Panser Tablet

Panser Tablet is used to treat pain, inflammation and fever. This medicine is prescribed for conditions such as osteoarthritis, rheumatoid arthritis, fibromyalgia, ankylosing spondylitis, etc. It relieves symptoms such as headache, muscle pain, joint pain, toothache, nerve pain, etc.

Panser Tablet contains three ingredients: diclofenac, paracetamol and serratiopeptidase (aka serralysin or serrapeptase). They work by blocking the pain signals and reducing the inflammation in the affected area. Paracetamol acts as a painkiller in this combination, while diclofenac and serratiopeptidase are anti-inflammatory agents which reduce inflammation, swelling and pain.

Panser Tablet should be taken as advised by your doctor. The dose of the medication will be adjusted depending on the severity of your clinical symptoms. Take them with your meals with ample water to avoid stomach discomfort. Try not to chew or break; swallow it as a whole. To prevent adverse effects, take it as per your doctor’s prescription.

Side effects of Panser Tablet include drowsiness, loss of appetite, stomach pain, heartburn, nausea, indigestion, diarrhoea and vomiting. These adverse effects usually go away on their own and should not be of any concern. If they persist or become worse, you should see a doctor.

This medicine may be contraindicated (unsafe) for people with stomach ulcers, liver and kidney diseases, blood clotting problems, ischaemic heart disease, ulcerative colitis, Crohn's disease and allergies to diclofenac, paracetamol and serratiopeptidase. Always let your doctor know of any health conditions you might have. Generally, this combination drug is considered safe for most people.

Panser Tablet is used to treat inflammation, fever and mild to moderate pain. This medicine can be prescribed for conditions such as:

Panser Tablet contains diclofenac, paracetamol and serratiopeptidase. It works by blocking pain signals in the brain and certain chemicals in our body that induce inflammation, swelling, fever and pain. It also breaks down specific proteins at the site of inflammation, which results in a speedy recovery of the tissue.

Diclofenac is a non-selective non-steroidal anti-inflammatory drug (NSAID) and phenylacetic acid derivative. As an NSAID, it reduces pain and inflammation without the harmful side effects of corticosteroids. It is used in treating osteoarthritis and rheumatoid arthritis, along with other musculoskeletal disorders, since it is a potent anti-inflammatory medicine.

Diclofenac works by reversibly inhibiting enzymes called COX-1 and COX-2. This lowers the synthesis of prostaglandins (hormone-like chemicals responsible for pain and inflammation) and leukocyte migration (movement of white blood cells between different tissues).

Paracetamol, also known as acetaminophen, is a non-narcotic (non-habit forming) analgesic-antipyretic agent (reduces both pain and fever). It has fewer side effects than its more potent counterpart, diclofenac, partly because it isn’t an effective anti-inflammatory agent.

Serratiopeptidase (aka serralysin, serrapeptidase, serratiapeptase or serrapeptase) is the third ingredient in this drug combination. It is a proteolytic enzyme made by a bacteria (enterobacterium Serratia) found inside silkworms. Certain literature claims that this enzyme helps break down proteins to reduce inflammation and pain in conditions like arthritis, osteoporosis, fibromyalgia and headache. There isn’t more information regarding this enzyme's efficacy and side effects.

1. Diclofenac and gastric ulcers

Diclofenac, one of the three ingredients in Panser Tablet, is a COX-1 and COX-2 inhibitor. In gastric mucosa, COX-1 is responsible for synthesising PGE2 and PGI2, which is responsible for increasing bicarbonate and mucus secretion, maintaining adequate blood flow to the mucosa and reducing gastric acid and pepsin secretion.

Since diclofenac inhibits COX-1 or Cyclooxygenase-1, it adversely affects the health of the stomach lining and causes gastrointestinal ulceration.

That is why the dose of Panser Tablet is adjusted for patients with pre-existing gastric ulcers. An overdose for a prolonged period causes gastric ulcers in patients with a perfectly healthy stomach lining.

2. Why the combination: Paracetamol and Diclofenac?

Paracetamol is an analgesic, which means it reduces mild to moderate pain effectively in most cases. It is, however, ineffective at reducing inflammation. That is why it is combined with diclofenac, a potent non-steroidal anti-inflammatory drug that prioritises effectiveness over specificity since it inhibits both COX-1 and COX-2.

Thus this combination is used to relieve pain in patients suffering from injury or arthritis since these cases involve not only pain but also severe inflammation.

• Diclofenac: NSAID (nhs.uk)
• Serrapeptase (ncbi.nlm.nih.gov)
• A brief overview of paracetamol (healthdirect.gov.au)