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

Pharmacodynamics:Paracetamol blocks cyclooxygenase I and II only in the CNS, affecting the centers of pain and thermoregulation (in inflammatory tissues, cellular peroxidases neutralize the effect of paracetamol on cyclooxygenase), which explains the almost complete absence of anti-inflammatory effect.The absence of influence on the synthesis of prostaglandins in peripheral tissues determines the absence of a negative influence on the water-salt metabolism (sodium and water retention) and gastrointestinal mucosa. The possibility of forming methaemoglobin is unlikely.

Indications:

Moderately or mildly expressed pain syndrome (headache, dental, migraine pain, neuralgia, myalgia).

Elevated body temperature for colds and other infectious and inflammatory diseases

Contraindications:

- Hypersensitivity to paracetamol.

- Children up to 8 years.

Carefully:renal and hepatic insufficiency, benign hyperbilirubinemia (including Gilbert's syndrome, viral hepatitis, alcoholic liver damage), alcoholism, pregnancy, lactation, elderly age, deficiency of glucose-6-phosphate dehydrogenase

Dosing and Administration:

Apply inside with a large amount of liquid for 0.5 g-1 g 2-3 times a day at intervals of not less than 4 hours. The maximum single dose for adults and children over 15 years is 1 g, daily - 4 g.

In patients with impaired hepatic or renal function, with Gilbert's syndrome and in elderly patients, the interval between doses should be at least 8 hours and the daily dose should be reduced.

Children are prescribed 10-15 mg / kg body weight 3 - 4 times a day (no more than 3 days, pre-grinding the tablet).

Duration of admission is no more than 5 days with the appointment as an anesthetic and 3 days as an antipyretic.

Side effects:

- Nausea, vomiting, epigastric pain, allergic reactions (skin rash, itching, hives, Quincke's edema).

- Rarely, anemia, leukopenia, thrombocytopenia, agranulocytosis.

- With prolonged use in large doses - hepatotoxic action, hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia.

- Nephrotoxicity (renal colic, pyuria, interstitial nephritis, papillary necrosis).

Overdose:

Symptoms: pallor of the skin, anorexia, nausea, vomiting; hepatonecrosis (the severity of necrosis directly depends on the degree of overdose). The toxic effect of the drug in adults is possible after taking more than 10-15 g of paracetamol: rise activity "hepatic" transaminase, enlargement prothrombin time, a detailed clinical picture of liver damage manifests itself after 1-6 days. Rarely, liver function abnormalities develop with lightning speed and can be complicated by renal failure (tubular necrosis).

Treatment: stop taking the drug, do a lavage, take Activated carbon. Further therapeutic measures should be carried out in the setting of a medical institution: the introduction of donators SH-groups and precursors of the synthesis of glutathione-methionine after 8-9 hours after an overdose and N - acetylcysteine - after 12 hours The need for additional therapeutic measures (further introduction of methionine, iv administration N - acetylcysteine) is determined depending on the concentration of paracetamol in the blood, and also on the time elapsed after its administration.

Interaction:

Stimulants of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which causes the possibility of developing severe intoxication with small overdoses. Ethanol promotes the development of acute pancreatitis. Inhibitors of microsomal oxidation (incl. cimetidine) reduce the risk of hepatotoxic effects.

Reduces the effectiveness of uricosuric drugs.

Special instructions:

With caution and under the supervision of a doctor,a drug for patients with impaired liver or kidney function, along with other anti-inflammatory and analgesic agents, as well as with anticoagulants and drugs that affect the central nervous system. When taking metoclopramide, domperidone, or cholestyramine, it is also necessary to consult a physician.

Distorts the indicators of laboratory tests in quantitative determination of uric acid in the plasma.

To avoid toxic damage to the liver paracetamol should not be combined with the reception of alcoholic beverages, but also to persons prone to chronic alcohol consumption.

The risk of liver damage increases in patients with alcoholic hepatosis.

For a long time use of the drug is necessary to control the picture peripheral, blood and functional state of the liver.

Form release / dosage:tablets, 200 and 500 mg.

Packaging:

For 10 tablets in, contour non-jaw or cell packaging.

1-2 contour packs together with instructions for use are placed in a pack of cardboard. It is allowed to place 200, 300, 400, 500, 600 or 1000 contour packs in a group package.

Storage conditions:

In a dry, dark place, out of the reach of children.

Shelf life:3 years. Do not use the drug after the expiration of the period indicated on the package.

Terms of leave from pharmacies:Without recipe

Registration number:LSR-000271/08

Date of registration:29.01.2008

The owner of the registration certificate:TATHIMFARMPREPARATY, JSC TATHIMFARMPREPARATY, JSC Russia

Manufacturer: & nbsp

TATHIMFARMPREPARATY, JSC Russia

Information update date: & nbsp08.10.2015

Illustrated instructions

Instructions

Paracetamol (Paracetamol)