Citramon Maxi will provide emergency treatment for headaches and migraine attacks with or without aura.
Active ingredients: paracetamol, caffeine, acetylsalicylic acid.
One tablet contains paracetamol 250 mg, caffeine 65 mg, acetylsalicylic acid 250 mg.
Excipients: low-substituted hydroxypropyl cellulose, citric acid, corn starch, microcrystalline cellulose, stearic acid.
Hypersensitivity to the components of the preparation, hypersensitivity to other xanthine derivatives, other salicylates.
Bronchial asthma, urticaria, or rhinitis caused by a history of salicylates or other NSAIDs
Congenital hyperbilirubinemia, severe renal failure or hepatic failure, Gilbert's syndrome, congenital deficiency of glucose-6-phosphate dehydrogenase;
Diseases of the blood, hemophilia, hemorrhagic diathesis, hypoprothrombinemia, anemia, leukopenia, increased tendency to bleeding, thrombosis, thrombophlebitis, hemorrhagic diseases;
Acute gastrointestinal ulcers, gastrointestinal bleeding, surgical interventions accompanied by significant bleeding;
Severe cardiovascular diseases, including arrhythmias, paroxysmal tachycardia, severe atherosclerosis, severe coronary heart disease, severe heart failure, acute myocardial infarction, severe arterial hypertension, portal hypertension, tendency to vasospasm.
Conditions of increased arousal, sleep disturbances, old age, alcoholism, glaucoma, hyperthyroidism, acute pancreatitis, prostatic hypertrophy, severe forms of diabetes mellitus.
Application simultaneously with MAO inhibitors, as well as within 2 weeks after the termination of their use.
Combination with methotrexate at a dose of 15 mg per week or more.
Contraindicated in patients using tricyclic antidepressants or β-blockers.
For headache: the usual recommended dose is 1 tablet, in addition it is allowed to take another 1 tablet with an interval between doses of 4-6 hours.
In case of more intense pain, 2 tablets can be taken.
When treating headache, the duration of therapy should be up to 4 days.
For migraine: if symptoms appear, take 2 tablets, if necessary, you are allowed to take 2 additional tablets with an interval of 4-6 hours between doses.
With migraine therapy, the duration of therapy should be up to 3 days.
For both headache and migraine, the maximum daily dose of the preparation is 6 tablets.
Take each dose of the preparation with a full glass of water.
Do not take with other medicines containing paracetamol.
It should be used with caution in elderly patients, especially those with low body weight.
Children
The preparation should not be used in children due to the risk of Reye's syndrome, hyperpyrexia, metabolic acidosis, disorders of the nervous system and psyche, vomiting, liver dysfunction, with hyperthermia against the background of viral diseases.
Pregnant
The preparation should not be used during pregnancy and lactation.
Acetylsalicylic acid has a teratogenic effect, when used during pregnancy in the first trimester, it leads to malformation, cleavage of the upper palate, in the third trimester - to inhibition of labor, closure of the ductus arteriosus in the fetus, which causes hyperplasia of the pulmonary vessels and hypertension in the vessels of the pulmonary circulation , impaired renal function with the possible subsequent development of renal failure with oligohydramnios, prolongation of bleeding time, antiplatelet effect that can occur even after very low doses.
Caffeine increases the risk of spontaneous miscarriage.
The preparation passes into breast milk, which increases the risk of bleeding in children due to impaired platelet function.
Drivers
Since adverse reactions from the nervous system may occur, when using the preparation, you should avoid driving and work that requires increased attention and speed of psychomotor reactions.
Liver damage is possible in adults who have taken 10 g more paracetamol, and in children who have taken more than 150 mg / kg of body weight.
Overdose symptoms in the first 24 hours: pallor, nausea, vomiting, anorexia and abdominal pain, liver damage may appear 12-48 hours after an overdose, glucose metabolism disorders and metabolic acidosis may occur, in severe poisoning, liver failure may progress to encephalopathy, hemorrhage, hypoglycemia, commas and lethal outcome, acute renal failure with acute tubular necrosis can manifest itself as severe low back pain, hematuria, proteinuria and develop even in the absence of severe kidney damage, as well as cardiac arrhythmia and pancreatitis.
With long-term use of the preparation in large doses on the part of the hematopoietic organs, aplastic anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia may develop.
When taking large doses from the central nervous system, dizziness, psychomotor agitation and disorientation may occur; from the urinary system, nephrotoxicity.
On the part of the hearing organs and vestibular apparatus: disorientation.
From the respiratory system, chest and mediastinal organs: rhinitis, nasal congestion, shortness of breath, bronchial asthma, bronchospasm in patients sensitive to acetylsalicylic acid and other NSAIDs.
From the gastrointestinal tract: dyspeptic disorders, including nausea, vomiting, discomfort and pain in the epigastrium, heartburn, abdominal pain; inflammation of the gastrointestinal tract, erosive and ulcerative lesions of the gastrointestinal tract, which in rare cases can cause gastrointestinal bleeding and perforation with corresponding laboratory and clinical manifestations, ulcers on the oral mucosa.
From the liver and biliary tract: increased activity of hepatic enzymes, usually without the development of jaundice, hepatonecrosis, transient hepatic failure with an increase in the level of liver transaminases.
From the kidneys and urinary system: nephrotoxicity, renal colic, interstitial nephritis, papillary necrosis.
From the endocrine system: hypoglycemia, up to hypoglycemic coma.
From the nervous system: headache, nervousness, anxiety, dizziness, tremors, paresthesias, tinnitus, visual disturbances, which may indicate an overdose: insomnia, sleep disturbances, increased excitability, disorientation, irritability.
From the side of the psyche: a feeling of fear, anxiety, anxiety.
From the side of the cardiovascular system: tachycardia, palpitations, arterial hypertension, arterial hypotension, arrhythmia.
On the part of the blood and lymphatic system: anemia, sulfate hemoglobinemia and methemoglobinemia, hemolytic anemia, bruising or bleeding; with prolonged use in high doses, aplastic anemia, pancytopenia, neutropenia, thrombocytopenia, agranulocytosis, such bleeding as intraoperative hemorrhages, hemorrhages, hematopoiesis were observed systems, nasal bleeding, bleeding from the gums, gastrointestinal bleeding and cerebral hemorrhages, which were rarely life-threatening.
From the immune system: hypersensitivity reactions, including anaphylaxis, anaphylactic shock.
In patients with individual hypersensitivity to salicylates, allergic skin reactions may develop, including symptoms such as skin flushing, fever, rash, urticaria, edema, itching, angioedema, rhinitis, nasal congestion. In patients with bronchial asthma, an increase in the incidence of bronchospasm is possible; minor to moderate allergic reactions, which can affect the skin, respiratory tract, digestive tract, cardiovascular system and manifest as rashes, urticaria, edema, itching.
On the part of the skin and subcutaneous tissue: itching, rash on the skin and mucous membranes, angioedema, exudative erythema multiforme.
Shelf life 2 years.
Store in its original packaging at a temperature not exceeding 25 ° C, out of the reach of children.
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