Dextromethorphan + Paracetamol (Dextromethorphanum + Paracetamolum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Anilides

Antitussives

Included in the formulation
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    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

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    ONLS

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    АТХ:

    R.05.D   Antitussives (excluding combinations with expectorants)

    N.02.B.E   Anilides

    R.01.B.A   Sympathomimetics

    Pharmacodynamics:

    Paracetamol inhibits cyclooxygenase in the central nervous system, resulting in reduced synthesis of prostaglandins, which has an analgesic and antipyretic effect.

    Dextromethorphan blocks glutamatergic NMDA receptors in various structures of the brain, including in the cough center (noncompetitive blockade of the ion channel) of the brainstem, the agonist σ1- and σ2receptors of the brain (a hallucinogenic effect), as a result, suppresses the excitability of the cough center in the brain, inhibiting the cough reflex.

    Pharmacokinetics:

    Paracetamol is evenly distributed in tissues, poorly bound to plasma proteins, metabolized in the liver, eliminated by the kidneys. The elimination half-life is 1-3 hours. Complete elimination of the drug occurs within a day.

    Dextromethorphan is also metabolized in the liver, excreted by the kidneys in an unchanged form and in the form of metabolites, which also have antitussive effects.

    Indications:

    Influenza and acute respiratory diseases, which are accompanied by a cough.

    ICD-10

    X.J00-J06.J06.9   Acute upper respiratory tract infection, unspecified

    X.J00-J06.J06   Acute upper respiratory tract infections of multiple and unspecified sites

    X.J10-J18.J10   Influenza caused by an identified influenza virus

    X.J10-J18.J11   Influenza, virus not identified

    Contraindications:

    Hypersensitivity, deficiency of the enzyme glucose-6-phosphate dehydrogenase, violations of the liver and / or kidney function, blood diseases, phenylketonuria, simultaneous reception of mucolytic agents, bronchial asthma, children under 6 years.

    Carefully:

    Renal and hepatic insufficiency, benign hyperbilirubinemia (including Gilbert's syndrome), viral hepatitis, alcoholic liver damage, alcoholism, old age.

    Pregnancy and lactation:

    Category Food and Drug Administration (US Food and Drug Administration) - FROM. It is not recommended to take the drug during pregnancy and lactation.

    Dosing and Administration:

    Oral reception, treatment period - 3 days.Adults-1-2 doses every 4 hours, but not more than 8 doses per day. Children from 6 to 12 years - 1 dose 4 times a day at intervals of 4 hours between meals.

    Side effects:

    From the hematopoiesis: thrombocytopenia, anemia.

    From the gastrointestinal tract: vomiting, epigastric pain, nausea. With prolonged use of the drug in conjunction with alcohol may develop a hepatotoxic effect (a violation of liver function).

    From the central nervous system: sleep disorders, increased nervous excitability (especially in children), drowsiness.

    Allergic reactions: skin rash, itching, angioedema.

    Overdose:

    Symptoms: paracetamol - pallor, nausea, vomiting, anorexia and abdominal pain. Liver involvement can occur 12-48 hours after an overdose. There may be disturbances in glucose metabolism and metabolic acidosis. With severe poisoning, liver failure can progress to encephalopathy, hemorrhage, hypoglycemia, coma and death. Acute renal failure with acute tubular necrosis may manifest with severe lumbar pain, hematuria, proteinuria and develop even in the absence of severe liver damage. Cardiac arrhythmia and pancreatitis were also noted.

    Dextromethorphan - nausea, vomiting, dizziness, drowsiness, visual impairment, inhibition, impaired coordination of movements, difficulty breathing. First aid: wash stomach, take Activated carbon and urgently consult a doctor.
    Interaction:

    It is not recommended to take other medications that contain paracetamol.

    With the simultaneous administration of barbiturates, anticonvulsants, rifampicin, the risk of hepatotoxic action is significantly increased.

    Long-term use of barbiturates reduces the effectiveness of paracetamol.

    The concomitant use of paracetamol in high doses increases the effect of anticoagulant drugs.

    Prolonged sharing of paracetamol and other non-steroidal anti-inflammatory drugs increases the risk of developing analgesic nephropathy and renal papillary necrosis, the onset of the terminal stage of renal failure.

    Simultaneous long-term use of paracetamol in high doses and salicylates increases the risk of developing kidney or bladder cancer.

    Dextromethorphan increases the effect of narcotic antitussive drugs and other drugs that depress the central nervous system.It is potentially possible to interact with monoamine oxidase inhibitors (taking dextromethorphan at the time of taking monoamine oxidase inhibitors should be avoided).

    Monoamine oxidase inhibitors (including furazolidone, procarbazine, selegiline) with simultaneous application can cause adrenergic crisis, collapse, coma, dizziness, agitation, increased blood pressure, hyperpyrexia, intracranial bleeding, lethargy, nausea, spasms, tremor.

    Special instructions:

    When taking the drug, you need to monitor the condition of the hematopoiesis system.

    Do not drink alcohol while taking the drug.

    When taking the drug should refrain from driving or other complex mechanisms.

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