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medicalmeds.eu Medicines Paracetamol in a combination with other drugs (excepting psikholeptik). Гриппомикс

Гриппомикс

Препарат Гриппомикс. СООО "Лекфарм" Республика Беларусь


Producer: SOOO "Lekfarm" Republic of Belarus

Code of automatic telephone exchange: N02BE51

Release form: Liquid dosage forms. Powder for preparation of solution for intake.

Indications to use: Flu. SARS. Hyper thermal syndrome (Fever).


General characteristics. Structure:

Active ingredients: 360 mg of paracetamol, 75 mg of Rimantadinum of a hydrochloride, 125 mg of ascorbic acid, 2,5 mg of a tsetirizin of dihydrochloride, 89,3 mg of calcium of a carbonate 70 with sorbitol that corresponds to the content of 25 mg of calcium.

Excipients: aspartame, citric acid anhydrous, fragrance (wild berries, lemon or orange), sugar.

Treatment of flu, acute respiratory viral infections, feverish states owing to virus damage of airways at adults and children is more senior than 12 years




Pharmacological properties:

Pharmacodynamics. Pharmacological activity of medicine is caused by complex action of its components – paracetamol, Rimantadinum of a hydrochloride, ascorbic acid, a tsetirizin of dihydrochloride and calcium of a carbonate.

Medicine renders the antiviral, interferonogenny, febrifugal, antiinflammatory, anesthetizing, antihistaminic, angioprotektorny action.

Paracetamol possesses febrifugal, analgeziruyushchy and some antiinflammatory action, reduces the pain syndrome which is observed at catarrhal diseases, a pharyngalgia, a headache, muscular and joint pain, reduces high temperature. Blocks cyclooxygenase of the first and second types preferential in the central nervous system. Due to the lack of the blocking influence on synthesis of prostaglandins in peripheral fabrics, does not influence a water salt metabolism (Na delay + and waters) and a mucous membrane of digestive tract.

Rimantadinum a hydrochloride – the antiviral means derivative of an adamantan. It is active concerning various influenza strains And, the Herpes simplex viruses of type I and II, viruses of a tick-borne encephalitis (Central European and Russian spring and summer of group of an arbovirus this. Flaviviridae). Has anti-toxic and immunomodulatory effect. Suppresses an early stage of a specific reproduction, the alpha and scale induces development of interferon, increases a functional lymphocyte activity - natural killers (NK cells), T-and B-lymphocytes. Being the weak basis, raises pH of the endosomes having a membrane of vacuoles and people around virus particles after their penetration into a cell. Prevention of an atsidifikation in these vacuoles blocks merge of a viral envelope to an endosome membrane, preventing thus transfer of virus genetic material to cell cytoplasm. Rimantadinum oppresses also an exit of virus particles from a cell, i.e. interrupts a transcription of a virus genome.

Ascorbic acid participates in regulation of oxidation-reduction processes, carbohydrate metabolism, coagulability of blood, an angenesis, reduces vascular permeability. Has the antiagregantny and expressed antioxidant properties. Maintains colloidal state of intercellular substance and normal permeability of capillaries (oppresses hyaluronidase). Due to activation of respiratory enzymes in a liver strengthens its disintoxication and belkovoobrazovatelny functions, increases synthesis of a prothrombin. Regulates immunological reactions (activates synthesis of antibodies, C3 component of a complement, interferon), promotes phagocytosis, increases body resistance to infections. Slows down release and accelerates degradation of a histamine, formation of prostaglandins and other mediators of an inflammation and allergic reactions oppresses.

Tsetirizina dihydrochloride – a blocker of peripheral histamine H1 receptors, antihistaminic antiallergic means, Hydroxyzinum metabolite. In pharmacological active doses does not possess significant sedation. Brakes a gistaminoposredovanny early phase of allergic reaction, prevents various physiological and pathophysiological effects of a histamine, such as expansion and a hyperpermeability of capillaries (edematization, small tortoiseshells, reddening), stimulation of sensitive nerve terminations (an itch, pain) and reduction of unstriated muscles of a respiratory organs and digestive tract. At a late stage of allergic reaction of a tsetirizin dihydrochloride inhibits allocation of a histamine and migration of eosinophils and other cells, weakening thus, late allergic reaction. Reduces an expression of molecules of adhesion, such as ICAM-1 and VCAM-1 which are markers of an allergic inflammation. Suppresses action of other mediators and inductors of secretion of a histamine, such as PAF (platelet activating factor) and substance P. Considerably lowers the hyperreactivity of a bronchial tree arising in response to release of a histamine at patients with bronchial asthma. These effects are not followed by the central action.

Calcium the carbonate prevents development of a hyperpermeability and fragility of vessels, promotes normal coagulability of blood, participates in implementation of processes of transfer of nervous impulses, reductions of skeletal and smooth muscles, in regulation of cordial activity.


Indications to use:

The etiotropic and symptomatic treatment of flu, acute respiratory viral infections, feverish states owing to virus damage of airways at adults and children is more senior than 12.


Route of administration and doses:

Inside. Contents of a bag are dissolved in 1 glass of boiled hot water. Use hot. To children 12 years and the adult – on 1 powder 3-4 times a day within 3-5 days, before disappearance of symptoms of a disease are more senior. In the absence of improvement of health during medicine reception, treatment it is necessary to stop and see a doctor!


Features of use:

Medicine is not intended for prevention.

Treatment should be begun no later than 48 h from emergence of the first symptoms of a disease. Use duration - no more than 5 days. At prolonged use (more than 7 days) the exacerbation of chronic associated diseases is possible, at patients of advanced age with arterial hypertension the risk of development of a hemorrhagic stroke increases (at the expense of Rimantadinum medicine which is a part).

At instructions in the anamnesis on epilepsy and the carried-out anticonvulsant therapy against the background of use of Rimantadinum the risk of development of an epileptic seizure increases.

At reception the risk of development of injuries of a liver in patients with an alcoholic hepatosis increases. Distorts indicators of laboratory researches at quantitative definition of glucose and uric acid in plasma (paracetamol).

In connection with a promoting effect of ascorbic acid on synthesis of corticosteroid hormones it is necessary to monitor function of adrenal glands and the ABP. Ascorbic acid as a reducer can distort results of various laboratory tests (content in blood of glucose, bilirubin, activity of hepatic transaminases and LDG).

Not to apply in the presence of the metastasizing tumors.

In order to avoid the possible damaging action on a liver, and also in connection with increase in risk of a GIT, during administration of drug it is not necessary to take alcohol.

Use in pediatrics. For formation of postinfectious immunity it is not necessary to use drug of children aged up to 12 years.

Influence on ability to driving of motor transport and to control of mechanisms. During treatment it is necessary to be careful during the driving of motor transport and occupation other potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions (since drug contains Rimantadinum).


Side effects:

From the central nervous system: seldom – a headache, increased fatigue, a hyperexcitability, dizziness, a tremor, a hyperkinesia.

From digestive tract: lasting reception more than 7 days are possible injuries of a mucous membrane of a stomach and a dvenadtsatitiperstny gut, dyspepsia, dryness in a mouth, nausea, anorexia, a meteorism, diarrhea.

From system of blood: lasting reception more than 7 days – an agranulocytosis, a leukopenia, thrombocytopenia, a neutropenia, anemia.

Allergic reactions: seldom – skin rash, an itch, a small tortoiseshell are possible.


Interaction with other medicines:

In need of joint reception with other medicines the patient has to consult with the doctor.

Combined use of paracetamol and Rimantadinum leads to decrease in Cmax and AUC of Rimantadinum approximately for 11%.

Ascorbic acid lowers Cmax of Rimantadinum by 10%.

Cimetidinum reduces clearance of Rimantadinum by 18%.

Rimantadinum reduces efficiency of antiepileptic means.

Paracetamol reduces efficiency of uricosuric medicines.

Inductors of a microsomal oxidation in a liver (Phenytoinum, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase products of hydroxylated metabolites that causes a possibility of development of heavy intoxications even at small overdose. Prolonged use of barbiturates reduces efficiency of paracetamol. Ethanol promotes development of acute pancreatitis.

Inhibitors of a microsomal oxidation (including Cimetidinum) reduce risk of a hepatotoxic action.

Prolonged combined use of Grippomiks and other NPVS increases risk of development of an "analgetic" nephropathy and renal papillary necrosis, development of an end-stage of a renal failure.

Diflunizal increases plasma concentration of paracetamol for 50% - risk of development of a hepatotoxic.

Miyelotoksichny drugs strengthen manifestations of a gematotoksichnost of Grippomiks.

Ascorbic acid increases concentration in blood of benzylpenicillin and tetracyclines; in a dose of 1 g/days increases bioavailability of ethinylestradiol (including being a part of oral contraceptives). Reduces efficiency of heparin and indirect anticoagulants. Increases risk of development of a crystalluria at treatment by salicylates and streptocides of short action, slows down removal by kidneys of acids, increases removal of the medicines having alkali reaction (including alkaloids). Increases the general clearance of ethanol which in turn reduces concentration of ascorbic acid in an organism. At simultaneous use reduces chronotropic action of an izoprenalin. Barbiturates and Primidonum increase removal of ascorbic acid with urine. Reduces therapeutic action of neuroleptics - derivatives of a fenotiazin, a canalicular reabsorption of amphetamine and tricyclic antidepressants.

At co-administration of Grippomiks with theophylline (especially if doses of theophylline exceed 400 mg) increase in concentration in serum and relative overdose of a tsetirizin because of reduced clearance can be observed.

Myelotoxic medicines strengthen manifestations of a gematotoksichnost of a tsetirizin.

It is necessary to observe extra care at combined use of medicine with hypnotic drugs and sedatives, alcohol.


Contraindications:

Hypersensitivity to one or several components which are a part of medicine; digestive tract erosive cankers in an aggravation phase; gastrointestinal bleedings; hemophilia; hemorrhagic diathesis; prothrombinopenia; portal hypertensia; renal failure; pregnancy and period of a lactation; children's age up to 12 years; thyrotoxicosis; acute diseases of kidneys, liver (acute glomerulonephritis, acute pyelonephritis, acute hepatitis); alcoholism.


Overdose:

Symptoms: in the first the 24th h are possible pallor, nausea, vomiting and pain in epigastric area, a tremor, drowsiness, tachycardia, increase in bilirubin in blood, disbolism, an exacerbation of the accompanying chronic diseases.

Paracetamol overdose symptoms: nausea, vomiting, stomach aches, pallor of integuments, anorexia. In a day or two are defined signs of damage of a liver. In hard cases the liver failure and coma develops. Toxic effect of paracetamol at adults perhaps after reception over 10-15 g of paracetamol: increase in activity of hepatic transaminases, increase in a prothrombin time (in 12-48 h after reception); the developed clinical picture of damage of a liver appears in 1-6 days. Seldom damage of a liver develops immediately and can be complicated by a renal failure (a tubular necrosis).

Treatment: at suspicion on overdose the patient has to see a doctor immediately. The victim should make a gastric lavage during the first 4 h poisoning, to accept adsorbents (absorbent carbon). Introduction of donators of SH-group and predecessors of synthesis of glutathione - methionine - in 8-9 h after overdose and N-Acetylcysteinum - in 12 h. Need for holding additional therapeutic actions is defined depending on concentration of paracetamol in blood, and also from time which passed after its reception.


Storage conditions:

Drug should be stored in the unavailable to children, protected from moisture and light place, at a temperature not above 25 °C. A period of validity - 2 years.


Issue conditions:

According to the recipe


Packaging:

On 10 g of powder in bags from the combined material. On 5, 10 or 15 bags in a cardboard pack together with the application instruction.



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