Dicycloverin + Paracetamol - instructions for use, dose, side effects, contraindications

Clinical and pharmacological group: & nbsp

Anilides

Spasmolytics myotropic

Included in the formulation

Dolospa tabs

pills inwards

Outline Pharma Pvt. Ltd. India

Trigan-D

pills inwards

Cadil Pharmaceuticals Co., Ltd. India

АТХ:

N.02.B.E.51 Paracetamol in combination with other drugs, excluding psycholeptics

Pharmacodynamics:Combined drug, the effect of which is due to its constituent components. Paracetamol - non-narcotic analgesic; blocks cyclooxygenase only in the central nervous system, affecting the centers of pain and thermoregulation; has analgesic and antipyretic effect. Dicycoxyverine a tertiary amine with m-cholinoblocking activity. Patients with a closed-angle form of glaucoma can be induced by an increase in intraocular pressure. Briefly increases the heart rate. Suppresses the secretion of glands, leading to dryness of the mucous membranes of the respiratory tract; expands bronchioles.

Pharmacokinetics:Ingestion dicycloridine absorbed quickly, reaching C_max in 60-90 minutes. The volume of distribution is 3.65 l / kg. Paracetamol metabolized in the liver with the formation of several metabolites, one of which - N-acetyl-benzoquinonimine - under certain conditions (an overdose of the drug, a lack of glutathione in the liver) can have a damaging effect on the liver and kidneys. About 80% of the drug is excreted in the urine and in small amounts - with feces.

Indications:Intestinal colic, renal colic, biliary colic, algodismenorea, irritable bowel syndrome, spastic constipation, pilorospasm, delayed evacuation of gastric contents.

ICD-10

XIV.N20-N23.N23 Renal colic, unspecified

XIV.N80-N98.N94.5 Secondary dysmenorrhea

XIV.N80-N98.N94.4 Primary dysmenorrhea

XI.K55-K63.K59.0 Constipation

XVIII.R50-R69.R52.9 Pain, unspecified

XVIII.R50-R69.R52.2 Another constant pain

XIII.M70-M79.M79.6 Pain in the limb

Contraindications:Hypersensitivity; deficiency of glucose-6-phosphate dehydrogenase; oppression of bone marrow hematopoiesis.

Carefully:Hepatic and / or renal failure, angle-closure glaucoma, urinary retention (prostatic hyperplasia), congenital hyperbilirubinemia (Gilbert syndrome, Dabin-Johnson syndrome and Rotor), pregnancy, lactation; children's age (up to 12 years).

Pregnancy and lactation:The drug is contraindicated in pregnancy and lactation.

Dosing and Administration:Enter intramuscularly, a single dose of 20 mg.If repeated administration is necessary, the interval between injections should be 4-6 hours.

Side effects:

Allergic reactions (skin rash, itching, urticaria, angioedema), nausea, epigastric pain, anemia, thrombocytopenia, agranulocytosis, dry mouth, dizziness, paresis of accommodation, mydriasis, blurred vision, vomiting, decreased potency, urinary retention.

With prolonged use in large doses - hepatotoxic effect, hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia; nephrotoxicity (renal colic, glucosuria, interstitial nephritis, papillary necrosis).

Overdose:

Symptoms: tachycardia, tachypnea, fever, agitation, convulsions, nausea, epigastric pain, decreased appetite, vomiting, anemia, thrombocytopenia, hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia, renal toxicity (papillary necrosis), gepatonekroz (severity is directly dependent on the degree of overdose have adults are possible after taking more than 10-15 g of paracetamol, accompanied by an increase in the activity of "liver" transaminases, an increase in prothrombin time, a detailed clinical picture of liver damage manifests I after 1-6 days).

Treatment: introduction of donors of SH-groups and precursors of glutathione-methionine synthesis - 8-9 hours after overdose and N-acetylcysteine - after 12 hours. To prevent late hepatotoxic action, gastric lavage.

Interaction:

Dicycloverin increases the concentration of digoxin in the blood due to a slowing of the gastrointestinal motility.

Amantadine, Class I antiarrhythmic drugs, antipsychotics, benzodiazepines, inhibitors monoamine oxidase, narcotic analgesics, nitrates and nitrites, adrenostimulators, tricyclic antidepressants and other drugs with anticholinergic action increase the risk of side effects.

Stimulants of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites of paracetamol, which allows the development of severe intoxication with small overdoses.

Ethanol promotes the development of acute pancreatitis and hepatotoxicity.

Inhibitors of microsomal oxidation (cimetidine) reduce the risk of hepatotoxic effects.

Paracetamol reduces the effectiveness of uricosuric medicines and increases - indirect anticoagulants.

Special instructions:All precautions should be taken to avoid intravascular injection. It is necessary to refrain from potentially dangerous activities requiring increased attention, since dicycloridine can lead to drowsiness and indistinctness of visual perception. Paracetamol distorts the indicators of laboratory studies in the quantitative determination of glucose and uric acid in plasma. During the treatment, control of the peripheral blood picture and the functional state of the liver is necessary.

Instructions

Dicycloverine + Paracetamol (Dicycloverinum + Paracetamolum)