Are common
This drug should not be taken concomitantly with medicines containing ASA or paracetamol.
Like other means for treating migraine, care should be taken to exclude other potentially serious neurological disorders prior to initiating treatment for suspected migraine in patients who have not previously been diagnosed with migraine, or for those patients with migraine who have atypical symptoms.
If patients develop vomiting during> 20% of migraine attacks, or> 50% of seizures require bed rest, the drug should not be used.
If migraine after taking the first two tablets of the drug is not stopped, you need to seek medical help.
The drug should not be used if the patient has had more than 10 headache attacks per month for at least the last three months. In this case, you should suspect a headache due to excessive use of drugs and cancel treatment.In addition, patients should seek medical help. Caution should be exercised in patients with risk factors for dehydration, for example, with vomiting, diarrhea, or before or after a major operation.
Due to its pharmacodynamic properties, the drug can mask the signs and symptoms of infection.
Due to the content in the preparation of acetylsalicylic acid
The drug should be used with caution in patients with gout, impaired renal or hepatic function, dehydration, uncontrolled hypertension, deficiency of glucose-6-phosphate dehydrogenase and diabetes mellitus.
Due to the inhibition of ASA platelet aggregation, the drug may lead to prolonged bleeding time during and after surgical interventions (including small ones, for example, tooth extraction).
The drug should not be used simultaneously with anticoagulants and other drugs that violate blood coagulation, without the supervision of a doctor (see section "Interaction with other drugs"). Patients with blood clotting disorders should be carefully monitored. Care should be taken with metro or menorrhagia.
If a patient develops bleeding or ulceration of the gastrointestinal tract when taking the drug, it must be immediately canceled. At any point in the treatment of any NSAID, potentially lethal bleeding, ulceration and perforation of the gastrointestinal tract may occur with and without precursors and severe gastrointestinal complications in the history, and without them. These complications, as a rule, are more severe in elderly patients. Alcohol, glucocorticosteroids and NSAIDs may increase the risk of gastrointestinal bleeding (see section "Interaction with other drugs"). The drug can promote the development of bronchospasm and the appearance of exacerbation of bronchial asthma (including bronchial asthma due to intolerance to analgesics) or other hypersensitivity reactions. Risk factors include bronchial asthma, seasonal allergic rhinitis, nasal polyposis, chronic obstructive pulmonary disease, chronic respiratory tract infections (especially associated with symptoms characteristic of allergic rhinitis). Such phenomena can also occur in patients with allergic reactions (for example, skin, including pruritus and urticaria) on other substances. In such patients it is recommended that special care be taken.
Children under 18 should not be prescribed medications containing acetylsalicylic acid as an antipyretic, since in the case of a viral infection they can increase the risk of developing Reye's syndrome. Symptoms of Reye's syndrome include hyperpyrexia, prolonged vomiting, metabolic acidosis, disorders of the nervous system and psyche, hepatomegaly and impaired liver function, acute encephalopathy, respiratory failure, convulsions, coma.
ASA can distort the results of laboratory tests of thyroid function due to a false positive concentration of levothyroxine (T4) and triiodothyronine (T3) (see section "Interaction with other drugs").
Due to the content of paracetamol in the preparation
Caution should be exercised when prescribing the drug to patients with impaired renal or hepatic function or alcohol dependence.
The risk of paracetamol poisoning is increased in patients taking other potentially hepatotoxic drugs or drugs that induce microsomal liver enzymes (for example, rifampicin, isoniazid, chloramphenicol, hypnotics and anticonvulsants, including phenobarbital, phenytoin and carbamazepine). Patients with an alcoholism in the anamnesis are a special risk group for liver damage (see section "Interaction with other drugs").
Serious skin reactions such as acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis, which can lead to death, can develop when the drug is used. Patients should be informed of the signs of serious skin reactions. The drug should be discontinued at the first manifestations of skin reactions or any other signs of hypersensitivity.
Due to the caffeine content in the preparation
The drug should be administered with caution to patients with gout, hyperthyroidism and arrhythmia.
When using the drug should limit the consumption of products containing caffeine, as excessive intake of caffeine can lead to nervousness, irritability, insomnia and, in some cases, increased heart rate.
Impact on laboratory research
High doses of ASA can distort the results of a number of clinical and biochemical laboratory studies.
The use of paracetamol can affect the results of the determination of uric acid by the phosphotungstic acid method and glycemia glucose oxidase / peroxidase method.
Caffeine can reverse the effects of dipyridamole on the bloodstream in the myocardium, thus distorting the results of this study. During the study, it is necessary to refrain from taking caffeine within 8-12 hours.