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

Active substances: acetylsalicylic acid acid (in terms of 100% substance) - 240 mg, paracetamol (in terms of 100% substance) - 180 mg, caffeine (in terms of 100 % substance) - 27.5 mg;

Excipients: cocoa, 22.5 mg, citric acid monohydrate - 5 mg, calcium stearate - 3 mg, talc - 6 mg, potato starch - 66 mg.

Description:Tablets of light brown color, with impregnations of more dark or more light color, round, flat-cylindrical, with a facet and a risk, with a smell of cocoa.

Pharmacotherapeutic group:Analgesic agent (non-steroidal anti-inflammatory drug + analgesic non-narcotic agent + psychostimulating agent)

ATX: & nbsp

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

Pharmacodynamics:Combined drug. Acetisalicylic acid has antipyretic and anti-inflammatory effect, relieves pain, especially caused by the inflammatory process, and also moderately inhibits aggregation platelets and thrombosis, improves microcirculation in the focus of inflammation.

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 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 effect on the thermoregulatory center in the hypothalamus and a weak ability to inhibit the synthesis of prostaglandins in peripheral tissues.

Pharmacokinetics:

Indications:Pain syndrome of mild and moderate severity (of various origins): headache, migraine, toothache, neuralgia, myalgia, arthralgia, algodismenorea. Feverish syndrome with acute respiratory illness, influenza.

Contraindications:Hypersensitivity; erosive and ulcerative lesions of the gastrointestinal tract (in the phase of exacerbation), gastrointestinal bleeding; bronchial, asthma, urticaria, or acute rhinitis, triggered by the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs; hemophilia, hemorrhagic diathesis, hypo-prothrombinemia, portal hypertension; Vitamin K vitamin deficiency; kidney failure; pregnancy (I and III trimesters), lactation period; deficiency of glucose-6-phosphate dehydrogenase, expressed arterial hypertensionζya, severe course of coronary 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, hyperuricemia, gastric ulcer and duodenal ulcer or gastrointestinal hemorrhage (history), liver disease, chronic obstructive pulmonary disease, hay fever, nasal polyposis, pregnancy (second trimester), advanced age.

Pregnancy and lactation:In the first and third trimesters of pregnancy and during lactation to apply this, the drug is contraindicated. Acetylsalicylic acid has a teratogenic effect; when applied in the first trimester leads to a developmental defect - splitting 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 circulation. Acetylsalicylic acid also excreted in breast milk, which increases the risk of bleeding in the child due to disturbed function of platelets.

If it is necessary to prescribe the drug in the second trimester of pregnancy, one should compare the prospective benefit to the mother and the potential risk to the fetus .

Dosing and Administration:

Inside (during or after a meal), 1 tablet every 4 hours, with a 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 no more than 7-10 days.

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 dosages 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. With prolonged use - dizziness, headache, visual impairment, tinnitus, decreased aggravationgation of platelets, hypocoagulation, haemorrhagic syndrome (epistaxis, bleeding gums, purpura, etc.), kidney damage with papillary necrosis; deafness; Reye's syndrome in children (hyperpyrexia, metabolic acidosis, disorders of the nervous system and psyche, vomiting, liver dysfunction).

Overdose:

Symptoms (caused by acetylsalicylic acid): When light intoxications - nausea, gastralgia, dizziness, tinnitus; -zatormozhennost severe intoxication, drowsiness, collapse, convulsions, bronchospasm, shortness of breath, - anuria, bleeding. Initially, central hyperventilation of the lungs leads to respiratory alkalosis (dyspnea, choking, cyanosis, sweating). As the intoxication intensifies, the progressive paralysis of respiration and the dissociation of oxidative phosphoryl_tcause respiratory acidosis.

Treatment: continuous monitoring of the acid-base state and electrolyte balance; depending on the state of metabolism-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 administration 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. 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 time of chloramphenicol elimination is increased by 5 times. At repeated reception paracetamol can enhance the effect of anticoagulants (derivatives of dicumarin). Simultaneous reception of paracetamol and ethanol increases the risk ofhepatotoxic effects. Caffeine accelerates the absorption of ergotamine.

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. Since 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 asthmatic reactions to salicylates or their derivatives acetylsalicylic acid can be prescribed only with special precautions (in emergency care settings). 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 leads to a developmental defect - splitting 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.Isolated with 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:

10 tablets are placed in a contour cell pack of film polyvinylchloride and aluminum foil or in a contour non-cellular package of paper with a polymer coating.

1 or 2 contiguous cell packs together with instructions for use put in a pack of cardboard.

Contour-cell or non-jellied packaging with attachment to each package of instructions for use is placed in a group package.

Storage conditions:

In a dry place at a temperature of 2 to 25 ° C.

Keep out of the reach of children.

Shelf life:

Shelf life 4 years.

Do not use after the expiration date printed on the package.

Terms of leave from pharmacies:Without recipe

Registration number:P N001075 / 01

Date of registration:21.05.2009

The owner of the registration certificate:MOSHIMFARM PREPARATES them. N.А.Semashko, OJSC MOSHIMFARM PREPARATES them. N.А.Semashko, OJSC Russia

Manufacturer: & nbsp

MOSHIMFARM PREPARATES them. NA Semashko OJSC Russia

Information update date: & nbsp23.03.2012

Illustrated instructions

Instructions

Citramon P (Citramon P)