Antiflu tablets p/o №12

DescriptionPale yellow, clear film-coated capsule-shaped tablets with “Antiflu” embossed on one side. The main active ingredient Paracetamol + phenylephrine + chlorphenamine Release form Tablets Pharmacological properties Pharmacodynamics Acetaminophen (Paracetamol) has an analgesic, antipyretic and weak anti-inflammatory effect. The mechanism of its action is to inhibit the synthesis of prostaglandins and influence the thermoregulatory center in the hypothalamus. Chlorpheniramine maleate is an antihistamine, an H1-histaminergic receptor blocker. It has an anti-allergic effect, reduces swelling and hyperemia of the mucous membranes of the nasal cavity, nasopharynx and paranasal sinuses, reduces runny nose and lacrimation. Phenylephrine hydrochloride is a ?-adrenergic agonist, which, due to its vasoconstrictive action, reduces swelling and hyperemia of the mucous membranes of the upper respiratory tract and paranasal sinuses. Pharmacokinetics Acetaminophen is rapidly and completely absorbed from the gastrointestinal tract. Peak plasma concentrations occur after 30-60 minutes. The elimination half-life is 2-2.5 hours and is prolonged in persons with liver disease. Acetaminophen is metabolized mainly in the liver due to conjugation with glucuronic and sulfuric acid, partially undergoes deacetylation or hydroxylation. Excreted in the urine (85% within 24 hours). Excretion slows down with impaired renal function, which can lead to accumulation in the body of acetaminophen and its metabolic products. Chlorpheniramine maleate is well absorbed from the gastrointestinal tract, penetrates into various tissues, including the central nervous system. The half-life is from 12 to 15 hours. Metabolized mainly in the liver. It is excreted in the urine in the form of metabolites and partially unchanged. Phenylephrine is absorbed from the gastrointestinal tract but has limited bioavailability due to first pass metabolism. Indications for use Symptomatic treatment of acute respiratory diseases and influenza, accompanied by fever, headache, sore throat, muscle and joint pain, nasal congestion, rhinorrhea. Dosage and administration Tablets should be swallowed whole with water. Adults: 1-2 tablets, if necessary, repeat every 4-6 hours, but not more than 8 tablets per day. Children over 12 years old: 1 tablet, if necessary, repeat every 4-6 hours. The drug is not recommended for use in children under 12 years of age. Patients with impaired liver and kidney function are advised to reduce the daily dose of the drug and increase the interval between injections. Use during pregnancy and lactation It is not recommended to take the drug during pregnancy and lactation. Influence on the ability to drive a car and control mechanisms During the period of treatment, driving, working with mechanisms and other potentially hazardous activities should be avoided. Precautions Duration of treatment – no more than 3 days. In the absence of a sufficient therapeutic effect, a high temperature that persists for more than 3 days during treatment, as well as the appearance of new symptoms, one should keep in mind the possibility of a more serious illness and consult a doctor urgently. Caution should be exercised when using the drug in patients with impaired liver and kidney function due to the risk of overdose. Patients with diseases of the cardiovascular system, epilepsy, Raynaud’s syndrome, prostate enlargement are advised to consult a doctor before using the drug. The drug should not be taken simultaneously with decongestants, other drugs to relieve symptoms of colds and flu. During the treatment period, you should refrain from taking alcohol, sleeping pills and sedatives (tranquilizers) drugs. Interaction with other drugs Hepato- and nephrotoxicity of acetaminophen is enhanced when combined with barbiturates, alcohol. Acetaminophen slows down the excretion of antibiotics from the body. Tetracyclines increase the risk of anemia and methemoglobinemia with acetaminophen. The rate of absorption of acetaminophen may increase when co-administered with metoclopramide and domperidone and decreases when co-administered with cholestyramine. With long-term regular use, acetaminophen enhances the anticoagulant effect of warfarin and other coumarins and increases the risk of bleeding, with rare use it does not have a significant effect. The simultaneous use of hypnotics and sedatives, antipsychotics, tranquilizers, alcohol significantly enhances the inhibitory effect of chlorpheniramine maleate on the central nervous system. Chlorpheniramine inhibits metabolism and increases the risk of phenytoin toxicity. Lopinavir may increase the plasma concentration of chlorpheniramine. Chlorpheniramine enhances the anticholinergic effect of atropine, antispasmodic tricyclic antidepressants, antiparkinsonian drugs. Phenylephrine hydrochloride weakens the hypotensive effect of reserpine and octadine. The combined use of monoamine oxidase inhibitors and phenylephrine hydrochloride can lead to the development of a hypertensive crisis. The simultaneous use of phenylephrine with other sympathomimetic amines may increase the risk of cardiovascular side effects. Phenylephrine may weaken the effect of beta-blockers and antihypertensive drugs, increasing the risk of developing arterial hypertension and other undesirable effects from the cardiovascular system. Tricyclic antidepressants (such as amitriptyline) when used together with phenylephrine increase the likelihood of adverse reactions from the cardiovascular system. The use of phenylephrine before inhalation anesthesia increases the risk of cardiac arrhythmias. The combined use of phenylephrine with digoxin and cardiac glycosides increases the risk of developing cardiac arrhythmias and heart attack. ContraindicationsIncreased individual sensitivity to the components of the drug. Severe disorders of the liver and / or kidneys, deficiency of the enzyme glucose-6-phosphate dehydrogenase, blood diseases, severe cardiovascular diseases, arterial hypertension, a tendency to vasospasm, angle-closure glaucoma, difficulty urinating with prostate adenoma, pulmonary emphysema or chronic bronchitis ; diabetes mellitus, hyperthyroidism, bronchial asthma, pheochromocytoma, congenital hyperbilirubinemia, alcoholism, combined use with monoamine oxidase inhibitors (MAO) and within 2 weeks after the abolition of MAO inhibitors; pregnancy, lactation. Active ingredients (1 tablet): acetaminophen (in the form of acetaminophen granules *) 325 mg, phenylephrine hydrochloride 5 mg, chlorpheniramine maleate 2 mg. Excipients: microcrystalline cellulose, stearic acid, croscarmellose sodium, colloidal silicon dioxide, D&C Yellow No. 10 Lac (E104), magnesium stearate. Shell: hydroxypropyl methylcellulose, mineral oil, magnesium silicate, polyethylene glycol. * the composition of the granules includes: pregelatinized starch, povidone, stearic acid, sodium starch glycolate. Overdose In adults and children over 12 years of age, when taking more than 10 g of paracetamol, liver damage is possible. Taking 5 g of paracetamol may cause liver damage in individuals with the following risk factors (see below): long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John’s wort, or other drugs that induce liver enzymes; alcohol abuse; probable glutathione deficiency (may occur with digestive disorders, cystic fibrosis, HIV infection, starvation, cachexia). Symptoms of paracetamol overdose: On the first day – pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may occur 12-48 hours after taking the drug. Changes in glucose metabolism and metabolic acidosis are possible. In severe poisoning, liver failure can progress to the development of encephalopathy, bleeding, hypoglycemia, cerebral edema, and death. If the patient complains of back pain, hematuria and proteinuria, acute renal failure with acute tubular necrosis should be suspected, which can occur even in the absence of liver damage. Treatment: Should be started immediately. Hospitalization is required regardless of the severity of symptoms due to the risk of organ damage. Reception of activated carbon is effective if no more than 1 hour has passed from the moment of taking paracetamol. Plasma concentrations of paracetamol should be assessed no earlier than 4 hours after ingestion. Within 24 hours after taking paracetamol, treatment with N-acetylcysteine can be carried out (if necessary – intravenously). The maximum effect is within 8 hours after taking excessive doses of paracetamol, then drops sharply. In the absence of vomiting, oral methionine may be given. Phenylephrine Symptoms of an overdose of phenylephrine – see the side effects described in the appropriate section. In addition, hypertension and reflex bradycardia are possible. The amount of phenylephrine that can cause serious manifestations is much less than the corresponding amount of paracetamol, sufficient for the development of liver toxicity. Treatment. Symptomatic. When severe hypertension occurs, it is advisable to use alpha-blockers, for example, phentolamine. Chlorpheniramine Symptoms of overdose: possible sedation, paradoxical excitation of the central nervous system, convulsions, shortness of breath, anticholinergic effects, dystonic reactions, arrhythmia. Treatment. Symptomatic and supportive. Particular attention should be paid to cardiac, respiratory, renal and hepatic function, water and electrolyte balance. In the absence of contraindications and a recent overdose – activated charcoal orally (this is most effective if no more than an hour has passed from the inside from the moment the drug was taken). Treatment of hypertension and arrhythmia should be started immediately. When seizures occur, diazepam is effective. In severe cases, hemoperfusion is possible. Side effectsAcetaminophen From the gastrointestinal tract: rarely – nausea, vomiting, loss of appetite, constipation, diarrhea or flatulence. With prolonged use of significant doses of the drug – pain in the epigastric region, hepatotoxic effect. On the part of the blood system: very rarely – hemolytic anemia, methemoglobinemia, thrombocytopenia, in isolated cases – aplastic anemia, pancytopenia, sulfhemoglobinemia, neutropenia, agranulocytosis, leukopenia. From the urinary system: renal colic, aseptic pyuria, interstitial glomerulonephritis, very rarely – nephrotoxic effect, papillary necrosis. Allergic reactions: rarely – skin rash, itching, urticaria, hyperemia, very rarely – bronchial obstruction, exudative erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, in isolated cases – anaphylactic shock, angioedema. Sometimes allergic-type reactions, including asthma attacks, are observed in patients with intolerance to acetylsalicylic acid. Others: rarely – hypoglycemia, general weakness, increased sweating. Chlorpheniramine maleate From the gastrointestinal tract: nausea, vomiting, epigastric pain, dry mouth or throat. On the part of the organs of vision: very rarely – mydriasis, disturbance of accommodation, increased intraocular pressure. From the side of the cardiovascular system: in isolated cases – tachycardia. From the side of the central nervous system: rarely – drowsiness, headache, tremor. From the urinary system: very rarely – urinary retention and stranguria (difficulty urinating). Phenylephrine hydrochloride From the side of the central nervous system: rarely – headache, insomnia, dizziness, confusion. From the side of the cardiovascular system: in isolated cases – tachycardia, reflex bradycardia, shortness of breath, heart pain, increased blood pressure (especially in patients with arterial hypertension), arrhythmia. From the gastrointestinal tract: nausea, diarrhea. Storage conditions At a temperature not exceeding 25 ° C, out of the reach of children. Buy Antiflu tablets p / o No. 12 Price for Antiflu tablets p / o No. 12