Citramon P - instructions for use, dose, side effects, contraindications

Excipients: starch potato - 56.34 mg, povidone - 2.44 mg, cocoa bean powder - 22.5 mg, citric acid monohydrate - 5 mg, calcium stearate monohydrate - 5.5 mg, talc - 5.22 mg, crospovidone - 5.5 mg.

Description:

Tablets of flat-cylindrical shape of light brown color with dark and light impregnations, possible white spots, with a risk and a facet, with the smell of cocoa.

Pharmacotherapeutic group:analgesic non-narcotic agent (non-steroidal anti-inflammatory drug + 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. action, relieves pain, especially caused by the inflammatory process, and also moderately inhibits platelet aggregation and thrombosis, improves microcirculation in the inflammatory focus. Paracetamol has analgesic, antipyretic and extremely weak anti-inflammatory effect, which is associated with its influence on the center of thermoregulation in the hypothalamus and a weak ability to inhibit the synthesis of prostaglandins in peripheral tissues. Caffeine increases the reflex excitability of the spinal cord, excites the respiratory and vasomotor centers, dilates the blood vessels of skeletal muscles, brain, heart, kidneys, reduces the aggregation of thrombinbocytes; reduces drowsiness, 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.

Pharmacokinetics:

When administered orally acetylsalicylic acid is rapidly absorbed mainly from the proximal part of the small intestine and to a lesser degree from the stomach. The presence of food in the stomach significantly alters the absorption of acetylsalicylic acid.

Metabolised in the liver by hydrolysis with the formation of salicylic acid, followed by conjugation with glycine or glucuronide. The concentration of salicylates in the blood plasma is variable.

It is excreted mainly by active secretion in the renal tubule in an unchanged form (60%) and in the form of metabolites. Removal of unchanged salicylate depends on the pH of the urine (alkalinization of urine increases the ionization of salicylates, their reabsorption is worsened, and significantlythe deduction is shown). The half-life of acetylsalicylic acid is approximately 15 minutes. The half-life of salicylate when taken in low doses is 2-3 hours, with an increase in the dose may increase to 15-30 hours. Paracetamol is characterized by rapid and complete absorption from the umbilical-intestinal tract, a uniform distribution in tissues,with a short half-life. The maximum concentration in the plasma is usually formed 30-60 minutes after ingestion. Revealing5 hours after a single dose.The bioavailability of the drug is very high, approaching 90%. The degree of binding to proteins is 25-50%. Metabolized paracetamol (up to 80%) by microsomal enzymes of the liver by glucuronation and sulfonation, only 3% is excreted by the kidneys in an unchanged form.

Ingestion caffeine well absorbed throughout the intestine. The maximum concentration is 1.58-1.76 mg / l. The half-life is 3.9-5.3 hours. Biotransformation in the liver with the formation of 5 metabolites. Elimination by the kidneys.

Indications:

Pain syndrome of mild and moderate severity (of various genesis): headache, migraine, toothache, neuralgia; myalgia, arthralgia, algodismenorea. Feverish syndrome: with ARI; influenza.

Contraindications:

Hypersensitivity; erosive-ulcerative lesions of the gastro-(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 and other non-steroidal anti-inflammatory drugs (including number in the anamnesis), a hemophilia, a hemorrhagic diathesis, gipoprotrombinemia, portal hypertension; avitaminosis K; kidney failure; pregnancy (I and III trimesters), lactation period; deficiency of glucose-6-phosphate dehydrogenase, severe arterial hypertension, severe course of ischemic heart disease, glaucoma, increased excitability, sleep disturbances; surgical interventions accompanied by bleeding, children's age (up to 15 years - the risk of developing Reye's syndrome in children with hyperthermia on the background of viral diseases).

Carefully:Gout, liver disease, pregnancy (second trimester), advanced age.

Pregnancy and lactation:The use of the drug is contraindicated in the I and III trimesters of pregnancy and during breastfeeding.

Dosing and Administration:

Inside (in, time or after eating), adults and children. Older than 15 years 1 tablet every 4 hours, with pain syndrome - 1-2 tablets; the average daily dose is 3-4 tablets, the maximum daily dose is 8 tablets. The course of treatment is not more than 7-10 days.

The drug should not be taken for more than 5 days as an analgesic drug and for more than 3 days as a antipyretic drug (without the appointment and supervision of a physician).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 (including 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).

At long reception - a giddiness, a headache, disturbances of sight, noise in ears, depression of aggregation of thrombocytes, hypocoagulation, gMorragic 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 intensifies, the progressive paralysis of respiration and the dissociation of oxidative phosphorylation cause respiratory acidosis.

Treatment: continuous monitoring of the 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 alkalinization of urine.

Interaction:

Strengthens the action 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 and medicines protivopodagricakih promoting excretion of uric acid.

Barbiturates, rifampicin, salicylamide, antiepileptic drugs and other stimulants of microsomal oxidation contribute to the formation of toxic metabolites of paracetamol that affect liver function.

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 anticoagulants (coumarin derivatives). Simultaneous reception of paracetamol and ethanol increases the risk of hepatotoxic effects. Caffeine accelerates the absorption of ergotamine.

Special instructions:

Children under 15 years of age should not be prescribed drugs 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 prolonged use of the drug, control of neRheypic blood and functional state of the liver.

Because the acetylsalicylic acid slows blood clotting,

the patient, if he is to undergo surgery, must warn the doctor in advance about taking the drug.

Patients with hypersensitivity or. with asthmoid reactions to salicylates or their derivatives, acetylsalicylic acid can be prescribed only with special precautions (in the conditions of an emergency care service).

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

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

Acetylsalicylic acid has a teratogenic effect: when applied in the first trimester of pregnancy leads to a malformation of the cleavage of the upper palate; in the third trimester - to inhibition of labor (inhibition of the synthesis of prostaglandins), to the closure of the arterial duct in the fetus, which causes hyperplasia of the pulmonary vessels and hypertension in the vessels of the small circle of blood circulation. Excreted in breast milk, which increases the risk of bleeding in the child due to impaired platelet function.

Effect on the ability to drive transp. cf. and fur:not described

Form release / dosage:

Pills.

Packaging:For 10 tablets in a planar cell pack, 6 or 10 tablets in a contiguous, cell-free package. 1 or 2 contour packs together with instructions for use, put in a pack of cardboard.Permissible metering contour and contour Valium packaging with an equal amount of document placed on the application directly into multipacks.

Storage conditions:

In a dry place, at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:

4 years. Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:Without recipe

Registration number:P N003636 / 01

Date of registration:10.06.2009

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

Manufacturer: & nbsp

TATHIMFARMPREPARATY, JSC Russia

Information update date: & nbsp11.04.2011

Illustrated instructions

Instructions

Citramon P (Citramon P)