Bromenz-D Tablet: Complete Guide to Uses, Side Effects, and Safety
When to Call Your Doctor IMMEDIATELY
- Blood in stool or vomit
- Severe abdominal pain
- Chest pain or difficulty breathing
- Severe headache with visual changes
- Sudden swelling of face, lips, or throat
- Yellowing of skin or eyes
- Decreased urine output
- Unusual bleeding or bruising
- Severe skin rash with blisters or peeling
- Persistent nausea or vomiting
If experiencing severe symptoms, call emergency services immediately.
What is cumbak tablet used for?
This medicine is a combination of Bromelain 90 mg and Diclofenac 50 mg used to relieve pain and inflammation in conditions like osteoarthritis and rheumatoid arthritis. It works by reducing prostaglandins and breaking down fibrin. Take it with food to avoid stomach upset.
- Generic Name: Bromelain + Diclofenac
- Manufacturer: Avis Lifecare Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 cumbak tablet के बारे में (Hindi Summary)
उपयोग: यह दवा ब्रोमेलेन 90 मिलीग्राम और डाइक्लोफेनाक 50 मिलीग्राम का संयोजन है, जिसका उपयोग सूजन और दर्द को कम करने के लिए किया जाता है। यह ऑस्टियोआर्थराइटिस, रूमेटॉइड आर्थराइटिस, और सर्जरी के बाद की सूजन में प्रभावी है। इसे भोजन के साथ लेना चाहिए ताकि पेट में जलन न हो।
साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, दस्त, पेट दर्द, और सिरदर्द शामिल हैं। गंभीर दुष्प्रभावों में पेट में रक्तस्राव, अल्सर, गुर्दे की समस्या, और हृदय संबंधी घटनाएं शामिल हैं। यदि आपको काला मल, उल्टी में खून, या गंभीर पेट दर्द हो तो तुरंत डॉक्टर से मिलें।
सुरक्षा सलाह: इस दवा को डॉक्टर के निर्देशानुसार ही लें। इसे भोजन के साथ लें ताकि पेट में जलन न हो। शराब का सेवन न करें क्योंकि इससे पेट में रक्तस्राव का खतरा बढ़ जाता है। यदि आप गर्भवती हैं या स्तनपान करा रही हैं, तो डॉक्टर से सलाह लें। 7 दिनों से अधिक इस दवा का उपयोग बिना डॉक्टर की सलाह के न करें।
💊 cumbak tablet Uses & Benefits
[{"condition":"Osteoarthritis","description":"Relieves pain and improves joint mobility in knee, hip, and hand osteoarthritis.","evidence":"Well-established"},{"condition":"Rheumatoid arthritis","description":"Reduces joint pain, inflammation" class="semantic-link" title="Medicines for swelling">swelling, and stiffness in rheumatoid arthritis.","evidence":"Well-established"},{"condition":"Post-surgical inflammation","description":"Helps reduce swelling and pain after surgical procedures.","evidence":"Moderate"},{"condition":"Acute musculoskeletal pain","description":"Provides relief from acute pain due to sprains, strains, and soft tissue injuries.","evidence":"Well-established"}]
Off-label uses: [{"condition":"Sinusitis","description":"Bromelain component may help reduce sinus inflammation and improve drainage.","evidence":"Limited"},{"condition":"Post-operative swelling after dental surgery","description":"Used off-label to reduce swelling and pain after tooth extraction.","evidence":"Limited"}]
Primary treatment for: Osteoarthritis
Also treats: Rheumatoid arthritis, Acute musculoskeletal pain, Post-surgical inflammation
📋 Drug Information
| Generic Name(s) | Bromelain + Diclofenac |
| Brand Name | Bromenz-D Tablet |
| Manufacturer | Avis Lifecare Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | PAIN ANALGESICS |
| Action Class | Proteolytic enzyme + NSAID |
| Route of Administration | Oral |
| Storage | Store at room temperature (15-30°C) in a dry place, away from direct sunlight. Keep in the original container, tightly closed. Do not refrigerate unless specified. Keep out of reach of children. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with complementary mechanisms. Diclofenac, an NSAID, reversibly inhibits cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, leading to decreased synthesis of prostaglandins, prostacyclin, and thromboxane. This results in reduced inflammation, pain, and fever. Bromelain, a mixture of proteolytic enzymes, enhances the breakdown of fibrin and reduces bradykinin levels, thereby decreasing swelling and inflammation. Bromelain also modulates adhesion molecules and may enhance the anti-inflammatory effects of diclofenac.
Mechanism Steps
💡 How to Take cumbak tablet
Strength: Bromelain 90 mg + Diclofenac 50 mg immediate-release tablet.
Dosage Information
| Adult Dosage | The usual adult dose is one tablet taken orally once or twice daily, preferably with food. The dose may be adjusted by your doctor based on the severity of your condition and your response to treatment. Do not exceed the recommended dose. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients (above 65 years) may be more sensitive to the effects of this medicine, especially gastrointestinal bleeding and kidney problems. Use the lowest effective dose for the shortest duration possible. Dose must be individualized by a qualified clinician based on renal and hepatic function. |
| Renal Impairment | Use with caution in patients with kidney impairment. Dose reduction may be necessary. Not recommended in severe kidney impairment (eGFR <30 mL/min). Dose must be individualized by a qualified clinician based on renal function. |
| Hepatic Impairment | Use with caution in patients with liver impairment. Dose reduction may be necessary. Not recommended in severe liver impairment. Dose must be individualized by a qualified clinician based on hepatic function. |
| Maximum Daily Dose | The maximum recommended daily dose is 2 tablets (180 mg bromelain and 100 mg diclofenac) per day. Do not exceed this dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of cumbak tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Warfarin | Major | |
| Other NSAIDs | Major | |
| Corticosteroids | Major | |
| Methotrexate | Major | |
| Lithium | Major | |
| ACE inhibitors | Moderate | |
| Diuretics | Moderate | |
| Aspirin | Moderate | |
| SSRIs | Moderate | |
| Cyclosporine | Moderate |
🚨 Major Interactions
- Warfarin
- Other NSAIDs
- Corticosteroids
- Methotrexate
- Lithium
- ACE inhibitors
- Diuretics
⚡ Moderate Interactions
- Aspirin
- SSRIs
- Antihypertensives
- Cyclosporine
- Digoxin
🍷 Alcohol Interaction
Avoid alcohol while taking this medicine. Alcohol increases the risk of gastrointestinal bleeding, ulcers, and liver damage. It may also increase drowsiness and dizziness.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known hypersensitivity to diclofenac, bromelain, or any other NSAIDs.","Active peptic ulcer or history of recurrent peptic ulcer.","Severe heart failure, ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.","Severe liver impairment.","Severe kidney impairment (eGFR
⚠️ Warnings & Precautions
["Take with food or milk to reduce gastrointestinal irritation.","Avoid alcohol while taking this medicine.","Do not use for more than 7 days without consulting a doctor.","Use with caution in elderly patients due to increased risk of GI bleeding and kidney problems.","Use with caution in patients with a history of gastrointestinal ulcers or bleeding.","Use with caution in patients with hypertension, heart failure, or kidney disease.","May cause dizziness or drowsiness; avoid driving or operating machinery until you know how it affects you.","Do not take if you are pregnant or breastfeeding without consulting your doctor.","Inform your doctor if you have a history of asthma, especially aspirin-sensitive asthma.","Monitor for signs of bleeding, such as black stools, vomiting blood, or unusual bruising."]
🤱 Lactation Safety
Diclofenac is excreted in breast milk in small amounts. Bromelain is likely safe during breastfeeding in food amounts. However, high-dose supplements should be avoided. Consult your doctor before taking this medicine while breastfeeding.
💊 Overdose Management
Overdose may cause nausea, vomiting, abdominal pain, gastrointestinal bleeding, drowsiness, dizziness, headache, and in severe cases, kidney failure, liver damage, and seizures. If overdose is suspected, seek immediate medical attention. Treatment is supportive and symptomatic. Activated charcoal may be administered if the patient presents within 1-2 hours of ingestion. There is no specific antidote. Monitor vital signs, renal function, and liver function. Hemodialysis is not effective for removing diclofenac from the blood.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
Additional Safety Advice
Take this medicine exactly as prescribed by your doctor. Do not take more than the recommended dose. Always take it with food or milk to reduce stomach irritation. Avoid alcohol while taking this medicine as it increases the risk of stomach bleeding. Do not use this medicine for more than 7 days without consulting your doctor. Inform your doctor if you have a history of stomach ulcers, kidney disease, liver disease, heart disease, or asthma. Do not take this medicine if you are allergic to diclofenac, bromelain, or any other NSAIDs. If you are pregnant or breastfeeding, consult your doctor before taking this medicine. Keep out of reach of children.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients (above 65 years) are at higher risk of gastrointestinal bleeding, kidney problems, and cardiovascular events. Use the lowest effective dose for the shortest duration possible. Monitor renal and hepatic function regularly.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before taking this medicine. Diclofenac may affect ovulation and is not recommended during the third trimester. Bromelain supplements should be avoided during pregnancy.
🏥 Post-Surgery Considerations
This medicine may be used after surgery to reduce pain and swelling. However, it may increase the risk of bleeding. Inform your surgeon if you are taking this medicine before any surgery. It is contraindicated in the perioperative period of coronary artery bypass graft (CABG) surgery.
🦷 Dental Procedures
Inform your dentist if you are taking this medicine before any dental procedure, as it may increase the risk of bleeding. Your dentist may advise you to stop the medicine temporarily before the procedure.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Avoid high-impact exercises that may strain joints while taking this medicine. Consult your doctor or physiotherapist before starting any new exercise routine. If you experience dizziness or drowsiness, avoid exercises that require balance or coordination.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness or drowsiness in some people. Avoid driving or operating heavy machinery until you know how it affects you. It may also cause stomach upset, so take it with food. If your work involves physical labor, consult your doctor about modifications.
🛑 When to Stop This Medicine
Stop taking this medicine and consult your doctor immediately if you experience severe side effects such as gastrointestinal bleeding, kidney problems, liver problems, or allergic reactions. Do not stop taking this medicine abruptly if you have been on long-term therapy without consulting your doctor.
📅 Long-Term Use Effects
Long-term use of this medicine may increase the risk of gastrointestinal bleeding, ulcers, kidney problems, liver damage, and cardiovascular events. Regular monitoring of liver and kidney function is recommended. Use the lowest effective dose for the shortest duration possible. Consult your doctor if you need to take this medicine for more than 7 days.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Can complement medicine for chronic pain and improve joint function.
Evidence: Well-establishedMay help reduce pain in some patients with osteoarthritis.
Evidence: ModerateMay provide localized pain relief with fewer systemic side effects.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
This medicine does not interact with vaccines. However, if you are scheduled for vaccination, inform your healthcare provider about all medicines you are taking.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
Carry this medicine in its original packaging with a copy of your prescription. Store at room temperature and avoid extreme heat or moisture. If traveling across time zones, adjust dosing schedule as advised by your doctor. Check customs regulations for carrying prescription medicines. Always keep it in your carry-on luggage.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: Pain relief from diclofenac typically begins within 30-60 minutes. Bromelain's anti-inflammatory effects may take several hours to days to become noticeable.
A: No, it should be taken with food or milk to reduce the risk of stomach upset and ulcers.
A: Do not take other NSAIDs or painkillers without consulting your doctor, as it may increase the risk of side effects.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.
A: This medicine is not recommended during the third trimester of pregnancy. Consult your doctor before taking it if you are pregnant or planning to become pregnant.
🤔 Common Patient Concerns
🔄 Substitutes for cumbak tablet
View AllAlternative brands with exact same active ingredient:
-
brutide-d tabletCanvarzys Healthcare Ltd ₹135.94 5.8% CHEAPER
-
thioxib forte tabletAlna Biotech Pvt Ltd ₹135.94 5.8% CHEAPER
-
everheal-d tabletAlcott Healthcare Pvt Ltd ₹136.88 5.2% CHEAPER
-
kinetozyme-d tabletSystopic Laboratories Pvt Ltd ₹139.69 3.2% CHEAPER
-
n rilex plus tabletLittle Greave Pharmaceutical Pvt Ltd ₹140.53 2.7% CHEAPER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine can be taken on an empty stomach.
Fact: This medicine should be taken with food to reduce the risk of stomach upset and ulcers. - Myth: This medicine is safe to take for any type of pain.
Fact: This medicine is specifically for inflammatory pain and should only be used as prescribed by a doctor. - Myth: This medicine can be taken with alcohol.
Fact: Alcohol should be avoided while taking this medicine as it increases the risk of gastrointestinal bleeding. - Myth: This medicine is safe to take during pregnancy.
Fact: This medicine is not recommended during the third trimester of pregnancy and should only be used if clearly needed and prescribed by a doctor.
🔄 Alternative Options
Generic Alternatives
- Bromelain + Diclofenac combination tablets
Brand Alternatives
- Bromenz-D Tablet