Kombigripp Hot Hoarsed

General characteristics. Structure:

Active ingredient of 1 sachet: 500 mg of paracetamol, 10 mg of Phenylephrinum of a hydrochloride, 10 mg of a tsetirizin of a hydrochloride.

Sachet excipients with lemon taste: silicon dioxide of koloidniya anhydrous, aspartame (Е 951), mannitol (E421), xanthane gum, Natrium benzoicum (E211), tartrazine (Е 102), fragrance lemon, sucrose.

Sachet excipients with crimson taste: silicon dioxide of koloidniya anhydrous, aspartame (Е 951), mannitol (E421), xanthane gum, Natrium benzoicum (E211), erythrosine (Е 127), fragrance crimson, sucrose.

It is applied for treatment of simtom of flu and cold, high temperature, since age of 12 years.

Pharmacological properties:

Pharmacodynamics. Kombigripp Hot Hoarsed – the combined drug possessing the expressed antipyretic, antiallergic and analgetic action. Kombigripp Hot the Vulture contains active components which, supplementing action of each other, quickly stop symptoms of acute respiratory diseases and flu.

Paracetamol renders the febrifugal, anesthetizing and poorly expressed antiinflammatory action. Paracetamol influences the center of thermal control in a hypothalamus owing to what there is a normalization of body temperature at patients to a hyperthermia. Paracetamol inhibits synthesis of prostaglandins and mediators of an inflammation (кинин, serotonin), reducing activity of enzyme of cyclooxygenase. The anesthetizing effect of paracetamol is implemented owing to oppression of generation and carrying out painful impulses on nervous structures.

Tsetirizina a hydrochloride - antihistamine of group of the selection antagonists of H1 receptors. Tsetirizina a hydrochloride interferes with development of the effects caused by a histamine due to competitive linkng with H1 - histamine receptors. Tsetirizina a hydrochloride also reduces migration of eosinophils and slows down release of mediators of an inflammation, without exerting the expressed impact on serotoninovy and cholinergic receptors.

Phenylephrinum the hydrochloride concerns to the selection α1-адреномиметикам. Fenilefrin has the expressed vasoconstrictive effect that promotes reduction of a rhinedema and volume of a nasal secret. At use of Phenylephrinum of a hydrochloride simplification of nasal breath at rhinitis of various etiology is noted.

Pharmacokinetics. Paracetamol is quickly soaked up from a digestive tract, the maximum concentration in a blood plasma is reached in 10-60 min. It is distributed in the majority of body tissues. At usual therapeutic concentration only an insignificant part of paracetamol contacts proteins of a blood plasma. Plasma elimination half-life of blood represents 1 - 3 hour. Paracetamol is metabolized mainly in a liver and removed by kidneys preferential in the form of glyukuronidny and sulphatic conjugates, less than 5% of a dose are allocated in not changed look.

Tsetirizina a hydrochloride is quickly soaked up from a digestive tract; at inclusion in food time absorption does not decrease, but can be slowed down a little. The maximum concentration in a blood plasma (about 0,3 mkg/ml) is reached in 30-60 min. after reception of 10 mg of a tsetirizin. The time elimination half-life at adults represents 6,7-10,7 hours, and at children - 6,1 - 7,1 hours. Tsetirizin is allocated preferential in not changed view with urine. At patients with easy or moderate renal failures the elimination half-life grows till 19 - 21 o'clock. About 90% of a tsetirizin contact proteins of a blood plasma.

Phenylephrinum the hydrochloride is easily soaked up after oral administration, however as a result of intensive presystem metabolism, is preferential in enterocytes, system bioavailability represents only 40%. The maximum concentration in a blood plasma is reached in 1-2 hours after reception. Plasma elimination half-life of blood represents 2-3 hours. After absorption Phenylephrinum biotransformirutsya intensively in a liver and is allocated with urine preferential in the form of metabolites, less than 20% of a dose are removed in not changed look.

Indications to use:

Kombigripp Hot the Vulture is applied as symptomatic means to therapy of the patients having acute respiratory viral infections, flu and allergic rhinitis. In particular Kombigripp Hot the Vulture appoint at such symptoms: the increased body temperature, a rhinedema, cold, a headache and a mialgiya.

Route of administration and doses:

Powder Kombigripp Hot the Vulture needs to be dissolved in a glass of hot water just before use. The received solution is accepted orally, irrespective of meal. Drug doses Kombigripp Hot Hoarsed and duration of therapy is determined by the doctor.

The recommended single dose of drug for adults and children is more senior than 12 years Kombigripp Hot the Vulture makes 1 sachet. Intervals between administrations of drug have to make not less than 4 hours.

The maximum recommended daily dose of drug Kombigripp Hot the Vulture makes 4 sachets.

The maximum duration of treatment - no more than 7 days.

Features of use:

During treatment by peroral solution Kombigripp Hot the Vulture is not recommended to drive the car or to work with potentially unsafe mechanisms

Pregnant women should not accept Kombigripp Hot the Vulture because safety of reception of paracetamol, a tsetirizin of a hydrochloride and Phenylephrinum during pregnancy is not established. Feeding by a breast should be stopped during treatment by drug Kombigripp Hot the Vulture as Phenylephrinum and paracetamol in a certain measure get into maternal milk.

Kombigripp Hot the Vulture patients should take with caution with a diabetes mellitus and closed-angle glaucoma, and also heavy disturbances in work of kidneys or a liver.

Paracetamol should be applied with care the patient with heavy abnormal liver functions or kidneys. The risk of overdose is much more at patients with not cirrhotic diseases of a liver caused by an alcohol abuse. It is not necessary to exceed the recommended doses and to accept other drugs which part paracetamol is.

Phenylephrinum can increase the arterial pressure therefore special care at drug use is necessary for patients who receive anti-hypertensive therapy, and also beta adrenoblockers.

Aspartame which is a source of phenylalanine which can be harmful to patients with a fenilketonuriya is a part of drug.

Patients with rare hereditary intolerance of fructose, a maltabsorbtsiy glyukozo-galactose or insufficiency of sucrose-isomaltase should not use drug.

Not to apply to children up to 12 years.

Side effects:

From vessels, heart and system of blood: changes of arterial pressure, heart consciousness, tachycardia, hypostases, methemoglobinemia, sulfhemoglobinemia, anemia (including hemolitic anemia).

From a nervous system: disturbance of concentration of attention, apathy, mental disturbances, dizziness, drowsiness, decrease in intellectual and physical working capacity, concern, emotional lability, decrease in visual acuity.

From gepatobiliarny system and a digestive tract: abdominal pain, nausea, vomiting, increase in activity of "hepatic" enzymes, jaundice, xerostomia.

Allergic reactions: urticaria, rash, erythema, skin itch, Quincke's disease, anaphylaxis, Lyell's disease, multiformny exudative erythema, bronchospasm.

Others: disturbance of an urination, ischuria, hypoglycemia.

Interaction with other medicines:

Kombigripp Hot the Vulture do not appoint combined with monoamine oxidase inhibitors and tricyclic antidepressants, and also within two weeks upon termination of treatment by monoamine oxidase inhibitors.

It is not recommended to use drug along with antipsychotic drugs, and also drugs for treatment of a disease of Parkinson.

Kombigripp Hot the Vulture it is not necessary to accept along with the drugs containing paracetamol or other substances of group of non-steroidal anti-inflammatory drugs.

Paracetamol at long use can strengthen effect of warfarin and other coumarinic anticoagulants.

Salicylamidum at the combined use increases a paracetamol elimination half-life.

Holestiramin at simultaneous use reduces efficiency of paracetamol Domperidon and Metoclopramidum at the combined use increase paracetamol absorption.

At the combined use of drug Kombigripp Hot the Vulture with inductors of enzymes of a liver (antiepileptic means, rifampicin and barbiturates) increases probability of development of toxic effects.

Paracetamol can increase a chloramphenicol elimination half-life to 5 times.

The hepatotoxic action of paracetamol amplifies at alcohol reception.

Contraindications:

Kombigripp Hot the Vulture do not appoint to patients with the known hypersensitivity to drug components.

Administration of drug Kombigripp Hot the Vulture is contraindicated at cardiovascular diseases (stenocardia, arterial hypertension, heart failure and disturbances of cordial conductivity) and a hyperthyroidism.

Kombigripp Hot the Vulture do not apply to therapy of the patients receiving tricyclic antidepressants or monoamine oxidase inhibitors.

Use of peroral solution is contraindicated Kombigripp Hot Hoarsed to children up to 12 years.

Drug is not recommended to be accepted to the patients suffering with a fenilketonuriya, and rare hereditary intolerance of fructose.

 

Overdose:

Reception of paracetamol in high doses can lead to development of hepatotoxic effect. Symptoms of damage of a liver can develop within 12-48 hours after reception of the overestimated drug dose. In particular at drug overdose Kombigripp Hot Hoarsed at patients perhaps development of an abdominal pain, nausea, vomiting, anorexia, pallor of integuments, a gepatonekroz and necrosis of renal balls. At further increase in a dose development of an acute renal failure, hepatic encephalopathy, a metabolic acidosis and coma is noted.

Characteristic symptoms of overdose of a tsetirizin of a hydrochloride at adults is drowsiness, and children have a superexcitation turning into drowsiness.

The overdose of Phenylephrinum of a hydrochloride can cause development of reflex bradycardia, increase in arterial pressure, a tremor, increase in motor activity, concern, excitement and hallucinations. It is necessary to consider that at overdose of the combined drugs the toxic dose of paracetamol is reached earlier, than the toxic effect of Phenylephrinum is shown.

In case of overdose of paracetamol it is necessary to ask for urgent medical care. At overdose the symptomatic treatment is shown. Within the first hour after overdose it is necessary to wash out a stomach or to enter syrup of an emetic root (ipecacuanha) into a stomach. Also use enterosorbentny drugs. At development of symptoms of overdose of paracetamol appoint introduction of N-Acetylcysteinum or reception of methionine.

At drug overdose Kombigripp Hot the Vulture it is necessary to control water and electrolytic balance and рН blood

Storage conditions:

To store in packaging of the producer at a temperature which is not exceeding 25 degrees Celsius in the places protected from access for children.

Issue conditions:

Without recipe

Packaging:

Sachet - software packages of 5 g of drug. On 5, 10 or 20 sachets packages in cardboard packaging.