Kopatsil

General characteristics. Structure:

Acting a veshchestva:kislota acetilsalicylic, paracetamol, caffeine;

1 tablet contains acetylsalicylic acid, in terms of 100% veshchestvo300 mg, paracetamol,  in terms of 100% substance of 100 mg, caffeine, in terms of 100% substance of 50 mg;

colloid anhydrous, talc, calcium stearate vspomogatelnyeveshchestva:krakhmat potato, sodium of a kroskarmeloz, a gipromeloz, silicon dioxide.

Pharmacological properties:

Kopatsil – the combined drug which renders the anesthetizing, febrifugal and antiinflammatory effects due to oppression of synthesis of prostaglandins. Components of drug exponentiate action of each other. Acetylsalicylic acid moderately oppresses aggregation of thrombocytes, improves microcirculation in the inflammation center. Caffeine excitingly influences the central nervous system, activates the respiratory and vascular and motive centers, increases heart rate, normalizes a tone of vessels of a brain. The therapeutic effect of drug occurs in 30-60 min. after intake, the dostigayetmaksimuma through 2-2,5 chasa lasts a 3-4chasa.

Indications to use:

The weak or moderately expressed pain syndrome; head and dentagra, migraine, neuralgia, premenstrual syndrome, rheumatic pain, sciatica, lumbago, muscle pain; as an antipyretic at the diseases of various etiology which are followed by fever.

Route of administration and doses:

Kopatsil apply inside after food. To adults and children   16 years on 1-2 tablets 2-3 times a day with an interval between receptions not less than 4 hours are more senior. The maximum daily dose – 8 tablets. The course of treatment depends on efficiency of therapy and, as a rule, does not exceed 7 days.

Features of use:

Use during pregnancy or feeding by a breast. Not to apply.

Ability to influence speed of response at control of motor transport or work with other mechanisms. Data are absent.

Children. Drug is not used to children aged up to 16 years (risk of development of a syndrome to Reja whose sign can be ongoing vomiting).

Side effects:

Allergic reactions: skin rash (as a rule, erythematic, small tortoiseshell), itch, Quincke's disease, multiformny exudative erythema (including Stephens-Johnson's syndrome), toxic epidermal necrolysis, not cardiogenic fluid lungs, bronchospasm, asthma.

From a digestive trakta:bol in a stomach, nausea, vomiting; at frequent or prolonged use of drug ulcer and hemorrhagic damages of a mucous membrane of a stomach and duodenum are possible.

From outside to a gepatobiliarny sistemy:povyshenia of activity of "hepatic" enzymes, as a rule, without development of jaundice, гепатонекроз (dozozavisimy effect).

From endocrine system: a hypoglycemia, up to a hypoglycemic coma.

From system of a hemopoiesis: sulfhemoglobinemia and methemoglobinemia (cyanosis, short wind, heartaches), hemolitic anemia, thrombocytopenia, agranulocytosis.

From cardiovascular system: slight short-term increase of arterial pressure, tachycardia, arrhythmia.

From the central nervous system: dizziness, sleeplessness, concern.

The acetylsalicylic acid which is a part of drug increases risk of development of bleedings which can lead to acute and chronic posthemorrhagic anemia.

Interaction with other medicines:

Contraindicated simultaneous use with inhibitors of a monoaminooxidase (MAO) and for 2 weeks after the end of their use, with tricyclic antidepressants, beta-blockers, with a methotrexate in doses of 15 mg/week or more. Kopatsil strengthens side effect of a methotrexate (gematotoksichesky effect), corticosteroids (risk of development of gastrointestinal bleeding). The system glucocorticosteroids which are applied in replacement therapy at Addison's disease (except a hydrocortisone), reduce the level of acetylsalicylic acid in blood owing to what after cancellation of glucocorticoids the risk of overdose by salicylates increases.

Kopatsil it is not necessary to apply along with other non-steroidal anti-inflammatory drugs (ibuprofen) and the drugs containing paracetamol in connection with strengthening of side effects; santikoagulyantami – because of risk of developing of bleeding.

Metoclopramidum, домперидон strengthen, and холестерамин reduces paracetamol absorption.

Kopatsil strengthens toxic action of anticonvulsants, an isoniazid, rifampicin, and also other hepatotoxic medicines, increases toxicity of levomycetinum. Barbiturates reduce febrifugal effect of Kopatsil.

Kopatsil reduces efficiency of antihypertensives, diuretics (Spironolactonum, furosemide), antigouty drugs, strengthens hypoglycemic effect of peroral anti-diabetic drugs. Kopatsil reduces efficiency of uricosuric medicines (бензобромарон, пробенецид), increases plasma concentration of digoxin.

Cimetidinum, hormonal contraceptives strengthen effect of caffeine. Caffeine strengthens effect of ergotamine; increases thyroid effect of thyritropic means; reduces concentration of lithium in blood; exponentiates effect of derivatives of xanthine, a-and β-adrenomimetik, psychogogic means; reduces effect of opioid analgetics, anxiolytics, hypnotic drugs and sedatives. Caffeine is an antagonist of anesthetics and other drugs, the oppressing TsNS, the competitive antagonist of drugs of adenosine, ATP.

Contraindications:

Hypersensitivity to drug components, a peptic ulcer of a stomach and duodenum; the lowered coagulability of blood, hemophilia, hemorrhagic diathesis, anemia, a leukopenia, an inborn hyperbilirubinemia; the bronchial asthma in the anamnesis caused by use of salicylates or substances of similar action (especially non-steroidal anti-inflammatory drugs); heavy atherosclerosis, severe forms of a diabetes mellitus, closed-angle glaucoma, epilepsy, hyperthyroidism; disturbance of cordial conductivity, coronary heart disease, heavy heart failure; heavy liver or renal failure; alcoholism; deficit glyukozo-6-fosfatdegidrogenazy; children's age up to 16 years; pregnancy, feeding period breast.

Appropriate security measures at use. Due to the existence in composition of drug of caffeine Kopatsil is not recommended to apply at a hyperexcitability, sleeplessness, the patient with arterial hypertension, with a prostatauxe, to patients of advanced age. Drug with care and on condition of constant observation of the doctor is appointed the patient with gout, a diabetes mellitus, at insufficiency of function of a liver (especially at patients with alcoholic hepatitis) and kidneys, at dehydration. When performing long therapy or at use of drug in high doses  observation  of the doctor  and  control  of  system  of coagulability  of blood, level of hemoglobin, urea, determination of quantity of thrombocytes in blood, the analysis a calla on the occult blood is necessary. Paracetamol can influence results of laboratory researches of content of glucose in blood.

During treatment it is not necessary to take alcohol.

Overdose:

Symptoms at overdose of easy degree: pallor of skin, perspiration, a sonitus, dizziness, a headache, decrease in visual acuity and hearing (especially at patients of advanced age), nausea, vomiting, an abdominal pain, anorexia, allergic reactions.

Symptoms at overdose of heavy degree: consciousness disturbance, oppression TsNS, an asthma, suffocation, the accelerated breath, a hyperthermia, dehydration, gastrointestinal bleeding, jaundice, pancreatitis, гепатонекроз, disturbance of hemocoagulation, disturbance of carbohydrate metabolism, a collapse, a hypoglycemia, the nephrotoxic phenomena (including intersticial nephrite, a papillary necrosis, renal colic, a renal failure), a liver failure up to development of toxic encephalopathy, in some cases – a coma. 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 of body weight. Hemopoiesis oppression (aplastic anemia, a pancytopenia, an agranulocytosis, a neutropenia, a leukopenia) is possible.

The overdose caused by caffeine: psychomotor excitement, concern, drowsiness, muscular contractions, tremor, spasms, premature ventricular contraction, tachycardia, arrhythmias. Datas of laboratory: alkali reaction of urine, metabolic acidosis, hamaturia, proteinuria, respiratory alkalosis, hypopotassemia, hyponatremia, thrombocytopenia, increase in a prothrombin ratio, increase in activity of hepatic transaminases, glucose metabolism disturbance.

Lecheniye:promyvaniye of a stomach, purpose of absorbent carbon, an artificial diuresis, in hard cases – a hemodialysis, infusional administration of solutions of electrolytes (Natrii hydrocarbonas, sodium of citrate or sodium of a lactate).

Storage conditions:

Period of validity 3 years. To store in an originalnoyupakovka, at a temperature not above 25 °C. To store in the place, unavailable to children.

Issue conditions:

Without recipe

Packaging:

On 6 or 10 tablets in the blister; 10 tablets in the blister, 2 blisters in a pack.