Azur is used to reduce fever and to relieve mild to moderate severe pain. Azur contains three active ingredients: 350mg Paracetamol/ 50mg Coffeine/ 30mg Codeine.
Paracetamol is a medicine used in the treatment of mild to moderate pain. It is also useful for reducing fever. It is not fully understood how paracetamol produces these effects.
Coffeine increases the pulse rate and is stimulating short term, but can be disturbing if you have an anxiety disorder. The coffeine acts on several neurosubstances: the release of noradrenaline and dopamine increase while the adenosine receptor is blocked (adenosine has a calming effect). You get a kick of energy.
Codeine belongs to group of medicines called opioids. Opioids mimic the effects of naturally occurring pain reducing chemicals (endorphins) that are found in the brain and spinal cord. They act on the opioid receptors in the brain and block the transmission of pain signals.

Special precautions

In deciding to use a medicine, the risks of taking Azur must be weighed against the good it will do. This is a decision you and your doctor will make. For Azur , the following should be considered:

Allergies— tell your doctor if you have ever had any unusual or allergic reaction to Azur . Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy— Although studies on birth defects with narcotic analgesics have not been done in pregnant women, these medicines have not been reported to cause birth defects. However, hydrocodone, hydromorphone, and morphine caused birth defects in animals when given in very large doses. Buprenorphine and codeine did not cause birth defects in animal studies, but they caused other unwanted effects. Butorphanol, nalbuphine, pentazocine, and propoxyphene did not cause birth defects in animals. There is no information about whether other narcotic analgesics cause birth defects in animals.

Too much use of Azur during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Also, some of these medicines may cause breathing problems in the newborn infant if taken just before delivery.

Breast-feeding— Most narcotic analgesics have not been reported to cause problems in nursing babies. However, when the mother is taking large amounts of methadone (in a methadone maintenance program), the nursing baby may become dependent on the medicine. Also, butorphanol, codeine, meperidine, morphine, opium, and propoxyphene pass into the breast milk.

Children— breathing problems may be especially likely to occur in children younger than 2 years of age. These children are usually more sensitive than adults to the effects of narcotic analgesics. Also, unusual excitement or restlessness may be more likely to occur in children receiving these medicines. Hydromorphone extended-release capsules should not be used in children younger than 18 years of age.

Older adults— Elderly people are especially sensitive to the effects of Azur . This may increase the chance of side effects, especially breathing problems, during treatment.

Other medicines— although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.

Other medical problems— the presence of other medical problems may affect the use of narcotic analgesics. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse, or history of, or
• Drug dependence, especially narcotic abuse, or history of, or
• Emotional problems—The chance of side effects may be increased; also, withdrawal symptoms may occur if a narcotic you are dependent on is replaced by buprenorphine, butorphanol, nalbuphine, or pentazocine
• Brain disease or head injury or
• Emphysema, asthma, or other chronic lung disease or
• Enlarged prostate or problems with urination or
• Gallbladder disease or gallstones—Some of the side effects of Azur can be dangerous if these conditions are present
• Colitis or
• Heart disease or
• Kidney disease or
• Liver disease or
• Underactive thyroid—The chance of side effects may be increased
• Convulsions (seizures), history of— Azur can cause convulsions

Side effects

Along with its needed effects, Azur may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Get emergency help immediately if any of the following symptoms of overdose occur :

•  Cold, clammy skin;  confusion;  convulsions (seizures);  dizziness (severe) ;  drowsiness (severe);  low blood pressure;  nervousness or restlessness (severe) ;  pinpoint pupils of eyes;  slow heartbeat;  slow or troubled breathing;  weakness (severe) 

Also, check with your doctor as soon as possible if any of the following side effects occur:

•  Less common or rare

• Dark urine (for propoxyphene only);  fast, slow, or pounding heartbeat;  feelings of unreality ;  hallucinations (seeing, hearing, or feeling things that are not there);  hives, itching, or skin rash ;  increased sweating (more common with hydrocodone, meperidine, and methadone);  irregular breathing;  mental depression or other mood or mental changes;  pale stools (for propoxyphene only);  redness or flushing of face (more common with hydrocodone, meperidine, and methadone);  ringing or buzzing in the ears;  shortness of breath, wheezing, or troubled breathing;  swelling of face;  trembling or uncontrolled muscle movements;  unusual excitement or restlessness (especially in children);  yellow eyes or skin (for propoxyphene only) 

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

•  More common

• Dizziness, light-headedness, or feeling faint;  drowsiness;  nausea or vomiting 

•  Less common or rare

• Blurred or double vision or other changes in vision;  constipation (more common with long-term use and with codeine) ;  decrease in amount of urine;  difficult or painful urination;  dry mouth;  false sense of well-being;  frequent urge to urinate;  general feeling of discomfort or illness;  headache;  loss of appetite;  nervousness or restlessness;  nightmares or unusual dreams;  redness, swelling, pain, or burning at place of injection;  stomach cramps or pain;  trouble in sleeping;  unusual tiredness or weakness 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Keep all appointments with your doctor and the laboratory.

Do not let anyone else take your medication.

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