Antigrippin effervescent tablets with grapefruit flavor №10 in a plastic case

Name:
Antigrippin with grapefruit flavor.
Description:
Tablets are round, flat, with a bevel and a separating risk on one side, white, almost white or creamy white in color, with a barely noticeable marbling. The main active ingredient Paracetamol + chlorphenamine + ascorbic acid Release form Effervescent tablets Dosage paracetamol – 325 mg chlorphenamine maleate – 10 mg ascorbic acid – 200 mg Pharmacological properties Combined drug consisting of three active substances. Paracetamol has an analgesic and antipyretic effect; eliminates headache and other types of pain, reduces fever. Chlorphenamine maleate is an antihistamine, a blocker of H1-histamine receptors, a propylamine derivative, has an anticholinergic effect. Antihistamines that exhibit H1-histaminolytic properties have the ability of reversible competitive antagonism with histamine in the tissues of the skin, lungs, intestines and blood vessels. The sedative effect of chlorphenamine maleate is due to its penetration through the blood-brain barrier. The adrenolytic properties of chlorphenamine maleate may increase the risk of orthostatic hypotension. It has an anti-allergic effect, helps to restore nasal breathing, reducing swelling of the nasal mucosa and mucus production, lacrimation and runny nose. Ascorbic acid (vitamin C) is involved in the regulation of redox processes, carbohydrate metabolism, increases the body’s resistance. Indications for use In adults and children over 15 years of age, to relieve symptoms associated with colds and flu, such as: clear nasal discharge, watery eyes, sneezing, headache and muscle pain and / or fever (fever). Dosage and administration Inside. Adults and children over 15 years old: 1 tablet 1-2 times a day. The tablet should be completely dissolved in a glass (200 ml) of warm water (50-60 ° C) and the resulting solution should be drunk immediately. It is better to take the drug between meals. The maximum daily dose is 2 tablets. The interval between doses of the drug should be at least 4 hours. In patients with impaired liver and kidney function, the interval between doses of the drug should be at least 8 hours (see also “Contraindications”, “Precautions”). In elderly patients: the maximum daily dose is 1 tablet (see “Precautions”). If the temperature does not decrease after 3 days of taking Antigrippin and / or there is no relief of the symptoms of the disease, you should consult a doctor. The maximum duration of administration as an anesthetic is 5 days. The drug is not suitable for the relief of pain not associated with colds, as it contains components that, in total, eliminate the symptoms of a cold. Use during pregnancy and lactation The presence of maleate in the composition of chlorphenamine, as well as ascorbic acid, determines the restrictions on use in this category of patients. Sufficient data on the safety of use are not available. Antigrippin is contraindicated during pregnancy and lactation. Precautions In the event of high fever, signs of superinfection, or if symptoms do not resolve within five days, treatment should be reassessed. In order to avoid the risk of overdose, it is necessary to make sure that there are no paracetamol, chlorphenamine maleate and ascorbic acid in the composition of other drugs (see also the section “Interaction with other drugs”). With prolonged use of high doses or improper use of analgesics, headaches may occur, which should not be stopped by taking even higher doses of painkillers. Frequent use of analgesics, especially when several of them are combined, leads to a risk of kidney damage and the occurrence of kidney failure. With sudden withdrawal after long-term use of high doses of analgesics, headaches, fatigue, muscle pain, nervousness and autonomic symptoms may occur, which disappear within a few days after stopping the drug. Until they disappear, you should avoid taking painkillers, their subsequent use is recommended after consultation with your doctor. – Do not exceed the recommended doses! Currently, there are recommendations to reduce the daily dose of paracetamol from 4 g/day to 3 g/day. Cases of acute liver failure (in some cases ending in liver transplantation or death) have been reported due to the use of paracetamol. In most cases, liver damage is associated with doses of more than 4 g per day, also often with more than one product containing paracetamol. Excessive consumption of paracetamol can be intentional or unintentional, such as when trying to get the maximum effect. Patients should immediately consult a doctor if more than 4 g of paracetamol has been taken at a time, even if they feel well. With prolonged use in doses significantly higher than recommended, the likelihood of impaired liver and kidney function increases, and monitoring of the peripheral blood picture is necessary. To avoid toxic liver damage, paracetamol should not be combined with the intake of alcoholic beverages, and should not be taken by persons prone to chronic alcohol consumption. The risk of developing liver damage increases in patients with alcoholic hepatosis. Patients who consume three or more drinks per day (1 drink: 10-12 g of alcohol = 1 glass of vodka or cognac (25-30 ml) = 1 glass of wine (100-120 ml) = 1 small glass of beer (220- 260 ml)) should be informed about the need to consult with your doctor about when and how to take paracetamol. Chronic drinkers are at an increased risk of liver damage when taking paracetamol, even at recommended doses. Chlorphenamine maleate should be used with caution, especially in combination with other drugs with anticholinergic effects, in epilepsy, increased intraocular pressure, severe cardiovascular disease or hypertension, chronic bronchitis, bronchiectasis or bronchial asthma. Children and the elderly are more likely to experience neurological anticholinergic effects and paradoxical arousal (eg, hyperactivity, restlessness, nervousness). Monitoring of the use of chlorphenamine maleate should be strengthened in elderly patients (higher likelihood of orthostatic hypotension, dizziness, sedation, chronic constipation and the risk of paralytic ileus, exacerbation of prostatic hypertrophy), with impaired liver and / or kidney function due to possible cumulation . The appointment of ascorbic acid to patients with rapidly proliferating and intensively metastasizing tumors can aggravate the course of the process. In patients with high iron content in the body, ascorbic acid should be used in minimal doses. You should not take large doses of ascorbic acid (more than 500 mg) with diabetes mellitus, hyperoxaluria, thalassemia, hemochromatosis, sideroblastic anemia. Due to the content of ascorbic acid, special care should be taken when prescribing to patients with increased blood clotting, polycythemia, leukemia, thrombophlebitis or a tendency to thrombosis, hyperoxaluria, nephrolithiasis. In conditions that may be accompanied by hyperglycemia, ascorbic acid can be taken only on the recommendation of a doctor and in minimal dosages. Taking large doses of ascorbic acid is associated with the formation of calcium oxalate stones in the kidneys, so ascorbic acid should be used with caution in patients with hyperoxaluria. When taking large doses of ascorbic acid (4 g per day) in patients with a deficiency of glucose-6-phosphate dehydrogenase, severe hemolysis was observed in some cases. Since the simultaneous use of ascorbic acid with antacids containing aluminum can increase the excretion of aluminum in the urine, their combined use in patients with renal insufficiency is not recommended. Effects on Diagnostic Tests Abnormally high concentrations of paracetamol may interfere with blood glucose tests performed by the glucose oxidase-peroxidase method. The use of paracetamol may affect the results of the determination of blood urea by a method that uses phosphotungstic acid. Ascorbic acid can also distort laboratory tests (quantification of glucose and uric acid in blood plasma, bilirubin, activity of “liver” transaminases – ALT, ACT, LDH). This medicinal product contains sorbitol, which should be taken into account in patients with sugar intolerance. Aspartame is a source of phenylalanine, do not use in patients with phenylketonuria! One dose of Antigrippin contains about 181 mg (8 mmol) Na +, which should be considered in patients on a low sodium diet. Interaction with other drugs Paracetamol In the interaction of paracetamol and inducers of microsomal oxidation in the liver (phenytoin, barbiturates, rifampicin, carbamazepine, ethanol), the production of hydroxylated active metabolites increases, which makes it possible to develop severe intoxications with small overdoses. Simultaneous reception of barbiturates reduces the effectiveness of paracetamol. The absorption rate of paracetamol increases when used simultaneously with metoclopramide and domperidone, decreases when taken together with drugs that slow gastric emptying (propantheline, antidepressants with anticholinergic properties, narcotic analgesics) and cholestyramine. When taken simultaneously with paracetamol, the half-life of chloramphenicol increases by 5 times. Paracetamol may reduce the effectiveness of lamotrigine. Salicylamide prolongs the half-life of paracetamol and leads to the accumulation of hepatotoxic metabolites. The simultaneous use of zidovudine and paracetamol increases the risk of neutropenia. Probenecid inhibits the conjugation of paracetamol with glucuronic acid and thus leads to a decrease in the clearance of paracetamol. Paracetamol at high doses (4 g/day) for more than 4 days may potentiate the effect of oral anticoagulants and therefore increase the risk of bleeding. Constant monitoring of the INR (International Normalized Ratio) is required. It is necessary to take into account the use of paracetamol when co-administered with oral anticoagulants and the discontinuation of paracetamol. Chlorphenamine maleate Chlorphenamine maleate can enhance the depressant effect on the central nervous system of many drugs and substances, slowing down the speed of reaction and reducing concentration. These are morphine derivatives (analgesics, antitussives), antipsychotics, tranquilizers, barbiturates, benzodiazepines, hypnotics, sedative antidepressants (amitriptyline, mianserin, mirtazapine, timipramine), Hi-blockers with sedative action, centrally acting antihypertensives, baclofen, thalidomide. Ethanol enhances the sedative effect of chlorphenamine maleate. Ascorbic acid Increases the concentration of benzylpenicillin and tetracyclines in the blood, improves the absorption of iron in the intestine (converts ferric iron to ferrous), can increase the excretion of iron when used simultaneously with deferoxamine. The simultaneous use of ascorbic acid with antacids containing aluminum may increase the excretion of aluminum in the urine. In the treatment of short-acting salicylates and sulfonamides, the combined administration of vitamin C slows down the excretion of acids by the kidneys, increases the excretion of drugs that have an alkaline reaction (including alkaloids), and increases the risk of developing crystalluria. Ascorbic acid, with simultaneous use, reduces the concentration in the blood of oral contraceptives, indirect anticoagulants, increases the total clearance of ethanol, reduces the therapeutic effect of isoprenaline, vitamin B12, antipsychotics – phenothiazine derivatives (for example, fluphenazine), reduces tubular reabsorption of tricyclic antidepressants. Simultaneous administration of barbiturates increases the excretion of ascorbic acid in the urine. Indomethacin may reduce the effectiveness of ascorbic acid. Contraindications Hypersensitivity to paracetamol, ascorbic acid, chlorphenamine or any of the excipients, phenylketonuria, sugar intolerance; deficiency of glucose-6-phosphate dehydrogenase; erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase); severe liver or kidney failure; angle-closure glaucoma; risk of urinary retention associated with prostatic hypertrophy; combined use with monoamine oxidase inhibitors (MAO) and within 2 weeks after their cancellation; chronic alcohol abuse; children’s age (up to 15 years); pregnancy, lactation; urolithiasis. Use with caution in the presence of such diseases or conditions as: epilepsy, blood clotting disorders, hyperoxaluria, thalassemia, hemochromatosis, sideroblastic anemia, progressive malignant tumors, congenital hyperbilirubinemia (Gilbert’s syndrome, etc.), diabetes mellitus, liver and kidney diseases, renal mild to moderate insufficiency, severe cardiovascular disease or arterial hypertension, chronic bronchitis, bronchiectasis or bronchial asthma, bladder neck obstruction, pyloroduodenal obstruction, polycythemia, leukemia, thrombophlebitis, a tendency to thrombosis, as well as in children and elderly patients ( see also the Precautions section). Composition Per tablet Active substances: paracetamol – 325 mg chlorphenamine maleate – 10 mg ascorbic acid – 200 mg loss of consciousness, coma. The maximum allowable daily dose of chlorphenamine maleate for adults and children over 15 years old is 24 mg, for elderly patients – 12 mg. Paracetamol overdose symptoms: nausea, vomiting, loss of appetite, pallor, abdominal pain. These symptoms usually appear within the first 24 hours. An overdose, starting with 10 g of paracetamol at a time for an adult and 150 mg per 1 kg of body weight at a time for a child, leads to liver cytolysis, which can lead to complete and irreversible liver necrosis, manifested in liver failure, metabolic acidosis, encephalopathy up to coma and death. At the same time, there is an increase in the level of hepatic transaminases, lactate dehydrogenase, bilirubin and a decrease in the level of prothrombin, which can occur 12-48 hours after ingestion. With an overdose of ascorbic acid, the risk of hemolysis and the formation of kidney stones increases. After a single dose of 3 g, sometimes, after a single dose of 10 g, diarrhea and gastrointestinal symptoms such as nausea or gastritis almost always develop. The literature describes isolated cases of acute and chronic overdose of ascorbic acid (more than 4 g / day) in patients with glucose-6-phosphate dehydrogenase deficiency. With DIC, an overdose of ascorbic acid can lead to a significant increase in the level of oxalate in the blood serum and urine. Emergency care: Immediate transfer of the patient to the hospital; collecting a blood test in a test tube to determine the initial concentration of paracetamol in plasma; rapid elimination of the taken drug by gastric lavage; treatment of paracetamol overdose usually involves giving the antidote N-acetylcysteine intravenously or orally as early as possible, if possible within the first ten hours after ingestion; symptomatic treatment. Side effects Minimizing the risk of adverse reactions is facilitated by compliance with the recommended doses and duration of the drug. Side effects may occur with varying frequency: Associated with the presence of paracetamol There are some rare cases of immediate hypersensitivity reactions: anaphylactic shock, Quincke’s edema, erythema, urticaria, skin rash. With these manifestations, you should immediately stop taking this drug and other medicines containing paracetamol. In very rare cases, thrombocytopenia, leukopenia and neutropenia have been reported. Associated with the presence of chlorphenamine maleate The pharmacological characteristics of chlorphenamine underlie the side effects of varying degrees of intensity, which are associated or not associated with the dosage of Antigrippin. From the autonomic nervous system. drowsiness, more pronounced at the beginning of treatment; orthostatic hypotension; anticholinergic effect: dry mucous membranes, constipation, disturbance of accommodation, dilated pupils, increased intraocular pressure, palpitations (arrhythmia is also possible), urination disorder (dysuria, urinary retention); balance disorders, dizziness, decreased memory or concentration, more common in older people; disorder of coordination of movements, trembling; confusion, hallucinations. Hypersensitivity reactions: erythema, eczema, severe itching, purpura; less often Quincke’s edema; anaphylactic shock. On the part of the hematopoietic organs: leukopenia, neutropenia; thrombocytopenia; hemolytic anemia. Other (frequency unknown): hepatitis, jaundice, muscle twitching, muscle weakness, chest tightness, fatigue. In children and elderly patients, neurological anticholinergic effects and paradoxical arousal (eg, increased activity, anxiety, nervousness) are more common. Associated with the presence of ascorbic acid Allergic reactions, irritation of the mucous membrane of the gastrointestinal tract are possible. Daily doses of vitamin C over 600 mg have a diuretic effect. With prolonged use of large doses of vitamin C, flushes to the face or redness of the skin, nausea, vomiting, diarrhea, ulceration of the gastrointestinal mucosa, irritability, fatigue, sleep disturbance, headache, and damage to the pancreatic insular apparatus may occur. When using large doses of vitamin C (usually at a daily dose of more than 1 g), there were cases of hyperoxaluria and the appearance of oxalate stones, the occurrence of hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency. The use of ascorbic acid in therapeutic doses can distort the results of tests to determine glucosuria, uric acid and creatinine, as well as the results of various laboratory tests (blood glucose, bilirubin, transaminase activity, lactate dehydrogenase). A dose of 1 g may give false negative results in the analysis of stool for occult blood. In case of adverse reactions, including those not listed in this leaflet, you should consult a doctor. Storage conditions At a temperature not higher than 25 °C. Keep out of the reach of children! Buy Antigrippin effervescent tablets with grapefruit flavor No. 10 in a plastic case