioedema, or severe skin eruptions.
• Hepatotoxicity: significant liver injury with jaundice or hepatitis.
• Acute kidney injury: sudden loss of renal function, especially in dehydrated patients.
• Stevens‑Johnson syndrome: rare severe mucocutaneous reaction.
• Blood dyscrasias: rare cases of thrombocytopenia or leukopenia.

Precautions should be observed before initiating therapy.

• Assess renal function: avoid or adjust use in patients with severe renal impairment.
• Monitor hepatic function: use with caution in liver disease and discontinue if significant injury occurs.
• Evaluate hypersensitivity history: discontinue immediately if allergic reaction develops.
• Limit concurrent NSAID use: increased risk of gastrointestinal ulceration and bleeding.
• Consult healthcare professional during pregnancy or breastfeeding: risk‑benefit assessment is required.
• Store at ambient temperature: keep in the original pack, protect from moisture and direct sunlight.

Potential drug interactions may affect safety or efficacy.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Other NSAIDs or COX‑2 inhibitors: heightened gastrointestinal toxicity and renal impairment.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or diuretics: possible reduction in renal function, especially in volume‑depleted patients.
• Lithium: ibuprofen may raise serum lithium concentrations, requiring monitoring.
• Methotrexate: reduced clearance may lead to toxicity, necessitating dose adjustment.