Maksigan

Maksigan – the combined medicine with analgeziruyushchy and spasmolytic effect.

Form of release and structure

Dosage forms:

• Tablets: a round flat form, white color, with dividing risky and a facet (on 10 pieces in blisters, in a cardboard pack of 1, 2 or 10 blisters);
• Solution for injections: transparent liquid of light yellow color (on 5 ml in glass ampoules of dark color, in a blister strip packaging of 5 ampoules, in a cardboard pack 1 packaging).

Content of active ingredients of Maksigan in 1 tablet / 1 solution ml:

• Fenpiveriniya bromide: 0,1 mg / 0,02 mg;
• Pitofenona hydrochloride: 5 mg / 2 mg;
• Metamizol sodium: 500 mg / 500 mg.

Auxiliary components:

• Tablets: silicon dioxide, starch, lactose, magnesium stearate, talc;
• Solution: Acidum hydrochloricum, water for injections.

Indications to use

• The moderate pain syndrome caused by a spasm of smooth muscles of internals, for example, at colic (intestinal, renal, hepatic or bilious), algodismenory, dyskinesia of biliary tract;
• Symptomatic (short-term) therapy at neuralgia, an ischialgia, a mialgiya, an arthralgia;
• The period after surgical operative measures and diagnostic testings – as analgeziruyushchy drug at severe pains.

Besides, use of tablets is shown at infectious and inflammatory and catarrhal pathologies as an antipyretic.

Contraindications

• Closed-angle glaucoma;
• Heavy renal failures and/or liver;
• Tachyarrhythmia;
• Granulocytopenia;
• Stenocardia (stable and unstable);
• Deficit glyukozo-6-fosfatdegidrogenazy genetic genesis;
• Megacolon;
• Clinical form of a hyperplasia of a prostate;
• Intestinal impassability;
• Oppression of a marrowy hemopoiesis;
• Acute form of a porphyria;
• Chronic form of heart failure in a decompensation stage;
• Collapse;
• I trimester and last 6 weeks of the period of pregnancy;
• Breastfeeding period;
• Hypersensitivity to drug components.

Besides, use is contraindicated:

• Tablets: age up to 5 years;
• Solution: the age up to 3 months of life or to children with body weight is less than 5 kg.

Under careful control of the doctor it is necessary to use drug at patients with renal failures or a liver, predisposition to a bronchospasm and/or arterial hypotension (systolic pressure less than 100 mm of a mercury column), at an aspirinovy triad in the anamnesis, individual hypersensitivity to not opioid analgetics or non-steroidal anti-inflammatory drugs.

Route of administration and dosage

Tablets
Pill is taken orally, it is desirable right after food.

Drug is appointed to the period by no more than 5 days with frequency rate of reception 2-3 times a day.

The recommended one-time dosing has age restrictions:

• Patients are more senior than 15 years: on 1-2 tablets, but no more than 6 tablets a day;
• Teenagers of 13-15 years: on 1 tablet;
• Children at the age of 9-12 years: on 3/4 tablets;
• Children of 6-8 years: on 1/2 tablets.

Solution for injections
Solution is intended for intramuscular (in oil) and intravenous (in/in) introductions.

Before introduction an ampoule with solution it is necessary to take some time in a hand that drug was warmed.

At acute gripes at patients 15 years are aged more senior introduction of 2 ml of Maksigan is recommended in/in slow (1 ml within 1 minute). For achievement of clinical effect in 6-8 hours the injection can be repeated.

At appointment in oil to patients 15 years are more senior enter 2 ml of drug 2 times a day.

It is impossible to exceed the maximum daily dose – 4 ml.

Treatment duration – no more than 5 days.

The dosing mode for children depends on age, the weight of the child and a way of introduction (in oil or in/in):

• 12-15 years (46-53 kg) on 0,8-1 ml in oil and in/in;
• 8-12 years (31-45 kg) on 0,6-0,7 ml or 0,5-0,6 ml;
• 5-7 years (24-30 kg) on 0,4-0,5 ml or 0,3-0,4 ml;
• 3-4 years (16-23 kg) on 0,3-0,4 ml or 0,2-0,3 ml;
• 1-2 years (9-15 kg) on 0,2-0,3 ml or 0,1-0,2 ml.

Only administration of drug in oil in a dose of 0,1-0,2 ml is shown to children at the age of 3-11 months (weight of the child of 5-8 kg).

If necessary repeated introduction is possible in an initial dose.

Side effects

• Alimentary system: in isolated cases – dryness in a mouth, a burning sensation in epigastric area;
• Cardiovascular system: lowering of arterial pressure (ABP), tachycardia;
• Nervous system: in isolated cases – accommodation paresis, a headache, dizziness;
• System of a hemopoiesis: a leukopenia, an agranulocytosis (a fever, fervescence, the complicated swallowing, a pharyngalgia, a vaginitis, stomatitis, a proctitis), thrombocytopenia;
• Respiratory system: a bronchospasm (is more often at patients, inclined to it);
• Urinary system: seldom (is more often against the background of long therapy or reception of high doses) – an anury, an oliguria, a proteinuria, coloring of urine in red color, intersticial nephrite; in isolated cases – the complicated urination;
• Allergic reactions: skin itch, rash; seldom – a small tortoiseshell, an acute anaphylaxis, a Quincke's disease; in isolated cases – a toxic epidermal necrolysis (Lyell's disease), a malignant exudative erythema (Stephens-Johnson's syndrome);
• Others: in isolated cases – decrease in sweating;
• Local reactions: in the place in oil of introduction emergence of infiltrates is possible.

Special instructions

If Maksigan's use lasts more than 7 days, treatment needs to be accompanied with regular control of a functional condition of a liver, quantity of thrombocytes and leukocytes in blood. In case of symptoms of an agranulocytosis or thrombocytopenia drug should be cancelled.

Co-administration of X-ray contrast means and colloid blood substitutes, and also alcohol intake during treatment is contraindicated.

Until clarification of the reason of acute abdominal pains solution cannot be used.

It is recommended to appoint parenteral administration at impossibility of oral administration of drug and in case of emergency, such as renal or hepatic colic.

Because of possible emergence of arterial hypotension it is necessary to carry out to introduction carefully, very slowly, only at horizontal position of a body of the patient, controlling the ABP, a respiration rate and cordial reductions.

During treatment the patient should refrain from control of vehicles and mechanisms.

Medicinal interaction

At simultaneous use of Maksigan:

• Not opioid analgetics cause strengthening of mutual toxic action;
• Oral contraceptives, Allopyrinolum, tricyclic antidepressants, breaking exchange processes, increase toxicity of drug;
• Barbiturates, inductors of microsomal enzymes of a liver (phenylbutazone) weaken effect of metamizole sodium;
• Cyclosporine reduces the level of the content in blood;
• Tranquilizers, sedatives activate analgesic effect of metamizole sodium;
• Derivatives of a fenotiazin, including Chlorpromazinum, can promote development of the expressed hyperthermia;
• Phenyl propyl ketones, амантадин, quinidine, fenotiazina, blockers histamine _{H1 receptors} strengthen m-holinoblokiruyushchee effect of drug;
• Thiamazolum, cytostatics increase risk of development of a leukopenia;
• Ethanol leads to mutual strengthening of effects;
• Peroral hypoglycemic means, indirect anticoagulants, indometacin, glucocorticosteroids strengthen the clinical action.

At a combination to codeine, blockers of histamine _H2 - receptors, delay of processes of an inactivation of metamizole sodium happens propranolol that causes increase in febrifugal, analgeziruyushchy and antiinflammatory action of Maksigan.

Pharmaceutical solution is incompatible with solutions of other medicines in one syringe.

Terms and storage conditions

To protect from children.

To store in the protected from light, dry place at a temperature up to 25 °C.

Period of validity – 3 years.