Flyukold

General characteristics. Structure:

Active ingredients: 125 mg of paracetamol, 2 mg of chlorpheniramine of a maleate.

Excipients: sorbitol (70% solution), aspartame, propylene glycol, polioksit 40 hydrogenated castor oil, glycerin, sodium carboxymethylcellulose, sodium ethylparaben, sodium propylparaben, sodium benzoate, dinatrium эдетат, citric acid, dye carmoisin, fragrance crimson, fragrance pink, the water purified.

Medicine for a symptomatic lechenya of flu and cold.

Indications to use:

The short-term symptomatic treatment of flu and cold, including fever and a fever, a headache, cold, sneezing and body pain at adults and children is more senior than 6 years.

Route of administration and doses:

Inside, to children at the age of 6 – 8 years – on 10 ml of syrup 4 times a day (each 6 h);  9 - 16 years – on 10-20 ml of syrup 4 times a day (each 6 h); to children since 16 years and the adult - on  10 ml to 4-6 times a day.

The course of treatment at children should not exceed 3 days.

Syrup is recommended to be dosed by means of the enclosed measured spoon.

Features of use:

It is impossible to exceed the recommended doses or to accept medicine more than 7 days in a row.

It is necessary to consult with the doctor if symptoms:

1. Do not improve within 7 days;
2. Are followed by fever which keeps more than 3 days;
3. Including a pharyngalgia which does not pass more than 3 days, are followed by fever, a headache, rashes, nausea or vomiting.

It is necessary to avoid simultaneous use of other medicines containing paracetamol.

It is necessary to consult surely with the doctor before accepting it HP at patients with the following states:

■ Hypertension;
■ Cardiovascular diseases;
■ Diabetes;
■ Hyperthyroidism;
■ increase in intraocular pressure (i.e. glaucoma);
■ Pheochromocytoma;
■ Increase in a prostate;
■ Obliterating endarteritis (for example, Reynaud's phenomenon);
■ Epilepsy;
■ Bronchitis;
■ Bronchietasia;
■ Bronchial asthma;
■ Disease of a liver and kidneys.

Pregnancy. Flyukold during pregnancy contraindicated. As gets through a placental barrier.

Lactation. Flyukold it is impossible to accept during feeding by a breast. As gets into breast milk.

Influence on control of motor transport. During treatment it is not recommended to manage motor transport and to work with the difficult mechanisms demanding the increased concentration of attention.

Use for children. - it is contraindicated to children up to 6 years; to children from 6 to 12 years - Apply on doctor's orders. Children are more inclined to test neurologic anticholinergic effects and paradoxical excitement (for example, uveliyecheny energy, concern, nervousness).

Side effects:

Paracetamol.

- Allergic reactions, skin rash, small tortoiseshell, Quincke's disease; - A hepatotoxic action at long use in a dose over 4000 mg/days;
- Nausea, pain in epigastriums;
- Hemolitic and aplastic anemia, thrombocytopenia, agranulocytosis, pancytopenia, methemoglobinemia;
- Nephrotoxic action in the form of renal colic, an aseptic pyuria, intersticial nephrite, a papillary necrosis;
- Lowering of arterial pressure, hypoglycemia, диспноэ, vasculitis.

Chlorpheniramine.

- Dizziness;
- Drowsiness; 
- A disorientation in space; 
- Spasms; 
- Faints; 
- Unpleasant feelings at an urination are possible; 
- Dryness in a mouth, in a nose or in a drink;
- Also there can be a hypererethism, nervousness and even nightmares.

Interaction with other medicines:

 At use of medicine it is not recommended to take alcoholic beverages as alcohol at a concomitant use of paracetamol can cause an abnormal liver function.

Chlorpheniramine can strengthen effect of alcohol therefore it is necessary to avoid simultaneous use.

It is necessary to be careful at patients with disturbance of kidneys and at patients with a liver failure because in given HP paracetamol and хлорфенерамин contains, increasing risk paracetamol of the connected injuries of a liver.

Patients who were diagnosed with a liver or renal failure have to see a doctor before accepting this medicine.

Simultaneous use with drugs which cause sedation such as tranquilizers and hypnotic drugs, can lead to increase in sedation therefore it is necessary to see a doctor before accepting chlorpheniramine along with these medicines.

Medicine should not be used with other antihistamines.

Elderly people test neurologic anticholinergic effects and paradoxical excitement more often (for example, increase in energy, concern, nervousness). If symptoms remain, it is necessary to see a doctor.

Interaction paracetamol.

Coumarins (including warfarin) - the anticoagulating effect can be strengthened at long, regular, daily use paracetamol - the containing drugs with the increased risk of bleedings. The dose decline of anticoagulants can be required if treatment paracetamol - the containing drugs is necessary.

Substances which increase a stomach emptying (for example, Metoclopramidum) - increase paracetamol absorption.

The substances reducing gastric emptying (for example, пропантелин, antideprisant with anticholinergic properties, narcotic analgetics) - reduce paracetamol absorption.

Chloramphenicol (levomycetinum) - concentration of paracetamol can be increased.

Potentially hepatotoxic drugs or means which cause induction of microsomal enzymes of a liver (for example, alcohol, anticonvulsant drugs) - the risk of toxicity of paracetamol increases.

Probenetsid - can influence release of paracetamol and ikhmenit concentration of paracetamol of plasma.

Colestyraminum - reduces paracetamol absorption if it is given within one hour to or after paracetamol.

Interaction chlorpheniramine.

MAO inhibitors - these substances strengthen anticholinergic effects of chlorpheniramine.

Hypnotic drugs - simultaneous use with chlorpheniramine increases drowsiness.

Anxiolytics - simultaneous use with chlorpheniramine increases drowsiness.

Alcohol - simultaneous use with chlorpheniramine increases drowsiness.

Phenytoinum - chlorpheniramine slows down metabolism of Phenytoinum that can result in toxicity of Phenytoinum.

Contraindications:

- Hypersensitivity to drug components (allergic reactions);
- Heavy cardiovascular, liver or renal failure;
- Inborn hyperbilirubinemia;
- Arterial hypertension (raised by the ABP);
- Pheochromocytoma;
- Thyrotoxicosis; 
- Prostate adenoma;
- Obstruction of a neck of a bladder;
- Blood diseases;
- Piloroduodenalny obstruction;
- Stenosal stomach ulcer and duodenum;
- Diabetes mellitus;
- Diseases of lungs (including bronchial asthma);
- Glaucoma;
- Deficit glucose-6-fosfatdegidrogenazy;
- Epilepsy;
- Alcoholism;
- Accompanying treatment by MAO inhibitors and within 2 weeks after the termination of their reception.

Overdose:

Paracetamol. Arises at reception of paracetamol in a dose over 10 g/days (or children have more than 140 mg/kg/days). At patients with alcoholism, hepatitis toxic effect of paracetamol can be shown even at its use in a dose of 2,5 - 4,0 g/days.

Symptoms: intoxication proceeds in 3 stages. the 1st stage proceeds 12 – 24 h and is characterized by the dispepsichesky phenomena, symptoms of irritation of digestive tract, nausea, vomiting, perspiration. the 2nd stage proceeds 2 – 3 days and is characterized by nausea, vomiting, increase in level of transaminases, bilirubin, increase in a prothrombin ratio to 2,0 – 2,5. the 3rd stage is observed at 20% of persons with intoxication and 3 – 5 days proceed. It is characterized by the deep progressing necrosis of hepatocytes, nausea, pernicious vomiting, jaundice, sharp povysheny transaminases, bilirubin, increase in a prothrombin ratio more than 2,5. There are symptoms of a liver failure, a hypoglycemia, encephalopathy, a stupor. The renal failure and a myocardial dystrophy develops.

Treatment includes medicine cancellation, a gastric lavage with absorbent carbon and purpose of salt laxatives for prevention of absorption of medicine in a stomach and intestines. Intravenously begin administration of glucose (5 – 10% solution of 200 - 400 ml). Enter a specific antidote - N-Acetylcysteinum (recovers reserves of glutathione and eliminates its deficit, at the same time the toxic metabolite of paracetamol is neutralized). 20% apply solution of N-Acetylcysteinum intravenously and inside: the first dose of 140 mg/kg (0,7 ml/kg), then on 70 mg/kg (0,35 ml/kg). In total enter 17 doses. The most effective is the treatment begun in the first 10 hours after development of intoxication. If from the moment of intoxication there passed more than 36 hours treatment is inefficient. At increase in a prothrombin ratio more than 1,5 apply K1 vitamin (phytomenadionum) of 1 - 10 mg; at increase in a prothrombin ratio more than 3,0 it is necessary to begin injection of native plasma or a concentrate of factors of coagulation (1 – 2 units).

At treatment of intoxication carrying out an artificial diuresis, hemodialysis is contraindicated. It is inadmissible to use antihistamines and glucocorticosteroids.

Chlorpheniramine. Symptoms. The overdose is shown by strengthening of side effects.

Treatment. At emergence of the first signs of overdose it is necessary to stop administration of drug and to wash out a stomach by means of the thick probe. The doctor has to estimate the patient's condition.

Storage conditions:

In the place protected from light and moisture at a temperature not above 25 °C. To store the opened bottle no more than 10 days. To store in the place, unavailable to children. Before the use it is good to shake up. Period of validity 3 years. Not to use after the expiry date specified on packaging.

Issue conditions:

Without recipe

Packaging:

Syrup on 100 ml in bottles from polyethyleneterephthalate with the screwing-up traffic jams from polyethylene of the low pressure intended for contact with foodstuff, with a ring of control of the first opening. Bottles together with a leaf insert and a measured spoon pack into a cardboard pack.