Citramonum P

General characteristics. Structure:

Active ingredients: 240 mg of acetylsalicylic acid, 180 mg of paracetamol, 30 mg of caffeine.

Excipients: cocoa powder, citric acid monohydrate, potato starch, talc, calcium stearate, polysorbate 80.

Pharmacological properties:

Pharmacodynamics. The combined drug. Acetylsalicylic acid possesses febrifugal and antiinflammatory action, weakens the pain which is especially caused by inflammatory process and also moderately oppresses aggregation of thrombocytes and a thrombogenesis, improves microcirculation in the inflammation center.

Paracetamol possesses analgetic, febrifugal and weak antiinflammatory action that is connected with its influence on the center of thermal control in a hypothalamus and slight ability to inhibit synthesis of prostaglandins (Pg) in peripheral fabrics.

Caffeine increases reflex irritability of a spinal cord, excites the respiratory and vasomotor centers, expands blood vessels of skeletal muscles, a brain, heart, kidneys, reduces aggregation of thrombocytes; reduces drowsiness, feeling of fatigue. In this combination caffeine in a small dose has practically no promoting effect on TsNS, however promotes regulation of a tone of vessels of a brain.

Indications to use:

— pain syndrome of weak and moderate expressiveness (various genesis): headache, migraine, dentagra, neuralgia, mialgiya, arthralgia, альгодисменорея;

— feverish syndrome: at acute respiratory diseases, including flu.

Route of administration and doses:

Inside (in time or after food), on 1 таб. each 4 h, at a pain syndrome-1-2 таб.; an average daily dose - 3-4 таб., the maximum daily dose - 8 tablets. Drug use no more than 7-10 days.

For reduction of irritant action by a GIT it is necessary to wash down a tablet with milk or alkaline mineral water.

Features of use:

Use at pregnancy and feeding by a breast. At pregnancy (I and III trimesters) and during breastfeeding drug is contraindicated. In the II trimester of pregnancy it is necessary to use drug with care, correlating estimated advantage for mother and potential risk for a fruit.

Use at abnormal liver functions. Drug use is forbidden to patients with the expressed abnormal liver functions.

Use at renal failures. Drug use is forbidden to patients with the expressed renal failures.

With care at a renal failure of easy and moderate degree.

Use for children. Use of a prepart for children aged up to 15 years is forbidden (risk of development of a syndrome to Reja at children with a hyperthermia against the background of a viral disease).

Acetylsalicylic acid slows down coagulability of blood. If surgical intervention is necessary to the patient, it is necessary to warn the doctor about administration of drug.

At long use of drug control of peripheral blood and a functional condition of a liver is necessary.

Patients with hypersensitivity or with astmoidny reactions to salicylic acid and its derivatives, including acetylsalicylic acid, can appoint only with observance of special precautionary measures (in the conditions of service of acute management).

At patients with predisposition to accumulation of uric acid administration of drug can provoke a gout attack.

During reception it is necessary to abstain from alcohol intake (increase in risk of gastrointestinal bleeding and toxic damage of a liver).

Acetylsalicylic acid has teratogenic influence; at use in the I trimester leads to a malformation - splitting of the upper sky; in the III trimester - to braking of patrimonial activity (inhibition of synthesis of Pg), to closing of an arterial channel at a fruit that causes a hyperplasia of pulmonary vessels and hypertensia in vessels of a small circle of blood circulation. It is allocated with breast milk that increases risk of developing of bleedings at the child owing to dysfunction of thrombocytes.

Children up to 15 years cannot appoint the medicines containing acetylsalicylic acid as in case of a viral infection they are capable to increase risk of emergence of a syndrome to Reja. Syndrome symptoms to Reja are long vomiting, acute encephalopathy, increase in a liver.

Influence on upravlenit ransportny funds and for service of the cars and mechanisms demanding concentration of attention. There are no data on influence on control of vehicles and on service of the cars and mechanisms demanding concentration of attention.

Side effects:

The side reactions characteristic of acetylsalicylic acid, paracetamol and caffeine can be observed: anorexia, nausea, vomiting, gastralgia (decrease in aggregation of thrombocytes), GIT erosive cankers, gastrointestinal bleedings, allergic reactions, bronchospasm, multiformny exudative erythema (including Stephens-Johnson's syndrome), toxic epidermal necrolysis (Lyell's disease), renal failure, liver failure, dizziness, tachycardia, increase in the ABP.

At prolonged use dizziness, a headache, vision disorders, a sonitus, decrease in aggregation of thrombocytes, hypocoagulation, a hemorrhagic syndrome (nasal bleeding, bleeding of gums, purple and др), damage of kidneys with a papillary necrosis are possible; deafness, a syndrome to Reja at children (a hyper pyrexia, a metabolic acidosis, disturbances from a nervous system and mentality, vomiting, abnormal liver functions).

Interaction with other medicines:

Strengthens effect of heparin, indirect anticoagulants, Reserpinum, steroid hormones and hypoglycemic medicines.

Simultaneous use with other non-steroidal anti-inflammatory drugs, a methotrexate increases risk of development of side effects.

Reduces efficiency of Spironolactonum, furosemide, hypotensive medicines, and also the antigouty medicines promoting removal of uric acid.

Barbiturates, rifampicin, Salicylamidum, antiepileptic medicines and other stimulators of a microsomal oxidation promote formation of the toxic metabolites of paracetamol influencing function of a liver.

Metoclopramidum accelerates paracetamol absorption. Under the influence of T1/2 paracetamol of chloramphenicol increases by 5 times. At repeated reception paracetamol can strengthen effect of anticoagulants (Dicumarinum derivatives).

Caffeine accelerates ergotamine absorption.

At a concomitant use of drug and alcohol-containing liquids the risk of toxic damage of a liver increases.

Contraindications:

— hypersensitivity to drug components;

— GIT erosive cankers (in an aggravation phase);

— gastrointestinal bleedings (including in the anamnesis);

— a full or incomplete combination of bronchial asthma, the nose recuring a polypose and okolonosovy bosoms of intolerance of acetylsalicylic acid or non-steroidal anti-inflammatory drugs (including in the anamnesis);

— the expressed abnormal liver functions and/or kidneys;

— hemorrhagic diathesis, hypocoagulation, hemophilia, prothrombinopenia;

— pregnancy (I and III trimesters);

— breastfeeding period;

— the surgical interventions which are followed by plentiful bleeding;

— deficit glyukozo-6-fosfatdegidrogenazy;

— glaucoma;

— the expressed arterial hypertension;

— portal hypertensia;

— tyazheloyetecheniye of coronary heart disease;

— avitaminosis To;

— children's age up to 15 years (risk of development of a syndrome to Reja at children with a hyperthermia against the background of a viral disease);

— hyperexcitability, sleep disorder.

With care. Renal failure of easy and moderate degree, liver disease, alcoholism, epilepsy and tendency to convulsive attacks, advanced age, gout, pregnancy (II trimester).

Overdose:

It is not necessary to exceed the recommended dose and duration of use! Symptoms of overdose are caused by acetylsalicylic acid.

Symptoms:

- at slight intoxications: nausea, vomiting, stomach aches, dizziness, a ring in ears;

- at heavy intoxication: block, drowsiness, a collapse, spasms, the complicated breath, an anury, bleeding.

Treatment: a gastric lavage with use of absorbent carbon, symptomatic therapy, depending on a condition of a metabolism - introduction of Natrii hydrocarbonas, sodium of citrate or sodium of a lactate that strengthens removal of acetylsalicylic acid due to urine alkalization.

Storage conditions:

Drug should be stored in the place, dry, unavailable to children, at a temperature not above 25 °C. Period of validity 4 years. After a period of validity not to use drug.

Issue conditions:

Without recipe

Packaging:

6 pieces - packagings bezjyacheykovy planimetric (900) - boxes cardboard.
10 pieces - packagings bezjyacheykovy planimetric (600) - boxes cardboard.
10 pieces - planimetric strip packagings (2) - packs cardboard.
10 pieces - planimetric strip packagings (1000) - a box cardboard.