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

Excipients: cocoa beans powder (cocoa powder) - 0.0218 g, lemon acid monohydrate 0.0004 g, potato starch 0.0613 g, calcium stearate monohydrate (calcium stearate 1 -water) 0.0055 g, povidone (polyvinylpyrrolidone) 0.0027 g, talc 0.0083 g.

Description:

Tablets of light brown color with impregnations, with a smell of cocoa, a flat-cylindrical form with a risk and a facet.

Pharmacotherapeutic group:Analgesic combined (NSAIDs + analgesic non-narcotic remedy + psychostimulant).

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, as well as expressed inhibits platelet aggregation and thrombosis, improves microcirculation in the inflammatory focus.

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 fatigue, 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, however, it helps to normalize the tone of the vessels of the brain, and acceleration of blood flow.

Paracetamol has analgesic, antipyretic and extremely weak anti-inflammatory effect, which is due to its influence on the center of thermoregulation in hypothalamus and a weak ability to inhibit the synthesis of prostaglandins (Pg) in peripheral tissues.

Pharmacokinetics:

Indications:

Citramon P is used in adults with moderate or mild painsyndrome (of various origins): headache, migraine, toothache, neuralgia, myalgia, thoracic radicular syndrome, lumbago, arthralgia, menstruation pain.

In adults and children older than 15 years to reduce high fever with "cold" and other infectious and inflammatory diseases.

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 anamnesis), hemophilia, hemorrhagic diathesis, hypoprothrombinemia, portal hypertension; avitaminosis K; kidney failure; deficiency of glucose-6-phosphate dehydrogenase, arterial hypertension III degree, severe course of coronary heart disease, glaucoma, increased excitability, sleep disturbances; surgical interventions, accompanied by bleeding.

Due to the presence of acetylsalicylic acid in the formulation,the drug is not prescribed as an antipyretic agent for children under 15 with acute respiratory infections caused by viral infections, because of the danger of developing Reye's syndrome (encephalopathy and acute fatty liver dystrophy with acute development of hepatic insufficiency).

Carefully:

Gout, liver disease, elderly age.

Pregnancy and lactation:

Application in pregnancy and during breastfeeding

The drug is contraindicated in pregnancy, at the time of treatment should stop breastfeeding.

Dosing and Administration:

The drug is used inside during or after a meal. To reduce the irritant effect on the gastrointestinal tract, the drug should be taken with water, milk, alkaline mineral water.

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 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).

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, liver dysfunction).

If any of the side effects indicated in the instructions for use are aggravated, or if you notice any other side effects not listed in the instructions for use, tell your doctor.

Overdose:

Symptoms caused by acetylsalicylic acid: with light intoxication - nausea, vomiting, gastralgia, dizziness, ringing in the ears; severe intoxication - inhibition, drowsiness, collapse, convulsions; bronchospasm, shortness of breath, anuria, bleeding.

Initially, central / hyperventilation of the lungs leads to respiratory alkalosis (shortness of breath, suffocation, cyanosis, sweating). As the intoxication progresses paralysis of respiration- and dissociation of oxidative phosphorylation cause respiratory acidosis.

Symptoms caused by paracetamol: during the first 24 hours after admission - pallor toskin, nausea, vomiting, anorexia, abdominal pain; metabolic disorder glucose, metabolic acidosis. Symptoms of liver dysfunction may appear 12-48 hours after an overdose. In severe intoxication - hepatic deficiency with progressive encephalopathy, coma, death; acute, renal insufficiency with tubular necrosis (including in the absence of severe lesions liver); arrhythmia, pancreatitis.

Chronic overdose: symptoms caused by acetylsalicylic acid: when long-term use - dizziness, headache, visual impairment, tinnitus, decreased aggregation of platelets, hypocoagulation, hemorrhagic syndrome (nasal bleeding) bleeding gums, purpura and others), kidney damage with papillary necrosis, deafness.

Symptoms caused by paracetamol: with long-term admission in high doses possibly hepatotoxic and nephrotoxic action (renal colic, Hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia).
Hepatotoxic effect in adults is manifested when taking 10 g or more.

Treatment: constant monitoring of changes in the parameters of the acid-base state (CBS) and electrolyte balance; depending on the state of metabolism - the introduction sodium bicarbonate, sodium citrate or sodium lactate. Increasing reserve alkalinity increases the excretion of acetylsalicylic acid due to alkalinization of urine.
If there is liver damage, donators are injected SH-r.пппп and precursors of synthesis glutathione - methionine for 8-9 hours after an overdose and acetylcysteine - in for 8 hours. The need for additional therapeutic (further introduction of methionine, intravenous injection of acetylcysteine) is determined depending on the concentration of paracetamol in the blood, and also on the time passed after its reception.

Interaction:

Acetylsalicylic acid increases the toxicity of methotrexate, reducing its renal clearance, valproic acid; enhances the effects of non-steroidal anti-inflammatory drugs, narcotic analgesics, oral hypoglycemic drugs,heparin, indirect anticoagulants, thrombolytics and antiplatelet agents, sulfonamides (including cotrimoxazole), T3 (triiodothyronine); reduces the effect of uricosuric medicines (benzbromarone, sulfinpyrazone), antihypertensive drugs, diuretics (spironolactone, furosemide). Glucocorticosteroid; facilities, ethanol and ethanol-containing drugsincrease the damaging effect on the mucosa of the gastrointestinal tract, increase the risk of developing gastrointestinal bleeding. Increases the concentration of digoxin, barbiturates, lithium salts in plasma. Antacids containing magnesium ions and / or aluminum ions slow down and worsen the absorption of acetylsalicylic acid. Myelotoxic drugs increase the manifestation of hematotoxicity of acetylsalicylic acid.

Paracetamol reduces the effectiveness of uricosuric medicines. The concomitant use of paracetamol in high doses increases the effect anticoagulant drugs (decreased synthesis of procoagulant factors in the liver). Inductors of microsomal liver enzymes (phenytoin, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, which makes it possible to develop severe intoxication even with a slight overdose. Long-term use of barbiturates reduces the effectiveness of paracetamol. Ethanol promotes the development of acute pancreatitis. Inhibitors of microsomal oxidation (including cimetidine) reduce the riskhepatotoxic effect. 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 administration of paracetamol in high doses of salicylates increases the risk of developing kidney or bladder cancer. Diflunisal plasmids the plasma concentration of paracetamol by 50% - the risk of developing hepatotoxicity. Myelotoxic medicines, intensify manifestations of hematotoxicity preparation.

Caffeine is an adenosine antagonist (large doses of adenosine may be required). With the joint use of caffeine and barbiturates primidone, anticonvulsant medicinal products (hydantoin derivatives, especially phenytoin) perhaps increased metabolism and increased clearance of caffeine, cimetidine, oral contraceptive drugs, disulfiram, ciprofloxacin, norfloxacin, decrease in metabolism of caffeine in the liver (slowing its elimination and increase concentration in the blood).

Mexiletin - reduces the excretion of caffeine, up to 50%; nicotine - increases speed excretion of caffeine; Inhibitors of monoamine oxidase, furazolidone; procarbazine and selegiline, large doses Caffeine can cause the development of a dangerous cardiac arrhythmia or a marked increase arterial pressure. Caffeine reduces the absorption of calcium in the gastrointestinal tract. Reduces the effect of narcotic and hypnotic drugs. Increases the excretion of lithium preparations by wetting. Accelerates absorption and enhances the action of cardiac glycosides, increases their toxicity. Joint use of caffeine with beta-blockers can lead to mutual suppression of therapeutic effects; with adrenergic bronchodilator drugs - to additional stimulation of the central nervous system.

Special instructions:

Children under 15 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 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 blood, the patient, if he has a surgical, intervention, 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 can in some cases to provoke a gout attack.

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

Effect on the ability to drive transp. cf. and fur:When ingestion in high doses (up to 8 tablets per day) caffeine, which is part of the drug makes it difficult to concentrate, so you need to refrain from driving vehicles and practicing potentially dangerous activities that require increased concentration and speed of psychomotor reactions.

Form release / dosage:

Pills.

Packaging:

For 6, 10 tablets in a contour non-jellied package of paper with a polymer coating.

For 10 tablets in a contour mesh package made of a polyvinylchloride film and aluminum foil or paper with a polymeric coating.

By 10,20,25,30,40, 50,60 tablets in cans of polymeric.

Each bank, or 1, 2, 3, 4, 5 contour non-jammed packages, or contour mesh packages together with the instruction for use, is placed in a bundle.

Banks polymeric, or contour non-cellular packages, or contour mesh packages with an equal number of instructions for use are placed in a bag of polyethylene film or a cardboard box.

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 expiration date.

Terms of leave from pharmacies:Without recipe

Registration number:P N002640 / 01

Date of registration:17.07.2008

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

Manufacturer: & nbsp

URALBIOFARM, OJSC Russia

Information update date: & nbsp18.05.2012

Illustrated instructions

Instructions

Citramon P (Citramon P)