Kombigripp of a deks

General characteristics. Structure:

Active ingredients: 500 mg of paracetamol, 30 mg of caffeine, 10 mg of Phenylephrinum of a hydrochloride, 2 mg of chlorpheniramine of a maleate, 10 mg of dextromethorphan of hydrobromide.

Excipients: starch corn, cellulose microcrystallic, methylhydroxybenzoate, пропилгидроксибензоат, povidone (PVPK-30), magnesium stearate, talc, sodium krakhmalglikolit, tartrazine, diamond blue

It is applied to treatment of simtom of flu and cold with symptoms of cough and high temperature, since 12 years.

Pharmacological properties:

Pharmacodynamics. Paracetamol works as the anesthetizing and febrifugal drug. Analgetichesky and febrifugal effect of paracetamol is connected with influence of drug on the center of thermal control in a hypothalamus and ability to inhibit synthesis of prostaglandins.

Caffeine – the central stimulator of a nervous system. Stimulates a respiratory center which increases the speed and depth of saturation of lungs oxygen, increases a tone of skeletal muscles, reduces a hypercapnia threshold. Its dose which is about 40% higher, than one dose in association with caffeine is necessary for emergence of the same reaction from analgesic means without caffeine. Thus, caffeine is applied as an adyuvant of paracetamol.

Phenylephrinum the hydrochloride stimulates postsynaptic alpha adrenoceptors it narrows pulmonary vessels and increases pulmonary pressure. As the vasoconstrictor carries out antikongestivny action: reduces hypostasis and a hyperemia of a mucous membrane of a nose, expressiveness of exudative manifestations, renews free breath.

Chlorpheniramine the maleate is _{H1 blocker} which detains reaction of smooth muscles to a histamine. He shows antiallergic action, reduces dacryagogue, an itch in a nose.

Dextromethorphan hydrobromide is antitussive of the central action. It suppresses the kashlevy center, directly affecting it and raising a threshold of the tussive center to the irritating agents.

Pharmacokinetics. Paracetamol is quickly soaked up from digestive tract, contacts proteins of plasma. Plasma elimination half-life makes 1 – 4 hour. It is metabolized in a liver with formations of a glucuronide and sulfate of paracetamol. It is removed by kidneys generally in the form of products of conjugation, less than 5% are excreted in an invariable look.

Caffeine and its water soluble salts are quickly soaked up in intestines (including in thick). Plasma elimination half-life makes near the 5th hour, in some persons – to the 10th hour. The main part demetilirutsya and oxidized. About 10% are removed by kidneys in an invariable look. In an organism of the full-term newborns and babies (1,5 – 2 months) it is removed more slowly (_T1/2 – from 80 to 26,3 hour, respectively).

Phenylephrinum the hydrochloride has low bioavailability owing to uneven absorption and influence of a monoaminooxidase in digestive tract and a liver at "the first passing". It is removed by kidneys in the form of metabolites. Acidulation of urine accelerates removal from an organism.

Chlorpheniramine the maleate is a component which reduces characteristic effects of histamines that is especially important in the prevention and simplification of many allergic symptoms. It is soaked up rather slowly in digestive tract, the maximum concentration in plasma is reached from 2,5 to 6 hour after use orally. Bioavailability low also makes from 25% to 50% of the used quantity. Chlorpheniramine gives in metabolism at "the first passing" in a liver. Chlorpheniramine the maleate is considerably metabolized in a liver with formations of metabolites dezmetit and дидезметилхлорфенирамд. Its about 70% contacts in plasma proteins. Chlorpheniramine is distributed on all body, passes through a blood-brain barrier.

Chlorpheniramine the maleate is considerably metabolized in a liver. Metabolites include dezmetit and дидезметилхлорфенирамд. A component in an invariable look and metabolites are removed, generally by urine; removal depends from рН urine and degree allocation. Only traces are revealed in Calais. Duration of action makes from 4 to 6 hour. More bystry and extensive absorption, more bystry removal and shorter elimination half-life were noted at children.

Dextromethorphan hydrobromide is quickly soaked up in digestive tract. It is metabolized in a liver and removed with urine as dextromethorphan in an invariable look and in the form of demetilizovany metabolites, including дэкстрорфан which suppresses cough.

The period semi-removal of dextromethorphan of hydrobromide makes the 4th hour.

Indications to use:

Treatment of symptoms of flu and SARS (hyperthermia, headache, cold, cough) at adults and children age is more senior than 12 years.

Route of administration and doses:

To adults and children of the senior 12 years – 1 tablet of Kombigripp Deks 4 times a day are not more often than in 3 – 4 hour.

Drug is used at least in half an hour after reception of food.

Duration of treatment is no more than 7 days.

Features of use:

Before Kombigripp Deks's appointment it is very important to be convinced that the main reason for cough is established and that decrease in intensity of cough will not increase risk of clinical or physiological complications.

Drug can reduce mental and/or physical abilities which need when performing potentially unsafe tasks, such as driving of vehicles or work with mechanisms. Fenilefrin can cause increase in pulse, dizziness or strong heartbeat; patients, respectively, have to be warned about it.

Drug it is not recommended to pregnant women.

Influence of drug when feeding by a breast it was not studied.

With care to apply at liver diseases, alcoholism.

During treatment to exclude alcohol intake.

Side effects:

Agranulocytosis, thrombocytopenia, anemia, renal colic, aseptic Piraeus, an intersticial glomerulonephritis, allergic reactions in the form of skin rashes. Sleeplessness, drowsiness, dizziness, consciousness misting, tachycardia, arrhythmia, increase in arterial pressure, nausea, vomiting, a loss of appetite, diarrhea, a konstipation, epigastric pains, the general weakness, the strengthened sweating, a hypoglycemia, lepressivny manifestations, a headache, a sonitus are also possible concern, excitement. Developing of renal colic and disturbance of an urination is possible.

Interaction with other medicines:

If the combination therapy is provided, dosages of one or both means has to be are reduced.

Caffeine increases effect of indirect anticoagulants (coumarin derivatives) and probability of damage of a liver hepatotoxic drugs. Metoclopramidum raises, and холестирамин reduces absorption speed.

Caffeine reduces effect of hypnotic drugs and drugs, raises (improving bioavailability) – acetylsalicylic acid, paracetamol and other non-narcotic analgetik. Improves absorption of ergotamine in a digestive tract.

Use of Phenylephrinum with other sympathomimetic amines and MAO inhibitors can lead to additional increase in blood pressure. MAO inhibitors can prolong anticholinergic effect of antihistamines. Alpha adrenoblockers (phentolamine), fenotiazin, furosemide and other diuretics interferes with vasoconstriction.

The bull it is noted incompatibility of chlorpheniramine of a maleate with Calcii chloridum, Kanamycinum by sulfate, noradrenaline, phenobarbital.

The hydrobromide dextromethorphan use with inhibitors of enzymes, including Amiodaronum, fluoxetine, a haloperidol, пароксетин, пропафенон and thioridazine, can influence mental capacities.

Contraindications:

Hypersensitivity to any component of drug.

Heavy abnormal liver functions and/or kidneys, an inborn hyperbilirubinemia, deficit glyukozo-6-fosfatdegidrogenazy, alcoholism, heavy arterial hypertension, unstable stenocardia, the acute period of a myocardial infarction, a hyperthyroidism, noncompensated heart failure, disturbance of cordial conductivity, acute pancreatitis, a prostatauxe, severe forms of a diabetes mellitus, glaucoma, the expressed anemia, a leukopenia.

Pregnancy and period of feeding by a breast.

Children's age up to 12 years.

Not to apply together with MAO inhibitors and within two weeks after phase-out of MAO inhibitors.

Overdose:

Signs and symptoms of overdose of separate components of Kombigripp can be distributed thus.

Paracetamol in large doses causes гепатонекроз. Clinical and biochemical signs of damage of a liver are found in 24 – 72 hour. To them belong: increase in activity of hepatic transaminases, increase in concentration of bilirubin and decrease in level to a prothrombin. Symptoms: anorexia, nausea, vomiting, abdominal pain, pallor skin to a cover.

The overdose of caffeine can cause a condition of alarm, concern, a tremor, a headache, misting of consciousness, premature ventricular contraction.

The overdose of Phenylephrinum of a hydrochloride is found ventricular premature ventricular contraction and short paroxysms of ventricular tachycardia, heavy feeling in the head and extremities, substantial increase of arterial pressure.

At maleate chlorpheniramine overdose the state can vary from suppressed to excited (concern and spasms). Atropinopodobny symptoms can be observed.

The overdose of dextromethorphan of a hydrochloride can entail excitement and mental disturbances. Very large doses can cause the suppressed breath.

The gastric lavage, introductions of N-Acetylcysteinum, symptomatic therapy appoint.

Storage conditions:

To store in the unavailable to children, protected from light place at a temperature below 30 °C.

Issue conditions:

Without recipe

Packaging:

On 8 tablets in the blister in cardboard packaging. On 10 packs in group cardboard packaging.