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

Similar drugsTo uncover

Dosage form: & nbsppills

Composition:

Active substances: Acetylsalicylic acid 220 mg, paracetamol 200 mg, caffeine 27.0 mg;

Excipients: cocoa powder 22.5 mg, citric acid monohydrate 4.6 mg, potato starch 68 mg, talc 2.4 mg, stearic acid 5.5 mg.

Description:Ploskotsilindricheskie tablets of light brown color with white impregnations, with a smell of cocoa, with a risk and a facet.

Pharmacotherapeutic group:analgesic non-narcotic agent (NSAIDs + psychostimulant + non-narcotic analgesic)

ATX: & nbsp

Acetylsalicylic acid in combination with psycholeptics

Pharmacodynamics:

Combined drug.

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

Indications:

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

Feverish syndrome: with acute respiratory infections (ARI), 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 ASA or other non-steroidal anti-inflammatory drugs (including in anamnesis), hemophilia, hemorrhagic diathesis, hypoprothrombinemia,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 under 18 years of age (the risk of developing Reye's syndrome in children under the age of 18 with hyperthermia on the background of viral diseases).

Carefully:

Gout, liver disease, advanced age, pregnancy (II trimester).

Pregnancy and lactation:

The use of Citramon-Borimed during pregnancy is possible only in the second trimester of pregnancy strictly under the supervision of a doctor. This is due to the fact that ASA has a teratogenic effect in the I and III trimesters of pregnancy (when applied in the first trimester, it leads to splitting of the upper palate; III trimester - to inhibition of labor due to a decrease in the synthesis of Pg, the closure of the arterial duct in the fetus, which causes hyperplasia of pulmonary vessels and pulmonary hypertension).

Isolated with breast milk, which increases the risk of bleeding in the child due to impaired platelet function.If it is necessary to use Citramon-Borimed during lactation, we should wean the baby for the entire period of treatment.

Dosing and Administration:

Apply inside, preferably between meals or immediately after meals.

Adults and children over 18 years of age appoint a dose of 1 tablet 2-3 times a day. The interval between doses of the drug should be at least 6-8 hours. The maximum single dose is 2 tablets, the maximum daily dose is 4 tablets.

As an antipyretic agent is prescribed at a body temperature of more than 38.5 ° C (in patients with febrile convulsions in the anamnesis - at a temperature of more than 37.5 ° C) in a dose of 1-2 tablets.

The duration of application as an analgesic should not exceed 5 days, as an antipyretic agent, not more than 3 days.

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).

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

Overdose:

Symptoms (due to ASA and paracetamol). For poisoning of mild severity, tinnitus, hyperventilation due to stimulation of the respiratory center, respiratory alkalosis due to loss of CO₂, anxiety, restlessness, tremor, headache, nausea, vomiting, sweating.

For poisoning moderate characteristic strong dyspnea, gipergermiya due to uncoupling of oxidation and phosphorylation (bad prognostic sign in adults), metabolic acidosis due to enhanced anaerobic glycolysis, tachyarrhythmia, increased transaminases, bilirubin, prothrombin index to increase 2,0-2, 5.

For severe poisoning, collapse, coma, convulsions with pathological intensification of tendon reflexes, hypoprothrombinemia (an increase in prothrombin index more than 2.5) are characteristic, a sharp increase in transaminases, bilirubin develops.

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 ASA due to alkalinization of urine.

In the presence of liver damage, a specific antidote of paracetamol, N-acetylcysteine, is administered. 20% N-acetylcysteine solution was applied intravenously and the inside: a first dose of 140 mg / kg (0.7 ml / kg) followed by 70 mg / kg (0.35 ml / kg). A total of 17 doses are administered. The most effective treatment is that started in the first 10 hours after the development of intoxication. If from the moment of intoxication has passed more than 36 hours treatment is ineffective.

Interaction:

Included in Citramon-Borimed acetylsalicylic acid It enhances the toxicity of methotrexate, valproic acid, barbituric drugs, the effects of narcotic analgesics, oral antidiabetic drugs sulfanilmidnyh means (including co-trimoxazole), triiodothyronine, digoxin due to displacement of their connection to the protein.

It increases the risk of bleeding while the use of indirect anticoagulants, platelet aggregation inhibitors, thrombolytic agents.

Weaken the effects of antihypertensive agents from the group of ACE inhibitors, loop (furosemide) and potassium-sparing (spironolactone) diuretics due to inhibition of the formation of prostaglandins in the kidneys.

Weaken the effect of uricosuric drugs due to the competitive excretion of uric acid in the tubules of the nephron.

When used simultaneously with lithium salts, the concentration of lithium ions in the plasma increases.

Glucocorticosteroids increase the toxic effect of acetylsalicylic acid on the gastric mucosa, increase its excretion and reduce the concentration in the blood plasma.

Combined oral contraceptives, phenytoin, alcohol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants increase the risk of hepatotoxic effects of paracetamol in the preparation.

Macrolide antibiotics (clarithromycin, erythromycin), interferon preparations and antifungal agents (ketoconazole, fluconazole) slow the metabolism of paracetamol and increase its concentration in the plasma.

Acetylsalicylic acid and paracetamol increase the toxic effect of alcohol on the mucous membrane of the gastrointestinal tract and the liver.

Part of Citramon-Borimed caffeine when applied simultaneously with β₂-adrenomimetics in high doses (salmeterol, salbutamol, fenoterol) increases the risk of hypokalemia.

When used simultaneously with preparations of methylxanthines (theophylline, aminophylline) there is an increase in the concentration of theophylline in the blood plasma and an increase in the risk of its toxic effects.

Caffeine accelerates the absorption of ergotamine.

Special instructions:

Children under the age of 18 can not be prescribed drugs containing ASA, 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 ASA 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 bronchospastic reactions to salicylates or their derivatives Citramon-Borimed can be prescribed only with special measuresprecautionary measures (in conditions of emergency or hospital services).

ASA 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).

Form release / dosage:

Pills.

Packaging:

10 tablets per contour cell pack.

1 circuit cell pack with instructions for medical use is placed in a pack of cardboard.

6 tablets in contour non-jammed packaging.

1 contour non-jawed package with instruction for medical use is placed in a pack of cardboard.

For 10 tablets in a planar cell package or 6 tablets in a contiguous, cell-free package, together with instructions for medical use (without a pack).

750 contour non-jammed packages or 300 contour mesh packages together with instructions for medical use, in an amount equal to the number of packages placed in transport containers not intended for consumers.

For hospitals: 750 contour non-jawed packages with 20 instructions for use are placed in a cardboard box.

Storage conditions:

In a dry, the dark place at a temperature of no higher than 25 ° C.

Keep out of the reach of children.

Shelf life:

4 years.

The drug should be used before the date indicated on the package.

Terms of leave from pharmacies:Without recipe

Registration number:П N012262 / 01

Date of registration:22.07.2011

The owner of the registration certificate:BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC Republic of Belarus

Manufacturer: & nbsp

BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC Republic of Belarus

Representation: & nbspBORISOVSKIY FACTORY OF MEDPREPARATES, OJSCBORISOVSKIY FACTORY OF MEDPREPARATES, OJSC

Information update date: & nbsp18.03.2016

Illustrated instructions

Instructions

Citramon-Borimed (Citramon-Borimed)