A prospective, single-arm, open-label, multicenter study to determine the safety and effectiveness of a fixed-dose combination of camylofin dihydrochloride and paracetamol in Indian children with acute colicky abdominal pain

Authors

  • Nagendra K. Cheluvamba Hospital, Opposite Mysore Medical College, Mysuru, Karnataka, India
  • Sarvanan P. Sapthagiri Clintrac Pvt. Ltd. Sapthagiri Medical Sciences and Research Centre, Bengaluru, Karnataka, India
  • Dinesh Chandra Pandey M. V. Hospital and Research Centre, Lucknow, Uttar Pradesh, India
  • Minakshi Nalbale Bhosale B. J. Govt. Medical College and Sassoon General Hospital, Pune, Maharashtra, India
  • Kapil Jindal Jindal Super Specialty Hospital, Clinical Research Room, Jaipur, Rajasthan, India
  • Uttam Hanse GNRC Hospital, Near IIT Sila Grant North, Guwahati, Assam, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20221821

Keywords:

Camylofin, Acute colicky pain, Nonsteroidal anti-inflammatory drugs, Spasmolytic

Abstract

Background: The aim of this prospective, single-arm, open-label, multicenter study was to determine the safety and effectiveness of a fixed dose combination of paracetamol and the antispasmodic camylofin dihydrochloride in Indian children with acute colicky abdominal pain.

Methods: A total of 197 children with acute colicky abdominal pain were enrolled to receive 2 teaspoons (10 mL) of the syrup thrice daily orally for 5 days per local label. Primary objective was to assess safety as incidence of adverse events (AEs) and change in the severity and frequency of AEs from baseline to end of treatment (EOT). Secondary objectives were effectiveness as evaluated by change in mean (standard deviation [SD]) pain intensity (based on the 100-mm visual analog scale [VAS]) and mean change in the frequency of daily pain episodes from baseline to EOT.

Results: In all, 182 (92.4%) patients completed the study. Twenty AEs were reported in 17 patients (8.7%). All AEs were treatment-emergent and of non-serious type. Common AEs included anemia, vomiting, and constipation. At EOT, mean pain intensity significantly (p<0.0001) reduced to 3.3 (8.50) with a mean change of -61.5 (19.56) from baseline. Percentage change in mean intensity of pain from baseline to EOT visit was 94.9%. At EOT, the frequency of daily pain intensity significantly (p<0.0001) reduced to 1.7 (1.01) with a mean change of -3.5 (2.14) from baseline.

Conclusions: A fixed-dose combination of camylofin dihydrochloride and paracetamol was effective and well tolerated and had a good safety profile in Indian children with acute colicky abdominal pain.

Author Biography

Nagendra K., Cheluvamba Hospital, Opposite Mysore Medical College, Mysuru, Karnataka, India

Department of Pediatrics

References

Spee LAA, Lisman-Van Leeuwen Y, Benninga MA, Bierma-Zeinstra SMA, Berger MY. Prevalence, characteristics, and management of childhood functional abdominal pain in general practice. Scand J Prim Health Care. 2013;31:197-202.

Wong C, Lau E, Palozzi L, Campbell F. Pain management in children: Part 1 Pain assessment tools and a brief review of nonpharmacological and pharmacological treatment options. Can Pharm J (Ott). 2012;145:222-5.

American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health; Task Force on Pain in Infants, Children, and Adolescents. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics. 2001;108:793-97.

Gabhane M, Braganza L. Preference trends for antispasmodics among Indian healthcare professionals: Results of a cross sectional survey. Indian Practitioner. 2015;68:32-7.

Assa A. School attendance in children with functional abdominal pain and inflammatory bowel diseases. J Pediatr Gastroenterol Nutr. 2015;61:553-7.

Kim JS. Acute Abdominal pain in children. Pediatr Gastroenterol Hepatol Nutr. 2013;16:219-24.

Devanarayana NM, De Silva DGH, De Silva HJ. Recurrent abdominal pain syndrome in children is a significant burden on health care system of Sri Lanka, Proceedings of the Annual Research Symposium 2006, Faculty of Graduate Studies, University of Kelaniya. 2006;88-98.

Reust CE, Williams A. Acute abdominal pain in children. Am Fam Physician. 2016;93:830-37.

Tytgat GN. Hyoscine butylbromide. Drugs. 2007;67:1343-57.

Rathod R, Misra D. SPICE Study: An Indian experience with buscopan plus in spasm and pain. Ind J Clin Prac. 2008;19:21-6.

Vinod K M, Ashish D. Oral drotaverine and aceclofenac combination versus aceclofenac alone for postoperative pain relief: A prospective randomized clinical trial. Ind J Pharm Prac. 2013;6:18-21.

Warke HS, Chauhan AR, Raut VS, Ingle KM. A randomised double-blind trial-Bombay Hospital Journal. J Clin Diagn Res. 2013;7(9):1897-99.

Mayadeo N. Camylofin dihydrochloride injection: a drug monograph review. Int J Reprod Contracept Obstet Gynecol. 2019;8:360-68.

Dubey R, Dubey R, Omrey P, Vyas SP, Jain SK. Development and characterization of colon specific drug delivery system bearing 5-ASA and Camylofine dihydrochloride for the treatment of ulcerative colitis. J Drug Target. 2010;18:589-601.

De Martino M, Chiarugi. Recent advances in pediatric use of oral paracetamol in fever and pain management. Pain Ther. 2015;4:149-68.

Mattia A, Coluzzi F. What anaesthesiologists should know about paracetamol (acetaminophen). Minerva Anestesiol. 2009;75:644-53.

Mallet C, Barrière DA, Ermund A, Jönsson BAG, Eschalier A, Zygmunt PM et al. TRPV-1 in brain is involved in acetaminophen-induced antinociception. PLoS ONE. 2010; 5:e12748.

Graham GG, Davies MJ, Day RO, Mohamudally A, Scott KF. The modern pharmacology of paracetamol: therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings. Inflammopharmacology. 2013;21:201-32.

de los Santos AR, Zmijanovich R, Pérez Macri S, Martí ML, DiGirolamo G. Antispasmodic/ analgesic associations in primary dysmenorrhea double-blind crossover placebo-controlled clinical trial. Int J Clin Pharmacol Res. 2001;21:21-9.

Mueller-Lissner S, Tytgat GN, Paulo LG, Quigley EMM, Bubeck J, Peil H et al. Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain. Aliment Pharmacol Ther. 2006;23:1741-8.

Mayadeo N. Role of camylofin and its combinations in obstetrics and gynaecological practice: a review of Indian evidence. Int J Reprod Contracept Obstet Gynecol 2019;8:343-8.

Ali M, Naik M. Open, randomized comparative study to evaluate efficacy, safety and tolerability of Anafortan Vs. dicyclomine+paracetamol in treatment of mild to moderate abdominal colic and spasmodic abdominal pain. Indian Med Gazette. 2010;314-21.

Downloads

Published

2022-07-25

Issue

Section

Original Research Articles