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

Name:
Theraflu por. for ca. solution for pr. ext. (lemon) in pack. in pack. №10
Description:
Powder for solution for oral administration (lemon) white with yellow patches, free-flowing, granular, without foreign particles, with a citrus smell; soft lumps are allowed. The main active ingredient is benzoxonium chloride + lidocaine. Release form: 30 ml of the drug in a high-density polyethylene vial with a spray device and a protective cap made of low-density polyethylene. The bottle, complete with a polypropylene spray nozzle and instructions for use, is placed in a cardboard box. Dosage 2 mg + 1.5 mg Special instructions To avoid toxic damage to the liver, the drug should not be combined with the use of alcoholic beverages. Patients should consult a doctor if: there is bronchial asthma, emphysema or chronic bronchitis; symptoms do not improve within 5 days or are accompanied by severe fever lasting for 3 days, rash, or persistent headache. These may be signs of a more serious disorder. Theraflu for flu and colds contains: sucrose 20 g per sachet. This should be taken into account in diabetic patients. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency should not take Theraflu for colds and flu; dye sunset yellow (E110). May cause allergic reactions; sodium 28.3 mg per sachet. This should be taken into account in patients on a sodium-restricted diet. Do not use the drug from damaged bags. Influence on the ability to drive vehicles and mechanisms Theraflu from flu and colds can cause drowsiness, so during treatment it is not recommended to drive vehicles or engage in other activities that require concentration and high speed of psychomotor reactions. Pharmacological action Combined drug, the action of which is due to its constituent components. It has an antipyretic, analgesic, vasoconstrictive effect, eliminates the symptoms of a “cold”. Narrows blood vessels and eliminates swelling of the mucous membrane of the nasal cavity and nasopharynx. Paracetamol has an analgesic and antipyretic effect by suppressing the synthesis of prostaglandins in the central nervous system. Does not affect platelet function and hemostasis. Pheniramine is an antiallergic agent, a blocker of histamine H1 receptors. Eliminates allergic symptoms, has a moderate sedative effect, and also exhibits antimuscarinic activity. Phenylephrine – alpha1-agonist, causes vasoconstriction, eliminates swelling and hyperemia of the nasal mucosa. Pharmacokinetics Paracetamol Paracetamol is rapidly and almost completely absorbed from the gastrointestinal tract. Cmax in plasma is achieved within 10-60 minutes after ingestion. Distributed in most tissues of the body. Penetrates through the placental barrier, excreted in breast milk. At therapeutic concentrations, plasma protein binding is negligible, but increases with increasing concentration. It undergoes primary metabolism in the liver. It is excreted mainly in the urine in the form of glucuronides and sulfates. T1 / 2 is from 1 to 3 hours. Pheniramine Cmax pheniramine in plasma is reached after about 1-2.5 hours. T1 / 2 pheniramine – 16-19 hours. 70-83% of the dose is excreted from the body in the urine as metabolites or unchanged . Phenylephrine Phenylephrine is absorbed from the gastrointestinal tract. It is metabolized during the “first pass” through the intestinal wall and in the liver, therefore, when administered orally, phenylephrine hydrochloride is characterized by limited bioavailability. Cmax in plasma is achieved in the range from 45 minutes to 2 hours. It is excreted by the kidneys almost completely in the form of sulfate compounds. T1 / 2 is 2-3 hours. Ascorbic acid is quickly and completely absorbed from the gastrointestinal tract. Plasma protein binding – 25%. Excreted as metabolites in the urine. Ascorbic acid, taken in excessive amounts, is rapidly excreted unchanged in the urine. Indications for use Symptomatic treatment of infectious and inflammatory diseases (ARVI, including influenza), accompanied by high fever, chills, body aches, headache and muscle pain, runny nose, nasal congestion, sneezing. Dosage and administration Inside. The contents of one sachet are dissolved in 1 cup of hot, but not boiling water. Taken hot. A second dose can be taken every 4-6 hours (no more than 3-4 doses in 24 hours). TheraFlu for flu and colds can be used at any time of the day, but the best effect is when taking the drug before bedtime, at night. If there is no relief of symptoms within 3 days after starting the drug, you should consult a doctor. Do not use TheraFlu for flu and colds for more than 5 days. In patients with impaired liver function or Gilbert’s syndrome, it is necessary to reduce the dose or increase the interval between doses. In severe renal failure (CC <10 ml / min), the interval between doses should be at least 8 hours. In elderly patients, dose adjustment is not required. Use during pregnancy and lactation It is not recommended to use TheraFlu for influenza and colds during pregnancy and lactation (breastfeeding). Interaction with other drugs Paracetamol Enhances the effects of MAO inhibitors, sedatives, ethanol. The risk of hepatotoxic action of paracetamol increases with the simultaneous use of barbiturates, phenytoin, phenobarbital, carbamazepine, rifampicin, isoniazid, zidovudine and other inducers of microsomal liver enzymes. With prolonged regular use of paracetamol, it is possible to increase the anticoagulant effect of warfarin and other coumarins, while increasing the risk of bleeding. A single use of paracetamol does not have a significant effect. Metoclopramide increases the rate of absorption of paracetamol and reduces the time to reach its Cmax in blood plasma. Similarly, domperidone may increase the absorption rate of paracetamol. Paracetamol can lead to an increase in T1 / 2 of chloramphenicol. Paracetamol is able to reduce the bioavailability of lamotrigine, while it is possible to reduce the effectiveness of lamotrigine due to the induction of its metabolism in the liver. The absorption of paracetamol may be reduced when co-administered with cholestyramine, but the reduction in absorption is not significant if cholestyramine is taken an hour later. Regular use of paracetamol concomitantly with zidovudine may cause neutropenia and increase the risk of liver damage. Probenecid affects the metabolism of paracetamol. In patients concomitantly taking probenecid, the dose of paracetamol should be reduced. Hepatotoxicity of paracetamol increases with prolonged excessive use of ethanol (alcohol). Paracetamol may interfere with the results of the uric acid test using the phosphotungstate precipitating reagent. Pheniramine May increase the effect of other substances on the central nervous system (for example, MAO inhibitors, tricyclic antidepressants, alcohol, antiparkinsonian drugs, barbiturates, tranquilizers and narcotic drugs). Pheniramine may inhibit the action of anticoagulants. Phenylephrine Theraflu for influenza and colds is contraindicated in patients who are receiving or have received MAO inhibitors within the past 2 weeks. Phenylephrine can potentiate the action of MAO inhibitors and cause a hypertensive crisis. The simultaneous use of phenylephrine with other sympathomimetic drugs or tricyclic antidepressants (for example, amitriptyline) may lead to an increased risk of adverse reactions from the cardiovascular system. Phenylephrine may reduce the effectiveness of beta-blockers and other antihypertensive drugs (eg, debrisoquine, guanethidine, reserpine, methyldopa). There may be an increased risk of arterial hypertension and other side effects from the cardiovascular system. The simultaneous use of phenylephrine with digoxin and cardiac glycosides may increase the risk of cardiac arrhythmias or myocardial infarction. Concomitant use of phenylephrine with ergot alkaloids (ergotamine and methysergide) may increase the risk of ergotism. Hypersensitivity to the components of the drug; severe cardiovascular disease; arterial hypertension; portal hypertension; diabetes mellitus; hyperthyroidism; angle-closure glaucoma; pheochromocytoma; alcoholism; sucrase / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption; simultaneous or within the previous 2 weeks taking MAO inhibitors; simultaneous use of tricyclic antidepressants, beta-blockers, other sympathomimetics; pregnancy; breastfeeding; children under 12 years of age. With caution: with severe atherosclerosis of the coronary arteries, cardiovascular diseases, acute hepatitis, hemolytic anemia, bronchial asthma, severe liver or kidney disease, prostatic hyperplasia, difficulty urinating due to prostatic hypertrophy gland, blood diseases, deficiency of glucose-6-phosphate dehydrogenase, congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes), with exhaustion, dehydration, pyloroduodenal obstruction, stenosing gastric and / or duodenal ulcer, epilepsy, while taking drugs that can adversely affect the liver (eg, inducers of microsomal liver enzymes); in patients with recurrent urate kidney stones. Composition 1 pack. paracetamol 325 mg pheniramine maleate 20 mg phenylephrine hydrochloride 10 mg ascorbic acid 50 mg mg, lemon flavor - 208.42 mg, tribasic calcium phosphate - 82 mg, citric acid - 1221.79 mg, sucrose - 20,000 mg. 22.1 g - multi-layer bags (4) - packs of cardboard. 22.1 g - multi-layer bags (10) - packs of cardboard. 22.1 g - multi-layer bags (14) - packs of cardboard. Overdose Symptoms of overdose are mainly due to paracetamol. Paracetamol Symptoms: mainly appear after taking 10-15 g of paracetamol. In severe cases of overdose, paracetamol has a hepatotoxic effect, incl. may cause liver necrosis. Also, an overdose can cause irreversible nephropathy and irreversible liver damage. The severity of overdose depends on the dose, so patients should be warned about the prohibition of the simultaneous use of paracetamol-containing drugs. The risk of poisoning is pronounced especially in elderly patients, in children, in patients with liver diseases, in cases of chronic alcoholism, in patients with malnutrition and in patients taking inducers of microsomal liver enzymes. An overdose of paracetamol can lead to liver failure, encephalopathy, coma and death. Symptoms of an overdose of paracetamol in the first 24 hours: pallor of the skin, nausea, vomiting, anorexia, convulsions. Abdominal pain may be the first sign of liver damage and usually does not appear within 24-48 hours and may sometimes appear later, after 4-6 days. Liver damage is most pronounced after 72-96 hours after taking the drug. There may also be impaired glucose metabolism and metabolic acidosis. Even in the absence of liver damage, acute renal failure and acute tubular necrosis may develop. Cases of cardiac arrhythmias and pancreatitis have been reported. Treatment: administration of acetylcysteine in / in or orally as an antidote, gastric lavage, ingestion of methionine can have a positive effect, at least within 48 hours after an overdose. Recommended intake of activated charcoal, monitoring of respiration and circulation. In the event of seizures, diazepam may be prescribed. Pheniramine and phenylephrine (overdose symptoms are combined due to the risk of mutual potentiation of the parasympatholytic effect of pheniramine and the sympathomimetic effect of phenylephrine in case of an overdose of the drug) Symptoms: drowsiness, which is further joined by anxiety (especially in children), visual disturbances, rash, nausea, vomiting, headache, irritability, dizziness, insomnia, circulatory disorders, coma, convulsions, behavioral changes, increased blood pressure and bradycardia. With an overdose of pheniramine, cases of atropine-like "psychosis" have been reported. Treatment: There is no specific antidote. The usual measures of care are needed, including the appointment of activated charcoal, saline laxatives, measures to support cardiac and respiratory functions. Psychostimulants (methylphenidate) should not be prescribed due to the risk of seizures. With arterial hypotension, the use of vasopressor drugs is possible. In the case of an increase in blood pressure, it is possible to / in the introduction of alpha-blockers, tk. phenylephrine is a selective ?1-adrenergic agonist, therefore, the hypotensive effect in overdose should be treated by blocking ?1-adrenergic receptors. With the development of convulsions, introduce diazepam. Side effectDetermining the frequency of side effects: very often (?1/10), often (?1/100 and <1/10), infrequently (?1/1000 and <1/100), rarely (?1/10000 and < 1/1000), very rare (<1/10,000), including individual messages, the frequency is unknown (it is impossible to determine the frequency from the available data). From the hemopoietic system: very rarely - thrombocytopenia, agranulocytosis, leukopenia, pancytopenia. From the immune system: rarely - hypersensitivity (rash, shortness of breath, anaphylactic shock), angioedema; frequency unknown - anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis. From the nervous system: often - drowsiness; rarely - dizziness, headache. Mental disorders: rarely - irritability, sleep disturbance. On the part of the organ of vision: rarely - mydriasis, paresis of accommodation, increased intraocular pressure. From the side of the cardiovascular system: rarely - tachycardia, palpitations, arterial hypertension. From the digestive system: often - nausea, vomiting; rarely - constipation, dryness of the oral mucosa, abdominal pain, diarrhea. From the side of the liver and biliary tract: rarely - increased activity of liver enzymes. From the skin and subcutaneous tissues: rarely - skin rash, itching, erythema, urticaria. From the urinary system: rarely - difficulty urinating. General reactions: rarely - malaise. If any of the above side effects worsen and any other side effects appear, the patient should consult a doctor. Storage conditions The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C. Buy Theraflu powder for oral solution (lemon) in bags #10 Price for Theraflu powder for oral solution (lemon) in bags #10 Instructions for use for Theraflu powder for oral solution (lemon) in bags # ten