Chrono 500mg Tablet 10'S

Introduction About CHRONO 500MG TABLET

CHRONO 500MG TABLET is a combination of Sodium valproate and Valproic acid,
which belong to the group of medicines called Anticonvulsant/Antiepile
drugs. It is used to manage epilepsy in adults and children. It is also used to
manage bipolar disorders. Epilepsy is an abnormal electrical activity in the
brain and nervous system. The symptoms may include temporary confusion, muscle
stiffness, jerky movements in legs or arms, loss of consciousness, psychological
symptoms (such as anxiety or fear), etc.

CHRONO 500MG TABLET is not recommended for use in patients with liver problems
or with a family history of liver problems, porphyria (a hereditary disease that
affects the skin or nervous system), blood coagulation or clotting disorders,
pancreatic diseases (inflammation of the pancreas), urea cycle disorder (a
genetic disorder) or Alpers-Huttenlocher syndrome (a rare disorder that affects
brain, liver & muscles), etc.

CHRONO 500MG TABLET should be used with caution in patients with kidney problems
or lung diseases (such as chronic obstructive pulmonary disease) and diabetes.
CHRONO 500MG TABLET is also not recommended for use in pregnant and
breastfeeding women. It should be used with caution in children (below 2 years
of age). Consult your doctor before taking the medicine.

The common side effects of taking CHRONO 500MG TABLET may include dizziness,
headache, sleep disorders, clumsiness/unsteadiness, trembling of hands and arms
and nervousness. Consult your doctor if any of the symptoms worsen or persist.

Uses Of CHRONO 500MG TABLET

• Manage epilepsy
• Manage bipolar disorders

How CHRONO 500MG TABLET Works

CHRONO 500MG TABLET helps in managing epilepsy, where sodium valproate and
valproic acid effectively increases the GABA (a neurotransmitter/chemical
messenger) concentration in the central nervous system by reducing its
degradation. It also blocks certain ion channels which reduce high-frequency
neuronal activity in the brain, thereby reliving seizure activity.

How to use CHRONO 500MG TABLET

Take CHRONO 500MG TABLET as advised by your physician. Swallow the medicine with
a glass of water with or after food. Do not crush or chew the medicine. Your
doctor will decide the correct dose and duration for you depending on your age,
body weight and disease condition.

Side Effects Of CHRONO 500MG TABLET

Common

• headache
• sleep disorders
• clumsiness or unsteadiness
• trembling of hands and arms
• nervousness
• changing moods
• blurred vision
• ringing in ears
• deafness
• dizziness
• flu
• abdominal or stomach pain
• heartburn
• nausea and vomiting
• diarrhoea
• skin rash
• hair loss or thinning of hair
• back pain
• change in menstrual periods
• lack or loss of strength
• mental confusion
• aggression
• convulsion
• memory problems
• becoming unreactive
• bedwetting
• signs of liver damage such as skin and eyes that appear yellowish (jaundice), abdominal pain and swelling.
• signs of inflammation of the pancreas (pancreatitis) such as upper abdominal pain, abdomen tenderness, fever and rapid pulse
• signs of Fanconi syndrome (a disorder of kidney tubes) such as excessive thirst, urination, vomiting
• overgrown gum tissue
• agitation
• disturbance in attention
• abnormal behaviour
• hyperactivity
• learning disorder

Uncommon

• unusual bleeding or bruising
• abnormal dreams
• anxiety
• feeling sad
• irritability
• pain in joints
• cough
• constipation
• dry eyes
• spots before the eyes
• ear infection
• ear pain
• runny nose
• dental pain
• bloating
• muscle pains or stiffness
• tiredness
• weight gain or loss
• learning disorder
• coma
• loss of muscle control
• brittle bones and fractures
• shortness of breath
• chest pain
• blood clotting problems

Rare

Stop taking CHRONO 500MG TABLET and contact your doctor if you experience any of
the following side effects:

• signs of allergic reactions such as swelling of the face, lips, eyelids, throat and tongue, which may cause difficulty in breathing and swallowing
• signs of altered levels of ammonia in the blood characterized by vomiting, balance issues and lack of alertness
• signs of liver problems characterized by nausea, vomiting, tiredness, sleepiness, weakness, stomach pain, yellowing of the skin or whites of the eye
• signs of inflammation of the pancreas characterized by acute abdominal pain
• chest pain
• shortness of breath
• hallucinations
• suicidal thoughts
• psychosis (mental disorder causing disconnection from reality)
• toxic epidermal necrolysis (life-threatening skin disorder causing widespread skin pain, rashes, blisters, sores and crusting)
• Steven-Johnson syndrome (a skin disorder characterized by painful rashes and blisters on the skin)
• anaphylaxis (severe allergic reaction characterized by shortness of breath, fainting or fastened heartbeat)
• erythema multiforme (a skin condition characterized by raised red rashes on the skin)
• polycystic ovarian syndrome (a disorder of ovaries characterized by irregular periods, hair growth on the skin, acne and weight gain)
• brain diseases such as cerebral pseudo atrophy (loss of brain cells), encephalopathy (disease altering brain structure and functions) and coma (loss of consciousness)
• signs of thrombocytopenia (a condition marked by decreased platelet count) such as spontaneous bruising or bleeding
• signs of agranulocytosis (severe decrease of white blood cells or bone marrow failure) such as fever and breathing difficulty
• signs of anaemia (decreased red blood cell count) as weakness, dizziness, pale skin and shortness of breath
• signs of macrocytosis (abnormally increased red blood cell size) such as brittle nails, loss of weight or diarrhoea
• signs of pancytopenia (decreased blood cells and platelets) such as weakness, dizziness, pale skin and shortness of breath
• drowsiness
• change in consciousness level (including coma)
• confusion
• memory loss
• abnormal behaviour such as changes in attention, concentration, mood, hallucinations or fits of more frequency and severity
• signs of hypothyroidism (underactive thyroid gland) such as tiredness or weight gain
• signs of pleural effusion (build-up of fluid between the tissues that line the lungs and the chest) such as breathing difficulty and pain
• increase in the number and severity of convulsions
• signs of rhabdomyolysis (a disorder caused by the breakdown of muscle tissue) such as muscle pain and weakness
• signs of systemic lupus erythematosus (autoimmune disorder) such as joint pain, fever, fatigue or rash
• signs of increased ammonia in the blood, such as problems in balancing and co-ordination, feeling lethargic or less alert associated with vomiting
• shakiness (tremor)
• jerky muscle movements
• unsteadiness when walking due to parkinsonism (brain disorder), extrapyramidal disorder or ataxia (a disorder marked by impaired coordination)
• uncontrollable and rapid movement of the eyes
• signs of kidney disease such as renal failure, tubulointerstitial nephritis such as blood in the urine, fever, increased or decreased urine output, weakness, confusion
• signs of Fanconi syndrome (a disorder of kidney tubes) such as excessive thirst, urination and vomiting m
• signs of decreased blood sodium levels such as confusion
• confusion that occurs due to decreased sodium levels in blood and syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion (a condition marked by high levels of the antidiuretic hormone that causes retention of water in the body)

How To Manage Side Effects

Headache:

Drink sufficient water and take plenty of rest. Do not skip meals. Do not take
mental stress and strain your eyes. Consult your doctor if the condition
persists or get worse in time.

Dizziness:

Lie down until the dizziness fades away and get up slowly. Do not attempt sudden
head movements. Take adequate rest. Consult your doctor if the condition
persists for long or gets worsened.

Diarrhoea:

Stay hydrated by consuming sufficient amount of water or fruit juice. Avoid
taking medicine on your own to manage diarrhoea. Consult your doctor if the
symptom gets worse or persist.

Constipation:

Consume healthy foods with high-fiber foods such as fresh fruit and vegetables,
cereals and drink plenty of water. Maintain doing regular exercise, such as
walking and running. Consult your doctor if the symptom gets worse or persist.

Nausea and vomiting:

Try to take CHRONO 500MG TABLET with or just after a meal or a snack. Stick to
simple meals. Avoid eating oily or spicy foods. Consult your doctor if the
symptom get worse.

Warning & Precautions

!### Pregnancy

CHRONO 500MG TABLET is not recommended for use by pregnant women. Women with
childbearing potential should use effective contrace
CHRONO 500MG TABLET. Consult your doctor before taking the medicine.

!### Breastfeeding

CHRONO 500MG TABLET is not recommended for use by breastfeeding mothers, as it
may pass through breastfed milk. Consult your doctor before taking CHRONO 500MG
TABLET.

!### Driving and Using Machines

Avoid driving or operating machines, if you feel drowsy or sleepy after taking
CHRONO 500MG TABLET.

!### Alcohol

Avoid consuming alcohol while taking CHRONO 500MG TABLET.

!### Kidney

CHRONO 500MG TABLET should be used with caution in patients with kidney
diseases. Consult your doctor for advice before taking CHRONO 500MG TABLET.

!### Liver

CHRONO 500MG TABLET is not recommended for use in patients with liver problems
or any family history of liver problems such as severe hepatic dysfunction,
particularly due to some medicine. Consult your doctor for advice before taking
CHRONO 500MG TABLET.

!### Allergy

CHRONO 500MG TABLET is not recommended for use if you are allergic to Valproic
acid, Sodium valproate or any other ingredients in this medicine.

!### Lungs

CHRONO 500MG TABLET should be used with caution in patients with lung diseases
such as chronic obstructive pulmonary disease. Consult your doctor for advice
before taking CHRONO 500MG TABLET.

Others

CHRONO 500MG TABLET is not recommended for use if you:

• have porphyria (a hereditary disease that affects the skin or nervous system)
• have blood coagulation or clotting disorders such as deep vein thrombosis, pulmonary embolism
• have pancreatic diseases
• have signs of urea cycle disorder (excessive ammonia build-up in the body) such as loss of appetite, vomiting and lethargy that causes excessive ammonia builds up in the body
• have a genetic disorder called Alpers-Huttenlocher syndrome (a progressive, neurodevelopmental syndrome characterized by three co-occurring clinical symptoms which are psychomotor regression (dementia); seizures; and liver disease)

Before taking CHRONO 500MG TABLET, inform your doctor if you:

• have diabetes
• are scheduled for surgery such as dental surgery
• have systemic lupus erythematosus (a disease of the immune system that affects bones, joints and body organs)
• have a certain brain disease or any metabolic condition affecting your brain such as hypoglycaemic encephalopathy
• have a deficiency condition such as carnitine palmitoyl transferase type II deficiency (a condition that manages the body from using certain fats for energy, particularly during periods without food)

Use in Paediatrics:

CHRONO 500MG TABLET should be used with caution in children (below 2 years of
age). Consult your doctor before taking CHRONO 500MG TABLET.

Use in Geriatrics:

CHRONO 500MG TABLET should be used with caution in elderly patients (aged above
68 years). Consult your doctor before taking CHRONO 500MG TABLET.

Interactions

A. Drug-Drug Interactions:

Before taking CHRONO 500MG TABLET, inform your doctor, if you are taking any of
the following medicine:

• medicines used to manage depression or Parkinson’s disease, such as monoamine oxidase inhibitors (MAOI) Ex. selegiline, phenelzin
• medicines used to manage emotional and mental conditions Ex. diazepam, olanzapine
• medicine used to manage HIV infection Ex. zidovudine
• medicines used for thinning the blood Ex. warfarin
• other medicines used to manage epilepsy Ex. phenytoin, phenobarbital, carbamazepine, primidone, rufinamide, topiramate, acetazolamide, lamotrigine and felbamate
• medicines used to manage pain and inflammation such as salicylates Ex. aspirin
• medicines used to manage malaria Ex. mefloquine, chloroquine
• medicines used to manage stomach ulcers Ex. cimetidine
• antibiotics or medicines used to manage bacterial infections such as carbapenem agents Ex. imipenem, meropenem, ertapenem, erythromycin
• medicines used to lower blood cholesterol Ex. cholestyramine
• medicines used to manage tuberculosis Ex. rifampicin
• medicines used to manage cancer Ex. temozolomide
• medicines used to manage bleeding in the brain Ex. nimodipine
• medicines used to anaesthetise Ex. Propofol
• medicines used for birth control Ex. oestrogen-containing products
• medicines used to manage pain and fever Ex. metamizole

Overdosage

If you or anyone else accidentally takes too much of CHRONO 500MG TABLET,
consult your doctor immediately or visit the nearby hospital. Symptoms of
overdose may include nausea, vomiting, headache, blurred vision, dizziness, poor
reflexes, confusion, memory loss, tiredness, muscle weakness, fits, loss of
consciousness, behavioural changes and breathing difficulties such as fast
breathing or shortness of breath or chest pain.

Synopsis

Drug	:	Sodium valproate, Valproic acid
Pharmacological Category	:	Anticonvulsants/Antiepile
Therapeutic Indication	:	Epilepsy, Bipolar disorder
Dosage Forms	:	Tablet

More Information

• Keep CHRONO 500MG TABLET out of reach from children
• Store CHRONO 500MG TABLET at room temperature

FAQs About CHRONO 500MG TABLET

What CHRONO 500MG TABLET is used for?

CHRONO 500MG TABLET is used to manage epilepsy in adults and children. It is
also used to manage bipolar disorders in affected individuals. Epilepsy is a
disorder of the brain and nervous system characterized by repeated seizures (at
least two unprovoked seizures within 24 hours). Consult your doctor before
taking.

What happens if you take more CHRONO 500MG TABLET than your required dose?

If you or anyone else accidentally takes too much of CHRONO 500MG TABLET,
consult your doctor immediately or visit the nearby hospital. Symptoms of
overdose may include nausea, vomiting, headache, blurred vision, dizziness, poor
reflexes, confusion, memory loss, tiredness, muscles weakness, fits, loss of
consciousness, behavioural changes and breathing difficulties such as fast
breathing or shortness of breath or chest pain.

What side effects are seen with CHRONO 500MG TABLET?

The common side effects of taking CHRONO 500MG TABLET are dizziness, headache,
sleep disorders, clumsiness/unsteadiness, trembling of hands and arms and
nervousness. Consult your doctor before taking it.

Who should avoid taking CHRONO 500MG TABLET?

CHRONO 500MG TABLET is not recommended for use in patients with liver problems
or with history of liver problems in the family, particularly due to some
medicine. It is not recommended for use in patients with porphyria (a hereditary
disease that affects the skin or nervous system), blood clotting disorders or
pancreatic diseases (inflammation of the pancreas). CHRONO 500MG TABLET is also
not recommended for use by pregnant and breastfeeding women. Consult your doctor
before taking it.

Is CHRONO 500MG TABLET safe to use in children?

CHRONO 500MG TABLET should be used with caution in children (below 2 years of
age) and in young girls (below 18 years of age) to ensure safety as well as
efficacy. Consult your doctor before taking CHRONO 500MG TABLET.

What if I forget to take CHRONO 500MG TABLET?

If you or your child have forgotten to take CHRONO 500MG TABLET at right time,
take it as soon as remember. However, if it is almost time for the next dose,
skip the missed dose and continue the regular dosing schedule. Do not double the
dose to make up for the forgotten one.

When to stop taking CHRONO 500MG TABLET?

Do not stop taking CHRONO 500MG TABLET, unless as advised by your doctor or if
you experience any signs of an allergy (swelling of the face, lips, eyelids,
throat, tongue which may cause difficulty in breathing and swallowing), abnormal
levels of ammonia in the blood (vomiting, balance issues or lack of alertness),
liver problems (nausea, vomiting, tiredness, sleepiness, weakness, stomach pain,
yellowing of the skin or whites of the eye), inflammation of the pancreas (acute
abdominal pain) or chest pain, etc.

Can I drive or use machines after taking CHRONO 500MG TABLET?

CHRONO 500MG TABLET should be used with caution while driving or operating
machines, as it might cause drowsiness and sleepiness. Consult your doctor
before taking the medicine.

How CHRONO 500MG TABLET works?

CHRONO 500MG TABLET helps in managing epilepsy where sodium valproate and
valproic acid effectively increase the GABA (a neurotransmitter/chemical
messenger)) concentration in central nervous system by reducing its degradation.
It also blocks certain ion channels which reduce high-frequency neuronal
activity in the brain, thereby reliving seizures.

Useful Diagnostic Tests

• Blood test
• Urine analysis
• Liver function test
• EEG (electroencephalogram)