Milistan is multisimptomny

General characteristics. Structure:

Active ingredients: 325 mg of paracetamol, 10 mg of a tsetirizin of a hydrochloride, 2 mg of chlorpheniramine of a maleate, 15 mg of dextromethorphan of hydrobromide.

Excipients: cellulose microcrystallic, starch, methylparaben, propylparaben, magnesium the stearate, talc purified of silicon dioxide colloid, sodium lauryl sulfate, sodium krakhmalglikolit, a gidroksimetilpropiltsellyuloza, polyethyleneglycol 4000, propylene glycol, titanium dioxide, water.

The effective drug intended for treatment of all symptoms of cold and flu.

Pharmacological properties:

Pharmacodynamics. Paracetamol has analgetic, febrifugal and weak antiinflammatory action. The action mechanism connected with inhibition of synthesis of prostaglandins and it is preferential influence on the center of thermal control in a hypothalamus.

Tsetirizina a hydrochloride - the selection antagonist of peripheral H1 - histamine receptors, Hydroxyzinum metabolite. Possesses antiallergic properties thanks to inhibition of a late phase of migration of cells which participate in inflammatory reaction (preferential eosinophils); also reduces an expression of molecules of adhesion, such as ICAM-1 and VCAM-1 which are markers allergic an inflammation. Suppresses action of other mediators and inductors of secretion of a histamine, such as PAF (тромбоцитактивируюй a factor) and substance P. Practically does not render anticholinergic and antiserotoninovy effects. In therapeutic doses has no sedative action.

Dextromethorphan hydrobromide – antibechic drug, effective at unproductive bronchial cough which arises through irritations of bronchial tubes on cold or at breath. The action mechanism connected with influence on the center of cough in a myelencephalon.

Chlorpheniramine a maleate – antiallergic drug, a blocker histamine H1 receptors. Has moderately expressed sedation.

Pharmacokinetics. Absorption. After internal use drug quickly and almost is completely soaked up from a digestive tract.

Administration of drug along with food does not influence absorption, but slightly reduces speed.

Distribution. Paracetamol is well distributed in fabrics (except for fatty tissue) and cerebrospinal fluid. Linkng of paracetamol with proteins of a blood plasma makes about 10% and slightly increases at overdose. Tsetirizin is also capable to contact proteins of a blood plasma. The low volume of distribution possesses (Vd – 0, 5 l/kg), does not get in a cell.

Metabolism. Paracetamol is metabolized preferential in a liver by conjugation with a glucuronide, sulfate and oxidation with participation of the mixed oxidases of a liver and P450 cytochrome. Tsetirizin in a liver is practically not metabolized. Dextromethorphan hydrobromide quickly and almost is completely metabolized in a liver to an active metabolite to a dekstrorfan.

Removal. The elimination half-life of paracetamol makes 1-3 hour. At patients with cirrhosis the elimination half-life lasts. The renal clearance of paracetamol makes 5%. It is removed with urine, generally in the form of glyukuronidny and sulphatic conjugates. Less than 5% are removed in the form of not changed paracetamol. Drug is capable is removed with breast milk. After single internal use of a tsetirizin of a hydrochloride the period of its semi-removal makes approximately the 10th hour. The elimination half-life of dextromethorphan of hydrobromide makes approximately the 4th hour, drug is removed through kidneys in not changed state and in the form of demetilirovanny metabolites (including декстрорфан). Active ingredients of drug get through a placenta and are emitted with breast milk.

Indications to use:

The symptomatic treatment of flu and other acute respiratory and viral infections which are followed by fervescence, muscle and joints pain, a headache, nose laying, cold, dacryagogues; the pollinosis, allergic rhinitis and other allergic diseases of upper respiratory tracts which are followed by the above symptoms; a pain syndrome of small and medium intensity of different genesis (the main, a dentagra, migraine, neuralgia, a mialgiya, a menalgiya, pain at injuries, burns), a diarrhea at infectious and inflammatory diseases.

Route of administration and doses:

The dose is established individually. At treatment of adults and children age 12 years are more senior use drug inside on 1 kapleta (the maximum single dose – 2 kapleta). Frequency rate of use - to 4 times a day. The maximum daily dose – 8 kaplt. The maximum duration of treatment – 5-7 days.

The patient with moderately expressed or severe form of a renal failure drug is appointed in a half dose.

Dose adjustment is not necessary for patients of advanced age with normal function of kidneys.

Features of use:

Pregnancy and lactation. Drug use Milistan multisimptomny during pregnancy perhaps only when the predicted advantage for mother exceeds potential risk for a fruit. It is desirable to abstain from use of drug in the period of a lactation, or it is necessary to resolve an issue about feeding suspension by a breast (drug is capable to get into breast milk).

Carefully apply in treatment of patients with an abnormal liver function, a digestive tract and kidneys, with a high-quality hyperbilirubinemia, closed-angle glaucoma, a prostatauxe, epilepsy, an ischuria, a serious cardiovascular illness, a diabetes mellitus, bronchial asthma, productive cough, and also patients of advanced age. At prolonged use of drug necessary control of peripheral blood and a functional condition of a liver (1 times for 10 days).

During use of drug it is necessary to avoid control of vehicles, works with mechanisms and other potentially unsafe types of activity.

During use of drug it is impossible to take alcohol!

Side effects:

Very seldom, as a rule owing to long use of large doses, drowsiness, a sleep disorder, a hyperexcitability, pain in epigastric area, nausea, toxic influence on a liver can be observed (are caused by paracetamol); skin itch, enanthesis, Quincke's edema, anemia, thrombocytopenia; dryness in a mouth, difficulty urination, accommodation disturbance, increase in intraocular pressure (are caused by cholinolytic effect of chlorpheniramine).

Interaction with other medicines:

At simultaneous use with barbiturates, anticonvulsants, rifampicin, and also at alcohol intake the risk of a hepatotoxic action considerably increases.

At combined use of Milistan of Multisimptomny with Metoclopramidum increase in absorption of paracetamol is possible.

At simultaneous use of Milistan of Multisimptomny and derivatives of coumarin development of an insignificant prothrombinopenia is possible.

Caffeine can exponentiate the anesthetizing effect of paracetamol.

Contraindications:

Hypersensitivity to drug components, an alcoholism, the expressed abnormal liver functions and/or kidneys, deficit of enzyme glyukozo-6-fosfatdegidrogenazy, a blood disease, children's age up to 12 years, pregnancy, the feeding period a breast.

Overdose:

Symptoms: sleep disorder, itch, rashes, delays mochevyvedeniye, fatigue, tremor, tachycardia.

Treatment: carry out symptomatic therapy. The hemodialysis is inefficient.

Storage conditions:

To store at the room temperature, in protected from light and the place, unavailable to children. A period of storage – 3 years.

Issue conditions:

Without recipe

Packaging:

On 12 kaplt in a blister strip packaging, on 1 strip packaging in a cardboard pack together with the application instruction.