Analginum

General characteristics. Structure:

Active ingredient: 500 mg of metamizole sodium (analginum).

Excipient: water for injections.

Analgetic of non-narcotic action.

Pharmacological properties:

Pharmacodynamics. Metamizole sodium is derivative pyrazyl ketone. Possesses anesthetic, zharopoyonizhayushchy and weak antiinflammatory action which mechanism is connected with an ugneyoteniye of synthesis of prostaglandins. On the action mechanism practically does not differ from other non-steroidal anti-inflammatory drugs.

Pharmacokinetics. After intravenous administration the elimination half-life for metamizol makes 14 minutes. About 96% are removed with urine in the form of metabolites. Communication of an active metabolite with proteins of a blood plasma - 50-60%. It is preferential removed by kidneys.

Indications to use:

Pain syndrome of various etiology (acute or chronic): including head, migrenozny, dentagra, neuralgia, mialgiya, radicular syndrome, альгодисменорея; at renal, hepatic and bilious gripes (in a combination with antispasmodics).

Analginum can be used for reduction of pains after surgical and diagnostic interventions.

The increased      body temperature   at    "catarrhal"    and    other    infectious and inflammatory diseases.  Expediency of use of drug is solved in each case depending on expressiveness, character and portability of fever.

Route of administration and doses:

Adults and teenagers of 15 years are also more senior: as a single dose 1-2 ml of 50% (500 mg / 1 ml) Analginum solution are recommended (in oil or in/in), the daily dose can make 50% of injection solution (no more than 2 g) to 4-8 ml, divided into 2-3 receptions. The maximum single dose can make 1 g (2 ml of 50% of solution).

Children and newborns: Newborns cannot accept analginum aged up to 3 months or at body weight less than 5 kg.

To children Analginum is appointed in a dose of 50-100 mg to 10 kg of body weight (0,1-0,2 ml of 50% of solution).

The single dose can be appointed to 2-3 times a day.

Before introduction solution is recommended to be heated to body temperature.

For children at the age of 3-12 months introduction is carried out only intramusculary! (body weight of the child from 5 to 9 kg).

At too bystry administration of drug critical falling of arterial pressure and shock can be observed. Intravenous administration has to be carried out slowly (rate of administering no more than 1 ml (500 mg of metamizol) a minute) in a prone position, at control of arterial pressure, pulse and a respiration rate.

As there is fear that falling of arterial pressure of not allergic genesis is dozozavisimy, the amount of solution of Analginum more than 2 ml (1 g) has to be entered with extra care.

Features of use:

At the patients having bronchial asthma and pollinoses development of hypersensitivity reactions is possible.

At prolonged use (more than 7 days) it is necessary to control a pattern of peripheral   blood.      Against the background of   reception    of metamizole sodium     development of an agranulocytosis in this connection, at identification of unmotivated rise in temperature, a fever, pharyngalgias, the complicated swallowing, stomatitis, erosive cankers of an oral cavity, a vaginitis or a proctitis, immediate drug withdrawal is necessary is possible.

Not to apply to removal of acute abdominal pains (before clarification of the reasons).

At treatment of the patients receiving cytostatic means, reception of metamizole sodium has to be carried out only under observation of the doctor.

At introduction in oil it is necessary to use a long needle.

For children at the age of 3-12 months introduction is carried out only intramusculary!

Within the first and last three months of pregnancy it is impossible to accept Analginum. With fourth on the sixth months of pregnancy reception of Analginum has to be carried out on strict medical indications. After Analginum reception feeding by a breast has to be stopped for 48 hours.

Side effects:

Allergic reactions: a small tortoiseshell, including on a conjunctiva and mucous membranes of a nasopharynx, a Quincke's edema; in rare instances - a malignant exudative erythema (  Stephens-Johnson's syndrome),  an acute  anaphylaxis, a toxic  epidermal necrolysis (Lyell's disease), a bronkhospastichesky syndrome.

So_storony_organov of a hemopoiesis: leukopenia, seldom agranulocytosis and thrombocytopenia, immune genesis;

From a mochevydelitelnoy_sistema: the renal failure, an oliguria, an anury, a protenuriya, is very rare development of acute intersticial nephrite, coloring of urine in red color (due to allocation of a metabolite - rubazonovy acid).

Others: the lowering of arterial pressure, disturbance of a cordial rhythm is possible; at intramuscular introduction infiltrates in an injection site are possible.

Interaction with other medicines:

Simultaneous use of Analginum with other non-narcotic analgesics can lead to mutual strengthening of toxic effects.

Tricyclic  antidepressants,    contraceptives for    intake  and Allopyrinolum break metabolism of metamizol in a liver and increase its toxicity.

Barbiturates and phenylbutazone weaken effect of analginum.

Analginum strengthens effects of alkogolsoderzhashchy drinks.

Rentgenokontrastpy substances, colloid blood substitutes and penicillin should not be applied during treatment by metamizol. Metamizol, forcing out from communication  with protein peroral hypoglycemic drugs, indirect   anticoagulants,   glucocorticosteroids  and  иидометацин,  increases  their activity.

Simultaneous use of Analginum with cyclosporine reduces the level of the last in blood. Thiamazolum and sarcolysine increase risk of development of a leukopenia.

The effect is strengthened by codeine, propranolol (slows down an inactivation).

Sedatives and tranquilizers strengthen the anesthetizing effect of analginum.

Because of  high  probability  of pharmaceutical  incompatibility  metamizol  cannot be mixed with other medicines in one syringe.

Contraindications:

- hypersensitivity to pyrazyl ketone derivatives (изопропиламинофеназол, пропифеназол, phenazone or phenylbutazone);

- bronchial asthma; the diseases which are followed by a bronchospasm;

- "aspirinovy asthma";

- the expressed        hemopoiesis disturbances    (an agranulocytosis,    a cytoplastic    and infectious neutropenia);

- the expressed abnormal liver functions or kidneys; hepatic porphyria;

- inborn deficit glyukozo-6-fosfatdegidrogenazy;

- pregnancy (especially in I and III trimesters);

- infantile age (up to 3 months with body weight less than 5 kg).

With care it is appointed the patient with systolic arterial pressure below 100 mm hg or at instability of blood circulation (for example, in case of the beginning heavy disturbance of blood circulation at a myocardial infarction, a multiple injury, the beginning shock), with anamnestic instructions to diseases of kidneys (pyelonephritis, a glomerulonephritis) and at the long alcoholic anamnesis.

Overdose:

In case of overdose it is necessary to consult with the doctor. Emergence of the following symptoms is possible: nausea, vomiting, stomach aches, oliguria, hypothermia, lowering of arterial pressure, tachycardia, short wind, sonitus, drowsiness, nonsense, consciousness disturbances,  acute   agranulocytosis,   hemorrhagic  syndrome,  acute   renal  and/or liver failure, spasms, paralysis of respiratory muscles.

Treatment: symptomatic. The specific antidote for metamizol does not exist. In the conditions of medical institution - carrying out an artificial diuresis, hemodialysis, at development of a convulsive syndrome - intravenous administration of diazepam and high-speed barbiturates.

Storage conditions:

List B. In dry protected from light, the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

Ampoules on 2 ml. On 10 ampoules together with the application instruction place in a pack from a cardboard.