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

Acetylsalicylic acid - 0.360 g, caffeine - 0.045 g, paracetamol - 0.270 g. Excipients: aromatizer orange or lemon (food flavoring "Orange durar" or "Lemon durar") - 0,02 g, aspartame - 0,0125 g, citric acid monohydrate (citric acid monohydrate food) - 0.35 g, sodium bicarbonate (sodium bicarbonate ) - 0.28 g, povidone low molecular weight - 0.0105 g, sucrose (sugar) -11.644 g.

Description:

A granular powder of light yellow color with white and yellow impregnations. The presence of easily disintegrating lumps is allowed. When dissolved in hot water for 3 minutes with stirring, an opalescent solution with a yellowish tinge with the smell of orange or lemon is formed.

Pharmacotherapeutic group:Analgesic agent (analgesic non-narcotic remedy + psychostimulating agent)

ATX: & nbsp

N.02.B.A.51 Acetylsalicylic acid in combination with other drugs, excluding psycholeptics

Pharmacodynamics:

Combined drug. Acetylsalicylic acid has antipyretic and anti-inflammatory effect, relieves pain, especially caused by the inflammatory process, and also moderately inhibits platelet aggregation and thrombosis, improves microcirculation in the inflammatory focus.

Caffeine increases the excitability of spinal cord reflex, excites the respiratory and vasomotor centers, dilates blood vessels in skeletal muscle, brain, heart, kidneys, reducing platelet aggregation;

reduces drowsiness, a feeling of fatigue, increases mental and physical performance. In this combination caffeine in a small dose practically does not have a stimulating effect on the central nervous system, but it contributes to the normalization of the vascular tone of the brain and the acceleration of blood flow.

Paracetamol has an analgesic, antipyretic and extremely weak anti-inflammatory effect, which is related to its influence on the thermoregulatory center in the hypothalamus and a weak ability to inhibit the synthesis of prostaglandin in peripheral tissues.

Indications:

Pain syndrome of mild and moderate severity (of various origins): headacheol, migraine, toothache; neuralgia, myalgia, arthralgia, algodismenorea.

Feverish syndrome: with acute respiratory disease, influenza.

Contraindications:

Hypersensitivity to the components of the drug; erosive and ulcerative lesions of the gastrointestinal tract (in the phase of exacerbation), gastrointestinal bleeding;

complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including in the anamnesis), hemophilia, hemorrhagic diathesis, hypoprothrombinemia, portal hypertension; avitaminosis K;

renal failure; deficiency of glucose-6-phosphate dehydrogenase expressed arterial hypertension, severe.current of ischemic heart disease, glaucoma, increased excitability, sleep disturbance; surgical interventions, accompanied by bleeding; with febrile syndrome - children's age before 18 years; with pain syndrome - children under 15 years of age; deficit sugarase / isomaltase, fructose intolerance, glucose-galactose malabsorption, phenylketonuria.

Carefully:

Gout, liver disease, advanced age, diabetes.

Pregnancy and lactation:Application during pregnancy and during breastfeeding is contraindicated.

Dosing and Administration:

Inside. One packet of the drug is dissolved in 100 ml of hot water. Use a freshly prepared solution. The drug is used after eating 1 packet 2-3 times a day. For relief of pain syndrome, adults and children over 15 years of age - 1-2 packs once, adults with febrile syndrome - 1 packet 3-4 times a day. The maximum daily dose is 6 packs. The interval between doses should be at least 4 hours. If there is a violation of the kidney or liver function, a break between receptions - not less than 6 hours.

The drug should not be taken more than 5 days as an analgesic drug and more than 3 days - antipyretic (without appointment and supervision of a doctor). Other doses and schedules are prescribed by the doctor.

Side effects:

Gastralgia, nausea, vomiting, hepatotoxicity, nephrotoxicity, erosive-ulcerative lesions of the gastrointestinal tract, allergic reactions (incl.Stevens-Johnson syndrome, Lyell), tachycardia, increased blood pressure, bronchospasm. Reye's syndrome in children (hyperpyrexia, metabolic acidosis, disorders of the nervous system and psyche, vomiting, impaired liver function).

With prolonged use - dizziness, headache, visual disturbances, tinnitus, reduced platelet aggregation, hypocoagulation, hemorrhagic syndrome (epistaxis, bleeding gums, purpura, etc.), kidney damage with papillary necrosis; deafness.

Overdose:

Symptoms (due to acetylsalicylic acid): with light intoxication - nausea, vomiting, gastralgia, dizziness, ringing in the ears; severe intoxication - retardation, drowsiness, collapse, convulsions, bronchospasm, shortness of breath, anuria, bleeding. Initially, the central hyperventilation leads to respiratory alkalosis (shortness of breath, dyspnea, cyanosis, perspiration). As the intoxication progressive paralysis and respiratory uncoupling of oxidative phosphorylation causes respiratory acidosis.

Symptoms (caused by caffeine): gastralgia, agitation, anxiety, agitation, motor anxiety, arrhythmia, frequent urination, nausea and vomiting.Symptoms (due to paracetamol): pallor of the skin, nausea, vomiting, abdominal pain, impaired glucose metabolism.

Treatment: constant monitoring of acid-base state and electrolyte balance; depending on the state of metabolism - the introduction of sodium bicarbonate, sodium citrate or sodium lactate. Increased reserve alkalinity increases the excretion of acetylsalicylic acid due to the alkalinity of urine.

Interaction:

Acetylsalicylic acid. Enhances the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs.

Simultaneous use with other non-steroidal anti-inflammatory drugs, methotrexate increases the risk of side effects. Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, as well as anti-arthritis drugs that promote the excretion of uric acid.

Paracetamol. Barbiturates, rifampicin, salicylamide, antiepileptic drugs and other stimulators of microsomal oxidation contribute to the formation of toxic metabolites of paracetamol,affecting the function of the liver.

Metoclopramide accelerates the absorption of paracetamol.

Under the influence of paracetamol, the half-life of chloramphenicol increases five-fold. At repeated reception paracetamol can enhance the effect of indirect anticoagulants (coumarin derivatives). Simultaneous reception of paracetamol and ethanol increases the risk of hepatotoxic effects.

Caffeine. Accelerates the absorption of ergotamine, reduces the absorption of calcium preparations in the gastrointestinal tract, reduces the effect of narcotic and hypnotics.

Special instructions:

Children should not be prescribed medications containing acetylsalicylic acid, since in the case of a viral infection they can increase the risk of developing Reye's syndrome. Symptoms of Reye's syndrome include prolonged vomiting, acute encephalopathy, and enlargement of the liver.

With continued use of the drug, control of peripheral blood and the functional state of the liver is necessary.

Because the acetylsalicylic acid slows the clotting of the blood, the patient, if he is to undergo surgery, must warn the doctor in advance about taking the drug.

Acetylsalicylic acid in low doses reduces the excretion of uric acid. In patients with a corresponding predisposition, this may in some casesto provoke a gout attack.

During treatment should be abandoned the use of ethanol (increased risk of gastrointestinal bleeding).

1 package contains 1 XE (bread unit).

Effect on the ability to drive transp. cf. and fur:During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities requiring increased attention and speed of psychomotor reactions.

Form release / dosage:

Powder for solution for ingestion orange, lemon.

Packaging:

For 13 g in heat-sealing bags of packaging combined material.

For 10 packages together with the instruction for use are placed in packs of cardboard box.

Storage conditions:

In a dry, protected from light place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:

2 years. Do not use after the expiration date.

Terms of leave from pharmacies:Without recipe

Registration number:LP-001004

Date of registration:18.10.2011

The owner of the registration certificate:MARBIOFARM, OJSC MARBIOFARM, OJSC Russia

Manufacturer: & nbsp

MARBIOFARM, OJSC Russia

Information update date: & nbsp18.10.2011

Illustrated instructions

Instructions

Citramarin® (Citramarin®)