Paracetamol

General characteristics. Structure:

Paracetamol active ingredient; N-(4-hydroxyphenyl) acetamide;
5 ml of syrup contain paracetamol 120 mg.
Excipients: sorbite solution which does not crystallize (Е 420); glycerin, propylene glycol, saccharin of sodium, potassium sorbate, aspartame (Е 951), fragrance "ASE 896 Orange", Yellow Decline of FCF azoic dye (Е 110), the water purified.

Liquid of orange color with a characteristic smell of orange, sweet on taste.

Pharmacological properties:

Paracetamol - an analgetic antipyretic. Renders the analgesic, febrifugal and weak antiinflammatory action connected with influence of paracetamol on the center of thermal control in a hypothalamus and an opportunity to inhibit synthesis of prostaglandins.
At intake about 90% of the entered paracetamol dose are absorbed.
Extent of absorption decreases at a concomitant use with food. The maximum concentration of paracetamol in a blood plasma is reached in 30 - 90 min. Drug is evenly distributed in organism liquids, the volume of its distribution - 0,95 l/kg. Linkng with proteins of plasma insignificant. It is actively metabolized in a liver. At babies intensity of metabolism is less expressed. A paracetamol elimination half-life - 1,5-2,5 hours. Less than 4% - in not changed look are removed preferential by kidneys, and. About 85-95% of a therapeutic dose are removed with urine within 24 hours.
At a renal failure elimination of paracetamol is slowed down, observed accumulation of conjugates. At a serious illness of a liver the drug elimination half-life from plasma considerably increases, however clinical value of this phenomenon is not clear.
At newborns and children up to 10 years the main metabolite is paracetamol sulfate whereas adult persons have a glyukuronidny conjugate. However it does not influence drug elimination speed.

Indications to use:

Hyperthermia at cold, flu and after vaccination. Pain syndrome of moderate and average intensity of various genesis (head and dentagra, mialgiya).

Route of administration and doses:

Accept inside. The drug dose for children depends on the body weight of the child. The single dose makes 15 mg/kg, the maximum daily dose for children should not exceed 60 mg/kg.
The recommended doses: to children aged from 2 months in which heat after vaccination appeared appoint 2,5 ml (60 mg of paracetamol), if necessary it is possible to repeat a dose in 4 - 6 hours. If body temperature does not decrease after the second reception, it is necessary to see a doctor.
Body weight - 4 - 8 kg: a single dose - 2,5 - 5 ml (60 - 120 mg of paracetamol);
body weight - 8 - 12 kg: a single dose - 5 - 7,5 ml (120 - 180 mg of paracetamol);
body weight - 12 - 16 kg: a single dose - 7,5 - 10 ml (180 - 240 mg of paracetamol);
body weight - 16 - 20 kg: a single dose - 10 - 12,5 ml (240 - 300 mg of paracetamol);
body weight - 20 - 24 kg: a single dose - 12,5 - 15 ml (300 - 360 mg of paracetamol);
body weight - 24 - 32 kg: a single dose - 15 - 20 ml (360 - 480 mg of paracetamol).
Drug is accepted to 4 times a day. The interval between administrations of drug has to make 6 hours. A dosage - by means of dosing the glass having graduation: 2,5 ml, 5 ml, 10 ml, 15 ml, 20 ml or a measured spoon which has graduation of 2,5 ml, 5 ml. The maximum duration of treatment without consultation of the doctor - 3 days at a hyperthermia and 5 days - at a pain syndrome.

Features of use:

It is not necessary to exceed the recommended dose. If symptoms of a disease remain or worsen, it is necessary to consult surely with the doctor.
With care appoint to patients with an abnormal liver function and kidneys, with a high-quality hyperbilirubinemia and at a diabetes mellitus.
It is not recommended to apply along with other drugs containing paracetamol through a possibility of overdose.
Administration of drug can influence results of analyses of uric acid (method of use of phosphatotungstic acid) and glucose in blood (oxidases-peroksidaznym by method). Drug can cause insignificant laxative effect.
Drug is intended for use for children aged from 2 months.

Side effects:

As well as other medicines, Paratsetamol-Vishfa can cause side effects of varying severity.
- Allergic reactions: skin itch, erythematic enanthesis and mucous membranes, Quincke's disease, multiformny exudative erythema (including Stephens-Johnson's syndrome), toxic epidermal necrolysis (Lyell's disease);
- From TsNS (usually develops at reception of high doses): dizziness, psychomotor initiation and disturbance of orientation;
- From the alimentary system: nausea, pain in epigastriums, increase in activity of "hepatic" enzymes in blood serum, as a rule, without development of jaundice, гепатонекроз (dozozavisimy effect);
- From endocrine system: a hypoglycemia, up to a hypoglycemic coma;
- From bodies of a hemopoiesis: anemia, sulfhemoglobinemia and methemoglobinemia (cyanosis, short wind, heartache), hemolitic anemia. At prolonged use in the doses exceeding therapeutic - aplastic anemia, a pancytopenia, an agranulocytosis, a neutropenia, a leukopenia, thrombocytopenia;
- From an urinary system (at reception of high doses): nephrotoxic action (renal colic, intersticial nephrite, papillary necrosis).
In case of any side effects it is necessary to stop drug use immediately.

Interaction with other medicines:

At the patients accepting Phenytoinum, rifampicin, barbiturates and tricyclic antidepressants, alcohol increase in an elimination half-life of paracetamol and increase in risk of a hepatotoxic action is possible. Paracetamol reduces efficiency of diuretics. Increases effect of indirect anticoagulants. Increases toxicity of levomycetinum. Inhibitors of a microsomal oxidation (including Cimetidinum) reduce risk of a hepatotoxic action of paracetamol.
Metoclopramidum and домперидон is increased, and Colestyraminum reduces paracetamol absorption speed.
Simultaneous use of high doses of paracetamol with an isoniazid increases risk of development of a hepatotoxic syndrome. Simultaneous use of paracetamol with hepatotoxic means increases toxic impact on a liver.
Prolonged combined use of NPVP increases risk of development of an analgetic nephropathy and renal papillary necrosis, approach of an end-stage of a renal failure.
At simultaneous use of any other means it is necessary to tell the doctor.

Contraindications:

Hypersensitivity to drug components. A liver and renal failure, an inborn hyperbilirubinemia (Gilbert's syndrome, the Cudgel Johnson, the Rotor), rare hereditary intolerance of fructose (deficit glyukozo-6-fosfatdegidrogenazy), blood diseases (the expressed anemia, a leukopenia). Age up to 2 months.

Overdose:

In case of overdose kliniko-biochemical signs of damage of a liver are shown in 12 - 24 hours. Biochemical signs: increase in activity of dehydrogenases, liver transaminases, increase in concentration of bilirubin, decrease in level of a prothrombin. Clinical symptoms: anorexia, nausea, vomiting, abdominal pain, pallor of integuments, hepatocellular insufficiency, liver necrosis, metabolic acidosis, encephalopathy, cardiac arrhythmia and pancreatitis. Damage of a liver is possible at adults who accepted 10 g and more paracetamol, and at children who accepted more than 150 mg/kg.

Treatment: urgent hospitalization, gastric lavage, provoking of vomiting, reception of absorbent carbon, introduction of N-Acetylcysteinum intravenously or methionine orally, symptomatic therapy.

Storage conditions:

To store at a temperature up to 25 °C in the place, unavailable to children.

Issue conditions:

Without recipe

Packaging:

On 60 ml or on 90 ml in bank with dosing a glass in a pack.