АнГриМакс

General characteristics. Structure:

Active ingredients: 180 mg of paracetamol, 25 mg of Remantadinum of a hydrochloride, 150 mg of ascorbic acid, 1,5 mg of a loratadin, 10 mg of Rutinum, 11,2 mg of calcium of a carbonate.

Excipients: calcium stearate, potato starch, lactose.

Structure of a cover of a gelatin capsule: gelatin, глицерол, methylparahydroxybenzoate (E218), пропилпарагидроксибензоат (E216), water cleared, titanium dioxide (E171), sodium lauryl sulfate, dye quinolinic yellow (E104), dye diamond blue (E133), dye a sunset yellow (E110).

The drug rendering the antiviral, interferonogenny, febrifugal, antiinflammatory, anesthetizing, antihistaminic, angioprotektorny action.

Pharmacological properties:

Pharmacodynamics. 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 TsOG1 and TsOG2 preferential in TsNS. 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 a GIT.

Remantadinum – 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 (after penetration of a virus into a cell and to an initial transcription of RNA); 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. Remantadinum 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 Pg, etc. mediators of an inflammation and allergic reactions oppresses.

Loratadin – a highly active blocker histamine H1 receptors of long action. Suppresses release of a histamine and C4 leukotriene from mast cells. Possesses antiallergic, antipruritic, antiexudative action. Reduces permeability of capillaries, edematization of fabrics warns, removes spasms of smooth muscles.

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.

Rutinum is a vasoprotective. Prevents development of a hyperpermeability and fragility of the vessels causing hemorrhagic processes at flu and also recovers microcirculation. Rutinum together with ascorbic acid participates in oxidation-reduction processes, has antioxidant properties, prevents oxidation and promotes deposition of ascorbic acid in fabrics. Both components strengthen a vascular wall (promote formation of intercellular substance and reduce activity of hyaluronidase), reduce permeability and fragility of capillaries.

Indications to use:

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

Route of administration and doses:

Inside, after food, washing down with water. To children 12 years and the adult – on 2 capsules 2-3 times a day to the current of 3-5 days are more senior at preservation of a feverish syndrome.

In the absence of improvement of health during administration of drug it is necessary to stop and see a doctor!

Features of use:

Use duration – no more than 5 days. At prolonged use (over 7 days) the exacerbation of chronic associated diseases is possible, at elderly patients with arterial hypertension the risk of development of a hemorrhagic stroke increases (at the expense of Remantadinum drug which is a part).

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.

During treatment it is necessary to refuse the use of alkogolsoderzhashchy drinks (increase in risk of gastrointestinal bleeding).

Patients have to abstain from the types of activity requiring special attention, bystry mental and motor reaction (drug contains Remantadinum).  

Side effects:

From TsNS: seldom – a headache, increased fatigue, a hyperexcitability, dizziness, a tremor, a hyperkinesia.

From a GIT: lasting reception more than 7 days are possible injuries of a mucous membrane of a stomach and a duodenum, 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 previously consult with the doctor.

Paracetamol and ascorbic acid lower Cmax of Remantadinum by 11 and 10% respectively. Cimetidinum reduces clearance of Remantadinum by 18%.

Paracetamol reduces efficiency of uricosuric HP. Inductors of a microsomal oxidation in a liver (Phenytoinum, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase products of hydroxylated active metabolites that causes a possibility of development of heavy intoxications even at small overdose. Long 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. Long sharing of paracetamol, etc. NPVP increases risk of development of an "analgetic" nephropathy and renal papillary necrosis, approach of an end-stage of a renal failure. Diflunisal increases plasma concentration of paracetamol for 50% - risk of development of a hepatotoxic. Myelotoxic medicines strengthen manifestations of a gematotoksichnost of drug.

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 reasorbtion of amphetamine and tricyclic antidepressants.

CYP3A4 inhibitors (including кетоконазол, erythromycin), CYP3A4 and CYP2D6 inhibitors (Cimetidinum, etc.) increase concentration of a loratadin in blood. Inductors of a microsomal oxidation (Phenytoinum, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) reduce efficiency of a loratadin.

Contraindications:

- hypersensitivity to one or several components which are a part of drug;

- pregnancy and period of a lactation;

- children's age up to 12 years.

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.

Treatment: to cause an emetic reflex, a gastric lavage, reception of adsorbents, symptomatic therapy.

In case of overdose the patient has to see a doctor.

Storage conditions:

Drug should be stored in the unavailable to children, protected from moisture and light place at a temperature from 15 °C to 25 °C. A period of validity - 2 years.

Issue conditions:

Without recipe

Packaging:

On 10 capsules in a strip packaging, on 2 strip packagings in a cardboard box.