Citramon-MFF - instructions for use, doses, side effects, contraindications

Excipients: to obtain a tablet weighing 0.55 g; Cocoa - 0.0225 g; Citric acid - 0.0050 g; Potato starch - 0.0650 g; Talc 0.0050 g; Calcium stearate - 0.0050 g

* - corresponds to 0.03 g of caffeine monohydrate

Description:

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

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

ATX: & nbsp

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

Pharmacodynamics:

Citramon-MFF has analgesic, antipyretic and anti-inflammatory effect.Combined action of the components of the drug ensures its effectiveness at low toxicity.

Acetylsalicylic acid has analgesic, antipyretic and anti-inflammatory action. Acetylsalicylic acid has antioxidant properties, contributes to an increase in the general resistance of the body and good tolerability of the drug.

Paracetamol has analgesic, antipyretic and antiinflammatory action are extremely weak, that is connected with its effect on hypothalamus thermoregulation center in mild and capable of inhibiting the synthesis of Pg in peripheral tissues.

Caffeine increases the excitability of spinal cord reflex, excites the respiratory and vasomotor centers, dilates blood vessels in skeletal muscle, brain, heart, kidneys, reducing platelet aggregation; reduces drowsiness, feeling fatigue, increases mental and physical operability. 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 tone of the vessels of the brain and the acceleration of blood flow.

Pharmacokinetics:

Acetylsalicylic acid: after intake is sufficiently absorbed. During absorption, it undergoes presystemic elimination in the intestinal wall and in the liver (deacetylated). The resorbed portion is very rapidly hydrolyzed by esterases (T1/2 is no more than 15-20 minutes). The anion of salicylic acid circulates in the body. Salicylates easily penetrate into tissues and body fluids, diffusion accelerates in the presence of hyperemia and edema, slows down - in the proliferative phase of inflammation. Salicylates penetrate the placenta, in small quantities are excreted in breast milk. Biotransformiruyutsya in the liver with the formation of 4 metabolites; excreted by the kidneys (urine alkalinization significantly increases excretion).

Caffeine: Well absorbed in the intestine, half-life - 5 hours (sometimes - up to 10 hours). It is excreted mainly by kidneys in the form of metabolites, about 10% - in unchanged form.

Paracetamol: rapidly absorbed from the gastrointestinal tract. The half-life of plasma is 1-4 hours. The maximum concentration in the plasma is determined usually 30-60 minutes after ingestion.

Metabolized in the liver with the formation of glucuronide and paracetamol sulfate. It is excreted by the kidneys mainly in the form of conjugation products, less than 5% is excreted unchanged.

Indications:

Citramon-MFF is used in adults when. moderately or poorly expressed pain syndrome (headache, toothache, joint pain, neuralgia, myalgia, dysmenorrhea, etc.) to reduce elevated body temperature with colds and other infectious and inflammatory diseases.

Contraindications:

Increased individual sensitivity to the components of the drug.

Peptic ulcer disease of the stomach and duodenum, gastrointestinal bleeding, pronounced impaired liver or kidney function.

Genetic absence of glucose-6-phosphate dehydrogenase. Diseases of the blood with a tendency to hemorrhage and bleeding.

Glaucoma, bronchial asthma.

I and III trimester of pregnancy and the period of breastfeeding.

Renal failure.

An attack of bronchial obstruction, hives or acute rhinitis in history, triggered by the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs; hemophilia, hemorrhagic diathesis,hypoprothrombinemia, portal hypertension; Vitamin K vitamin deficiency. Confirmed hyperkalemia.

Arterial hypertension, severe course of IHD, increased excitability, sleep disturbance; surgical interventions accompanied by bleeding. The drug is not prescribed for children under 15 with acute respiratory infections caused by viral infections (acute respiratory viral infection, influenza) because of the danger of developing Reye's syndrome.

Carefully:

With caution apply in the elderly, patients with impaired liver or kidney function (creatinine clearance less than 60 ml / min), with gout.

With IHD, cerebrovascular diseases, congestive heart failure, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking.

Anamnestic data on the development of gastrointestinal ulcer, long-term use of NSAIDs, concomitant therapy with selective serotonin reuptake inhibitors.

Pregnancy and lactation:Acetylsalicylic acid when used in the first trimester of pregnancy has a teratogenic effect; in the third trimester - can lead to inhibition of labor.It is excreted in breast milk, therefore it is contraindicated during lactation.

Dosing and Administration:

Citramon-MFF is administered orally after meals 1-2 tablets 2-3 times a day, the maximum daily dose is 6 tablets. Break between meals for at least 6 hours. In case of violations of the kidney or liver function, the interval between doses should be at least 8 hours.

The drug should not be used for more than 5 days as an anesthetic and for more than 3 days as an antipyretic without prescription and supervision by a doctor. Other dosages and regimens are prescribed by the doctor.

Side effects:

It is rare to have skin allergic reactions (rash, itching, urticaria), palpitations, dizziness, nausea, pain in the stomach. With prolonged use in high doses, there may be impaired liver and kidney function. 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, reduced platelet aggregation, hypocoagulation,hemorrhagic 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).

The side effects of the drug, including those not listed in the instructions, must be reported to your doctor.

Overdose:

Do not exceed the recommended dose and duration of use!

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 progressive paralysis and respiratory uncoupling of oxidative phosphorylation causes respiratory acidosis.


	Treatment: If you suspect a poisoning, you should immediately seek medical help.The affected person should make a gastric lavage using activated charcoal.

Interaction:

The drug enhances the effect of drugs that reduce blood clotting and platelet aggregation, as well as side effects of glucocorticoids, sulfonylurea derivatives, methotrexate, non-narcotic analgesics and non-steroidal anti-inflammatory drugs.

Strengthens the action of reserpine and hypoglycemic agents.

Reduces the effectiveness of spironolactone, furosemide, hypotensive drugs, as well as antidotal drugs that promote the excretion of uric acid. Barbiturates, rifampicin, salicylamide, antiepileptic drugs, etc. stimulators of microsomal oxidation contribute to the formation of toxic metabolites of paracetamol, which affect liver function. Metoclopramide accelerates the absorption of paracetamol. Under the influence of paracetamol T1 / 2 chloramphenicol increases 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 of hepatotoxic effects. Caffeine accelerates the absorption of ergotamine.

Use of other medicines should be agreed with the doctor.

Special instructions:

Do not prescribe the drug to children under 15 due to the high risk of developing Reye's syndrome. Reye's syndrome is manifested by prolonged vomiting, acute encephalopathy, enlargement of the liver.

Acetylsalicylic acid slows blood clotting. If the patient is to undergo surgery, a doctor should be warned in advance about taking the drug,

In patients with a predisposition to the accumulation of uric acid, taking the drug may trigger a gout attack.

During the intake should refrain from drinking alcohol (increased risk of gastrointestinal bleeding and toxic damage to the liver).

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

Form release / dosage:

Pills.

Packaging:

By 6 or 10 pieces in a contour non-jellied package or 10 tablets in a contour cell package.

For 2 or 3 contour packs of 10 tablets or 2 or 3 contour non-jawed packages of 6 or 10 tablets, together with the instructions for use are placed in a cardboard box.

Contour-cell and non-cellular packages are allowed together with an equal number of instructions for use packed in 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 expiry date.

Terms of leave from pharmacies:Without recipe

Registration number:P N001793 / 01

Date of registration:11.11.2008

The owner of the registration certificate:MOSCOW PHARMACEUTICAL FACTORY, CJSC MOSCOW PHARMACEUTICAL FACTORY, CJSC Russia

Manufacturer: & nbsp

MOSCOW PHARMACEUTICAL FACTORY, CJSC Russia

Information update date: & nbsp16.12.2011

Illustrated instructions

Instructions

Citramon-MFF (Citramon-MFF)