Paradex And Digesic

[harlan99]

My mother-in-law's(78 y.o receiving high level care in a nursing home) recent Functional Independence Assessment scored 28/91 for 'Motor' function and 27/35 for 'Cognitive' Function. A bit of checking on the internet revealed Digesic and Paradex are implicated in serotonin toxicity which can cause cognitive and motor dysfuntion. How does the combination of Paradex 32.5mg/325mg 2 QID prn and Digesic 32.5mg/325mg 2 mane benefit the patient? Aren't these essentially the same drug and if so why might she be prescribed both of these and not just the one brand?

[Hereweald]

Carey

Digesic and Paradex are exactly the same drug, so there is no need for both to be prescribed. Moreover, the maximum daily dose is eight tablets a day, so there is a risk that this will be exceeded at the dose regimens you describe.

In terms of analgesic effect, two tablets of Digesic/Paradex are no more effective than two paracetamol 500mg tablets and the dextropropoxyphene(a synthetic opiate) only increases the risks of toxicity. In fact the combination is being withdrawn in most countries around the world as it has more risks than benefits.

My advice would be to see if your mother in law can be changed onto plain paracetamol as this will address the issue of the products being withdrawn and potentially remove any sedation which is imparing her motor and cognitive functions. I suspect this may be more significant than a possible serotonin toxicity, but discontinuation would address this as well.

I hope this helps.