Other Brands/Names

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How It Works

The primary active ingredients of counterpain are menthol and methyl salicylate. These ingredients act as counterirritants. They create an initial cooling followed by a warming sensation on the skin, distracting the nervous system from deeper pain arising in muscles, joints, and tendons.

Indications

• Counterpain helps relieve muscle and joint pain, sprains, and pain related to low back pain.

• Counterpain Cool soothes mild muscular aches from sprains, bruises, or sports injuries.

• Counterpain PXM (piroxicam) alleviates pain and inflammation in:

  • Osteoarthritis (arthrosis, a degenerative joint condition).

  • Post-traumatic or acute musculoskeletal problems such as tendonitis (tendonosynovitis), sprains, muscle strains, and low back pain.

Contraindication

History of allergy or hypersensitivity to menthol, methyl salicylate, aspirin, or other salicylates such as salsalate. If hives or a red rash develops immediately after application, discontinue use. Do not apply counterpain to open wounds or irritated skin; avoid contact of medicine with eyes or mucous membranes (e.g., mouth).

Side Effects

Redness, burning, and stinging at the application site may occur. Serious (rare) effects can include:

• Severe blistering/swelling/redness at the applied skin

• Unusual or worsening local pain

• Nausea/vomiting

• Tinnitus

If any of these occur, contact a healthcare professional promptly.

Types

There are three variants available in Indonesia: Counterpain cream, Counterpain Cool, and Counterpain PXM.

• Counterpain
  • Analgesic cream
  • Packaging tubes of 5 g, 15 g, 30 g, 60 g, and 120 g
  • Each gram contains methyl salicylate 102 mg, eugenol 13.6 mg, menthol 54.4 mg, in a fast-absorbing base up to 1000 mg
• Counterpain Cool 
  • Analgesic gel
  • Packaging tubes of 5 g, 15 g, 30 g, 60 g, and 120 g
  • Contains menthol 4%
• Counterpain PXM
  • Anti-inflammatory & analgesic gel
  • Packaging tubes of 25 mg
  • Composition: piroxicam 5 mg, methyl salicylate 102 mg, eugenol 13.6 mg, menthol 54.4 mg, in a fast-absorbing base up to 1000 mg.
• Counterpain patch 
  • Water-based (hydrogel) patch, high level
  • Composition: glycol salicylate 1.4%, l-menthol 4.9%, dl-camphor 0.9%, tocopherol acetate (vitamin E) 2.0%

Dosage

For external use only. Apply to the painful muscle or joint 3–4 times daily.

Safety

Because it contains salicylates, do not use in children and adolescents under 18 years who have chickenpox, influenza, or who have recently received a vaccine. If you have medical conditions such as asthma or nasal polyps, consult a doctor before use.

During pregnancy, use counterpain only if it is indicated after discussing the risks and benefits of counterpain use with a healthcare provider. It is unknown whether the product can be excreted in the breast milk; consult your doctor before breastfeeding.

Drug Interactions

Methyl salicylate may interact with anticoagulants (blood thinners) such as warfarin, anisindione, and dicumarol. Using these together can raise bleeding risk. If you are taking anticoagulants, avoid or limit use and seek medical advice.

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