Grippolek Plus powder for solution for oral administration (lemon) in bags No. 10

Name:
Grippolek Plus pore.d/prig.p-ra d/pr.in. (lemon) in pack.in pack No. 10 Main active ingredient Caffeine + paracetamol + phenylephrine + pheniramine Release form powder Composition One package contains: active substances: paracetamol – 325 mg, caffeine – 30 mg, pheniramine maleate – 20 mg, phenylephrine hydrochloride – 10 mg. excipients: anhydrous citric acid, sodium citrate, aspartame, sugar, lemon lime flavor (powder for oral solution (lemon) or raspberry flavor and cranberry flavor (powder for oral solution (raspberry and cranberry).
Description:
Powder from white to white with a yellowish tint with a lemon or raspberry and cranberry odor.Soft lumps, blotches of white, yellow and dark yellow color are allowed. and a weak anti-inflammatory effect, mainly by inhibiting the synthesis of prostaglandins in the central nervous system, as well as affecting the centers of pain and thermoregulation.Caffeine has a stimulating effect on the central nervous system, especially on the centers of mental activity, which leads to a decrease in fatigue and drowsiness, to increased yu mental performance. Caffeine affects the respiratory center, which increases the frequency and depth of breathing. It stimulates muscle activity, causing an increase in physical performance. Additionally, caffeine also has a weak bronchodilatory and diuretic effect. Pheniramine has anti-allergic activity, provides rapid relief of symptoms such as runny nose and nasal congestion, sneezing, irritation of the eyes and nose, and lacrimation. Phenylephrine is a sympathomimetic agent that has a moderate vasoconstrictor effect – it helps to eliminate edema and mucus, reduce rhinorrhea and nasal congestion. Indications for use Short-term symptomatic treatment of colds, influenza and SARS in adults and children over 15 years of age, accompanied by fever, headache and muscle pain, sneezing, watery eyes, nasal congestion, clear discharge from the nose. Contraindications Hypersensitivity to individual components of the drug, diseases of the cardiovascular system (severe coronary heart disease, myocardial infarction, unstable angina pectoris, aortic stenosis, severe atherosclerosis, cardiac arrhythmias, decompensated heart failure, uncontrolled arterial hypertension), pulmonary and arterial hypertension , bronchial asthma, chronic obstructive pulmonary disease, erosive and ulcerative lesions of the gastrointestinal tract in the acute stage, acute pancreatitis, pheochromocytoma, a tendency to vasospasm, vasospastic diseases (Raynaud’s syndrome), metabolic acidosis, hypovolemia, hypercapnia, hypoxia, angle-closure glaucoma, irritability, sleep disturbance, psychomotor agitation, epilepsy and a tendency to convulsive seizures, alcohol abuse, porphyria, diabetes mellitus, thyrotoxicosis, severe liver and / or kidney dysfunction, congenital hyperthyroidism ilirubinemia (Gilbert, Dubin-Johnson, Rotor syndromes), prostatic hypertrophy with urinary retention, diseases of the blood system, severe leukopenia, anemia, congenital deficiency of glucose-6-phosphate dehydrogenase, children under 15 years of age, pregnancy, breastfeeding. Do not take simultaneously with tricyclic antidepressants, beta-blockers, sympathomimetics, monoamine oxidase (MAO) inhibitors and within 2 weeks after discontinuation of MAO inhibitors, with other paracetamol-containing drugs, decongestants, drugs for the treatment of symptoms of colds and flu . With caution: advanced age, concomitant use with antihypertensive drugs. Use during pregnancy and lactation The drug is contraindicated during pregnancy and lactation. Dosage and administration Dissolve the contents of 1 sachet in a glass of hot water, mix and drink. It is necessary to take the drug with a large amount of liquid 1-2 hours after eating. Adults and children over 15 years old: take one sachet 3-4 times a day with an interval between doses of 4-6 hours (no more than 4 sachets per day). The maximum duration of treatment without consulting a doctor is 3 days (when taken as an antipyretic) and no more than 5 days (as an anesthetic). Side effect Disturbances from the blood and lymphatic system: thrombocytopenia, leukopenia, agranulocytosis, pancytopenia, neutropenia, hemolytic anemia; Immune system disorders: anaphylactic reactions, skin hypersensitivity reactions (eg, urticaria, allergic dermatitis, exfoliative dermatitis, skin rash, Quincke’s edema and Stevens-Johnson syndrome), including cross-sensitivity with other sympathomimetics; Respiratory, thoracic and mediastinal disorders: bronchospasm in patients sensitive to acetylsalicylic acid and other NSAIDs, increased density of bronchial secretions; Liver and biliary tract disorders: liver dysfunction; Gastrointestinal disorders: nausea, dry mouth, vomiting, abdominal pain, diarrhea, dyspepsia; Metabolic and nutritional disorders: anorexia; Cardiovascular disorders: increased blood pressure, hypotension, tachycardia and arrhythmia, palpitations; Musculoskeletal and connective tissue disorders: muscle twitching, muscle weakness; Renal and urinary disorders: urinary retention (most likely in patients with infravesical obstruction such as prostatic hypertrophy), dysuria; Psychiatric disorders: nervousness, irritability*, restlessness and excitability*, confusion*, nightmares*; Nervous system disorders: inhibition, drowsiness, impaired attention, impaired coordination, dizziness, headache; On the part of the organs of vision: blurred vision, mydriasis, paresis of accommodation, increased intraocular pressure, acute and angle-closure glaucoma; General disorders and disorders at the injection site: fatigue, chest tightness. * – children and the elderly are more susceptible to neurological cholinergic effects and paradoxical arousal (eg, increased energy, anxiety, nervousness). In the event of the above adverse reactions or adverse reactions not listed in these instructions for medical use of the drug, you should consult a doctor. Paracetamol overdose Liver damage is possible in adults who have taken 10 g or more of paracetamol. Taking 5 g or more of paracetamol can lead to liver damage if you have the following risk factors: a) are on long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John’s wort and other drugs that induce liver enzymes; b) regularly consume ethanol in excess of the recommended amounts; c) exhausted, for example, in the presence of cystic fibrosis, HIV infection, during starvation. Symptoms caused by paracetamol Seek immediate medical attention. Symptoms of paracetamol overdose in the first 24 hours include: pallor, nausea, vomiting, loss of appetite and abdominal pain. Liver damage may appear within 12-48 hours after taking paracetamol. Possible violation of glucose metabolism and the occurrence of metabolic acidosis. In severe poisoning, liver failure can progress to encephalopathy, bleeding, hypoglycemia, cerebral edema, and death. Acute renal failure with acute necrosis, low back pain, hematuria, and proteinuria may develop even in the absence of severe liver damage. There have been reports of cardiac arrhythmias and pancreatitis. Treatment Immediate measures are of great importance in the treatment of paracetamol overdose. Despite the absence of significant early symptoms of overdose, the patient should be immediately taken to the hospital. Symptoms may be limited to vomiting and may not be consistent with the severity of the overdose or the risk of organ damage. Care must be provided in accordance with established standards of care. Treatment with activated charcoal should be considered if an overdose has been diagnosed within 1 hour of taking paracetamol. Plasma concentrations of paracetamol should be measured every 4 hours after taking the drug. Treatment with N-acetylcysteine can be used within 24 hours after taking paracetamol, however, the maximum protective effect is achieved within 8 hours after taking the drug. The effectiveness of the antidote drops sharply after this time. If necessary, N-acetylcysteine can be administered intravenously. In the absence of hypersensitivity to methionine in a patient, methionine may be a suitable alternative for emergency medical care. Symptoms caused by potentiation of the parasympathetic action of the antihistamine component (pheniramine) An overdose of pheniramine can lead to effects similar to those listed in the “Side effect” section. Additional symptoms may include paradoxical arousal, toxic psychosis, convulsions, apnea, dystonic reactions and cardiovascular insufficiency, drowsiness that may be arousal (especially in children); ulcers of the oral mucosa, coma, convulsions, behavioral changes, bradycardia, atropine-like “psychosis”. Treatment Symptomatic treatment. Symptoms caused by caffeine CNS stimulation, nervousness, restlessness, insomnia, agitation, muscle cramps, confusion. From the side of the cardiovascular system: tachycardia, cardiac arrhythmias. From the gastrointestinal tract: abdominal pain. Other: diuresis, redness of the face. Treatment Treatment of caffeine overdose is mainly symptomatic and supportive. Due to increased diuresis, it is necessary to maintain water and electrolyte balance. CNS symptoms can be treated with intravenous diazepam. Symptoms caused by phenylephrine Overdose symptoms include increased blood pressure and associated with hypertension reflex bradycardia and arrhythmias. Treatment Elevated blood pressure should be treated with an alpha receptor antagonist, such as intravenous phentolamine. A decrease in blood pressure leads to a reflex increase in heart rate, so if necessary, this condition can be alleviated by the administration of atropine. Interaction with other drugs Paracetamol Coumarins (including warfarin) The anticoagulant effect may be enhanced by prolonged daily use of drugs containing paracetamol, which may lead to an increased risk of bleeding. Random doses do not have a significant effect. The dose of anticoagulants may need to be reduced if treatment with drugs containing paracetamol is necessary Substances that increase gastric emptying (eg, metoclopramide) These substances increase the absorption of paracetamol Substances that reduce gastric emptying (eg, propanteline, antidepressants with anticholinergic properties, narcotic analgesics) These substances reduce absorption of paracetamol Chloramphenicol Paracetamol levels may be increased Potentially hepatotoxic drugs or agents that induce microsomal liver enzymes (eg, rifampicin, isoniazid, alcohol, anticonvulsants) Risk of drug hepatotoxicity may be increased Probenecid May interfere with paracetamol excretion and alter paracetamol concentrations in plasma. Cholestyramine Reduces the absorption of paracetamol if administered within 1 hour before or after taking paracetamol. Drug interactions with paracetamol are usually minor but increase when concomitant medications are anticoagulants (warfarin and coumarin) and anticonvulsant drugs with a low therapeutic index. Simultaneous use of paracetamol with NSAIDs may increase their nephrotoxicity. Pharmacodynamic interactions may occur with other pain relievers such as caffeine, opiates. Barbiturates reduce the antipyretic effect. Chloramphenicol: when taken simultaneously with paracetamol, the half-life of chloramphenicol increases by 5 times. Lamotrigine: Paracetamol may reduce the bioavailability and, as a result, the effectiveness of lamotrigine. Salicylamide prolongs the half-life of paracetamol and leads to the accumulation of hepatotoxic metabolites. Zidovudine: The simultaneous use of zidovudine and paracetamol increases the risk of neutropenia. Pheniramine Monooxidase inhibitors These substances increase the anticholinergic effects of pheniramine Anxiolytics, hypnotics, antiparkinsonian and antipsychotics, tricyclic antidepressants, alcohol Simultaneous use with pheniramine enhances the inhibitory effect of these drugs on the CNS Phenytoin Pheniramine inhibits the metabolism of phenytoin, which can lead to phenytoin toxicity Pheniramine reduces the effect of coumarin derivatives . Phenylephrine should be used with caution in combination with the following drugs: Monoamine oxidase inhibitors (including moclobemide) Interactions between phenylephrine and monoamine oxidase inhibitors may cause a hypertensive effect Sympathomimetic amines Concomitant use of phenylephrine with other sympathomimetic amines may increase the risk of cardiovascular side effects Beta- blockers and other antihypertensive drugs (including debrisoquine, guanethidine, reserpine, methyldopa) Phenylephrine may reduce the effectiveness of beta-blockers and antihypertensive drugs. Risk of hypertension and other cardiovascular side effects may be increased Tricyclic antidepressants (eg, amitriptyline) Possible increased risk of cardiovascular side effects of phenylephrine Ergot alkaloids (ergotamine and methylseride) Increased risk of ergotism Digoxin and cardiac glycosides Increased risk occurrence of irregular heartbeat and heart attack Precautions If the febrile syndrome continues against the background of the use of the drug for more than 3 days and pain syndrome – more than 5 days, you should consult a doctor. A doctor should be consulted if symptoms: do not improve within 5 days; accompanied by a fever that lasts more than 3 days; include a sore throat that does not go away for more than 3 days, accompanied by fever, headache, rash, nausea or vomiting. Avoid the simultaneous appointment of other drugs containing paracetamol. Long-term use of painkillers, especially a combination of different analgesics, can lead to irreversible kidney damage with the development of kidney failure (analgesic nephropathy). Chronic use of analgesics for headaches can lead to a persistent, intractable headache (drug headache). One sachet contains 117.3 mg (5.1 mmol) of sodium, which should be considered in patients on a low sodium diet. Due to the presence of sugar in the composition, the drug is not recommended for patients with rare congenital fructose intolerance or glucose-galactose malabsorption. When using the drug, it is not recommended to drink alcoholic beverages, since ethyl alcohol, when taken simultaneously with paracetamol, can cause liver dysfunction. It is imperative that you consult your doctor before taking this medicinal product in the following conditions: hypertension, cardiovascular disease, diabetes, hyperthyroidism, increased intraocular pressure (glaucoma), pheochromocytoma, enlarged prostate, vascular endarteritis obliterans (eg Raynaud’s phenomenon), epilepsy, bronchitis, bronchiectasis, bronchial asthma, liver and kidney diseases. Caution should be exercised in patients with impaired renal function and in patients with hepatic insufficiency due to the fact that this drug contains paracetamol and pheniramine, which increase the risk of paracetamol-related liver damage. Patients who have been diagnosed with hepatic and / or renal insufficiency should consult a doctor before taking this drug. Pheniramine can enhance the effect of alcohol, so their simultaneous use should be avoided. Simultaneous use with drugs that cause sedation, such as tranquilizers and hypnotics (especially barbiturates), should be avoided, as this may increase the sedative effect. Grippolec Plus should not be taken with other antihistamines. The elderly are more likely to experience neurological anticholinergic effects and paradoxical arousal (eg, increased energy, restlessness, nervousness). When taking pheniramine in the evening, the symptoms of gastroesophageal reflux may increase. When using pheniramine in combination with drugs that can cause an ototoxic effect, caution is necessary, as symptoms of ototoxicity may be masked. If symptoms persist, a doctor should be consulted. Phenylephrine may contribute to false positive doping control results in athletes. The risk of drowsiness increases with the use of alcoholic beverages, drugs containing alcohol, or sedatives. The risk of drug dependence appears only at doses higher than recommended, or with long-term treatment. To avoid the risk of overdose, make sure that other medicines the patient is taking do not contain paracetamol. For adults weighing more than 50 kg, the total dose of paracetamol should not exceed 4 g per day. The recommended dose of the drug contains about the same amount of caffeine as is in a cup of coffee. While taking the drug, you should limit the use of drugs, drinks and foods containing caffeine, since excessive consumption of caffeine causes nervousness, irritability, insomnia and sometimes tachycardia. Use in pediatrics Children under 15 years of age, this drug is contraindicated. Storage conditions In a place protected from moisture and light at a temperature not exceeding 25 ° C. Keep out of the reach of children. Buy Grippolek Plus powder for oral solution (lemon) in bags No. 10 Price for Grippolek Plus powder for oral solution (lemon) in bags No. 10 Instructions for use for Grippolek Plus powder for preparation oral solution (lemon) in bags No. 10