Migrenium

General characteristics. Structure:

Acting substances: 500 mg of paracetamol, 65 mg of caffeine.

Excipients: potato starch, cellulose microcrystallic, croscarmellose sodium, hypro rod (oxypropyl-cellulose), silicon dioxide colloid, magnesium stearate, коповидон, talc, titanium dioxide, silicone emulsion (50% solution).

The combined anesthetic.

Pharmacological properties:

Pharmacodynamics. Migrenium - the combined drug which effect is defined by the components which are its part.

Caffeine renders psychogogic (stimulates the psychomotor centers of a brain), analeptical action, strengthens effect of analgetics, eliminates drowsiness and feeling of fatigue, increases physical and intellectual effeciency. Influences cardiovascular system: increases the frequency and force of cordial reductions (ChSS), increases the arterial pressure (AP) at hypotension (does not change normal). Expands bronchial tubes, bilious ways, blood vessels of skeletal muscles, hearts, kidneys, narrows vessels of abdominal organs. Lowers aggregation of thrombocytes. Stimulates secretion of glands of a stomach, raises standard metabolism, has moderate diuretic effect.

Paracetamol - febrifugal and analgeziruyushchy action (at the expense of inhibition of cyclooxygenase (TsOG) and oppression of synthesis of prostaglandins (Pg) also carrying out painful impulses in the central nervous system (CNS) influences the center of thermal control in a hypothalamus. Drug bloyokirut cyclooxygenase I and II preferential in TsNS, influencing the centers of pain and thermal control. In the inflamed fabrics cellular peroxidases neutralize influence of paracetamol on cyclooxygenase that explains almost total absence at not its antiinflammatory effect. Drug the vozdeystyoviya does not render the digestive tract (DT) on a water salt metabolism (a delay of sodium and water) and mucous negative owing to an otyosutstviye of influence on synthesis of prostaglandins in peripheral fabrics. The possibility of formation of a methemoglobin - is improbable.

Pharmacokinetics. Caffeine and its water soluble salts are well soaked up in intestines (including thick). The elimination half-life of drug (T1/2) makes about 5 h, at some persons - to 10 h. The main part demetilirutsya and oxidized. About 10% are allocated with kidneys in not changed look.

Paracetamol is quickly and almost completely soaked up from a GIT. Concentration in plasma reaches peak in 30-60 min. T1/2 of plasma-1-4 h. It is metabolized in a liver. It is allocated with urine, mainly, in the form of ethers with glucuronic and sulfuric acids; less than 5% are removed in an invariable look.

Indications to use:

Pain syndrome (weak and moderate expressiveness): headache, migraine, ossalgiya, mialgiya, neuralgia, arthralgia, альгодисменорея, dentagra; feverish syndrome, "catarrhal" diseases, SARS (including flu).

Route of administration and doses:

Inside, adults and children are later 12 years old - on 2 tablets 4 times a day with an interval not less than 4 h. The maximum daily dose - 8 tablets.

Use duration – no more than 3 days (as febrifugal) and no more than 5 days (as analgeziruyushchy).

Features of use:

The excessive use of kofeinsoderzhashchy products (coffee, tea) against the background of treatment can cause overdose symptoms. At long (more than 1 week) treatment control of a picture of peripheral blood and a functional condition of a liver is necessary.

Without consultation of the doctor accept no more than 3 days at treatment of a feverish syndrome and no more than 5 days - at a pain syndrome.

Can change results of analyses of a drug test of athletes. Complicates establishment of the diagnosis at acute "acute abdomen".

The patients having atopic bronchial asthma, pollinoses have an increased risk of development of allergic reactions. During treatment it is necessary to refuse the ethanol use (increase in risk of development of a hepatotoxic).

Side effects:

Allergic reactions (skin rash, Quincke's disease, small tortoiseshell), dispepsichesky frustration (including nausea, epigastric pain).

In rare instances - hemolitic anemia, thrombocytopenia, a methemoglobinemia.

At prolonged use in high doses - a hepatotoxic, a pancytopenia, nephrotoxicity (renal colic, a pyuria, intersticial nephrite, a papillary necrosis).

Interaction with other medicines:

Strengthens effect of inhibitors of a monoaminooxidase (MAO).

Reduces efficiency of uricosuric medicines. Caffeine accelerates ergotamine absorption. Under the influence of paracetamol time of removal of chloramphenicol increases by 5 times.

At long reception paracetamol can strengthen effect of anticoagulants (Dicumarinum derivatives). The concomitant use of paracetamol and ethanol increases risk of development of hepatotoxic effects and acute pancreatitis.

Barbiturates, Phenytoinum, ethanol, rifampicin, phenylbutazone, tricyclic antidepressants, etc. stimulators of a microsomal oxidation, increase products of hydroxylated active metabolites, causing a possibility of development of heavy intoxications at small overdoses.

Inhibitors of a microsomal oxidation (Cimetidinum) reduce risk of a hepatotoxic action. Metoclopramidum and домперидон is increased, and Colestyraminum reduces absorption.

Contraindications:

Hypersensitivity, heavy liver and/or renal failure, epilepsy, deficit glyukozo-6-fosfatdegidrogenazy, senile age, children's age (up to 12 years).

With care: pregnancy, lactation period, inborn hyperbilirubinemias (Gilbert's syndromes, Cudgel Johnson and Rotor).

Overdose:

Symptoms: pallor of integuments, a loss of appetite, nausea, vomiting, sometimes with blood; гепатонекроз (expressiveness of a necrosis owing to intoxication directly depends on extent of overdose), a gastralgia, agitation, uneasiness, excitement, motive concern, confusion of consciousness, a delirium, dehydration, tachycardia, arrhythmia, a hyperthermia, the speeded-up urination, a headache, the increased tactile or painful sensitivity, a tremor or muscular twitchings; a ring in ears, epileptic seizures (at acute overdose - toniko-clonic), increase in activity of "hepatic" transaminases, increase in a prothrombin time; the developed clinical picture of injury of a liver is shown in 1-6 days. 

Treatment: introduction of donators of SH-group and predecessors of synthesis of glutathione - methionine through 8-9chas after overdose and N-Acetylcysteinum - in 12 h. For prevention of a late hepatotoxic action carry out a gastric lavage.

Storage conditions:

In the dry, protected from light place at a temperature not above 25 °C. In the place, unavailable to children, the Period of validity 3 years. Not to use after the expiry date specified on packaging

Issue conditions:

Without recipe

Packaging:

Tablets, film coated 65 mg + 500 mg. On 10 tablets in a blister strip packaging together with the application instruction