Гриппомикс with fructose

General characteristics. Structure:

Active ingredients: 360 mg of paracetamol, 75 mg of Rimantadinum of a hydrochloride, 125 mg of ascorbic acid, 2,5 mg of a tsetirizin of dihydrochloride, 89,3 mg of calcium of a carbonate 70 with sorbitol that corresponds to the content of 25 mg of calcium.

Excipients: aspartame, citric acid anhydrous, fragrance wild berries, fructose.

Innovative lekartvenny drug for treatment of flu, acute respiratory viral infections, feverish states owing to virus damage of airways at adults and children is more senior than 12 years. It can be applied at patients with a diabetes mellitus

Pharmacological properties:

The combined drug for intake. Pharmacological activity of drug of Grippomiks is caused by complex action of its components - paracetamol, Rimantadinum of a hydrochloride, ascorbic acid, a tsetirizin of dihydrochloride and calcium of a carbonate.

Гриппомикс renders the antiviral, interferonogenny, febrifugal, antiinflammatory, anesthetizing, antihistaminic, angioprotektorny action.

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 TsOG-1 and TsOG-2 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 (a delay of sodium and water) and a mucous membrane of a GIT.

Rimantadinum a hydrochloride - the antiviral means derivative of an adamantan. It is active concerning various influenza strains And, the Herpes simplex 1 and 2 viruses of types, viruses of a tick-borne encephalitis (Central European and the Russian family, spring and summer from group of an arbovirus. Flaviviridae). Rimantadinum renders the inhibiting effect at an early stage of a replikativny cycle, perhaps inhibits a transcription of a virus genome. Results of genetic researches allow to assume that virus protein specified, a gene of Sq.m of virion plays an important role in a susceptibility of an influenza virus And to Rimantadinum. Rimantadinum inhibits replication in cellular culture of isolates of each of three antigenic subtypes of an influenza virus And, i.e. H1N1, H2N2 and H3N3 allocated from cells of the person. Rimantadinum is inactive or almost inactive concerning an influenza virus of Century. The quantitative ratio between a susceptibility in cellular culture of an influenza virus And to Rimantadinum and clinical effect is not established. The results of researches of sensitivity expressed as the concentration of medicinal substance necessary for inhibition of replication of a virus for 50% or more in cellular culture, strongly differ (from 19 nanometers to 93 microns) depending on the used protocol of researches, the size of an inoculum, the isolated strains of influenza viruses And yes used like cells.

Resistance: in cellular culture and in vivo isolates of an influenza virus, resistant to Rimantadinum, And, the resulted treatments were emitted. Rimantadinum-resistant influenza strains And appeared among recently allocated strains in experimental conditions where Rimantadinum was used. It was shown that resistant viruses can be transmitted and are a cause of illness typical flu. Replacement of any of five amino acids in a membrane of the Sq.m domain results in resistance of Rimantadinum. The most widespread replacements causing resistance include flu of A (H1N1) and A (H3N2) and S31N. Other, less widespread replacements causing resistance include A30F, V27A and L26F. Resistance to Rimantadinum is found in the isolated strains of pandemic seasonal flu in the persons who were not receiving Rimantadinum. It was shown that viruses of swine flu of A (H1N1) (S-OIV) which were rezistentna to Rimantadinum contain S31N replacement.

Cross resistance: cross resistance among adamantan, Rimantadinum and an amantadin is observed. Resistance to Rimantadinum arises through cross resistance to an amantadin and vice versa. Replacements of amino acids which are the reason of resistance to Rimantadinum include (most often) S31N Sq.m, and also less widespread changes of V27, V30A, L26F and A30T.

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 prostaglandins and other mediators of an inflammation and allergic reactions oppresses.

Tsetirizina dihydrochloride - a blocker of peripheral histamine H1 receptors, antihistaminic antiallergic means, Hydroxyzinum metabolite. In pharmacological active doses does not possess significant sedation. Brakes a gistaminoposredovanny early phase of allergic reaction, prevents various physiological and pathophysiological effects of a histamine, such as expansion and a hyperpermeability of capillaries (edematization, small tortoiseshells, reddening), stimulation of sensitive nerve terminations (an itch, pain) and reduction of unstriated muscles of a respiratory organs and a GIT. At a late stage of allergic reaction of a tsetirizin dihydrochloride inhibits allocation of a histamine and migration of eosinophils and other cells, weakening thus, late allergic reaction. Reduces an expression of molecules of adhesion, such as ICAM-1 and VCAM-1 which are markers of an allergic inflammation. Suppresses action of other mediators and inductors of secretion of a histamine, such as PAF (platelet activating factor) and substance P. Considerably lowers the hyperreactivity of a bronchial tree arising in response to release of a histamine at patients with bronchial asthma. These effects are not followed by the central action.

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 unstriated muscles, in regulation of cordial activity.

Indications to use:

The etiotropic and symptomatic treatment of flu, acute respiratory viral infections, feverish states owing to virus damage of airways at adults and children is more senior than 12 years. It can be applied at patients with a diabetes mellitus.

Route of administration and doses:

Inside. Contents of a bag are dissolved in 1 glass of boiled hot water. Use hot. To children 12 years and the adult - on 1 powder 3 times a day are more senior at preservation of a feverish syndrome within 3-5 days. In the absence of improvement of health during medicine reception, treatment it is necessary to stop and see a doctor!

Features of use:

Medicine is not intended for prevention.

Treatment should be begun no later than 48 h from emergence of the first symptoms of a disease. Use duration - no more than 5 days. At prolonged use (more than 7 days) the exacerbation of chronic associated diseases is possible, at patients of advanced age with arterial hypertension the risk of development of a hemorrhagic stroke increases (at the expense of Rimantadinum medicine which is a part).

At instructions in the anamnesis on epilepsy and the carried-out anticonvulsant therapy against the background of use of Rimantadinum the risk of development of an epileptic seizure increases.

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.

In order to avoid the possible damaging action on a liver, and also in connection with increase in risk of a GIT, during administration of drug it is not necessary to take alcohol.

Use in pediatrics. For formation of postinfectious immunity it is not necessary to use drug of children aged up to 12 years.

Influence on ability to driving of motor transport and to control of mechanisms. During treatment it is necessary to be careful during the driving of motor transport and occupation other potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions (since drug contains Rimantadinum).

Side effects:

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

From the alimentary system: 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 a hemopoiesis: 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 the patient has to consult with the doctor.

Combined use of paracetamol and Rimantadinum leads to decrease in Cmax and AUC of Rimantadinum approximately for 11%.

Ascorbic acid lowers Cmax of Rimantadinum by 10%.

Cimetidinum reduces clearance of Rimantadinum by 18%.

Rimantadinum reduces efficiency of antiepileptic means.

Paracetamol reduces efficiency of uricosuric medicines.

Inductors of a microsomal oxidation in a liver (Phenytoinum, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase products of hydroxylated metabolites that causes a possibility of development of heavy intoxications even at small overdose. Prolonged 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.

Prolonged combined use of Grippomiks and other NPVS increases risk of development of an "analgetic" nephropathy and renal papillary necrosis, development of an end-stage of a renal failure.

Diflunizal increases plasma concentration of paracetamol for 50% - risk of development of a hepatotoxic.

Miyelotoksichny drugs strengthen manifestations of a gematotoksichnost of Grippomiks.

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 reabsorption of amphetamine and tricyclic antidepressants.

At co-administration of Grippomiks with theophylline (especially if doses of theophylline exceed 400 mg) increase in concentration in serum and relative overdose of a tsetirizin because of reduced clearance can be observed.

Myelotoxic medicines strengthen manifestations of a gematotoksichnost of a tsetirizin.

It is necessary to observe extra care at combined use of medicine with hypnotic drugs and sedatives, alcohol.

Contraindications:

Hypersensitivity to one or several components which are a part of medicine; digestive tract erosive cankers in an aggravation phase; gastrointestinal bleedings; hemophilia; hemorrhagic diathesis; prothrombinopenia; portal hypertensia; renal failure; pregnancy and period of a lactation; acute diseases of kidneys, liver (acute glomerulonephritis, acute pyelonephritis, acute hepatitis); alcoholism.

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.

Paracetamol overdose symptoms: nausea, vomiting, stomach aches, pallor of integuments, anorexia. In a day or two are defined signs of damage of a liver. In hard cases the liver failure and coma develops. Toxic effect of paracetamol at adults perhaps after reception over 10-15 g of paracetamol: increase in activity of hepatic transaminases, increase in a prothrombin time (in 12-48 h after reception); the developed clinical picture of damage of a liver appears in 1-6 days. Seldom damage of a liver develops immediately and can be complicated by a renal failure (a tubular necrosis).

Treatment: at suspicion on overdose the patient has to see a doctor immediately. The victim should make a gastric lavage during the first 4 h poisoning, to accept adsorbents (absorbent carbon). Introduction of donators of SH-group and predecessors of synthesis of glutathione - methionine - in 8-9 h after overdose and N-Acetylcysteinum - in 12 h. Need for holding additional therapeutic actions is defined depending on concentration of paracetamol in blood, and also from time which passed after its reception.

Storage conditions:

Drug should be stored in the unavailable to children, protected from moisture and light place, at a temperature not above 25 °C. A period of validity - 2 years.

Issue conditions:

Without recipe

Packaging:

On 10 g of powder in bags from the combined material. On 5, 10 or 15 bags in a cardboard pack together with the application instruction.