Pharmacodynamics. Menthol has a local irritant, analgesic, distracting, antipruritic, antiseptic, sedative effect. The effect is mainly due to reflex reactions associated with irritation of sensitive nerve endings: irritation of skin receptors stimulates the formation and release of endogenous biologically active substances (enkephalins, endorphins, peptides, kinins) involved in the regulation of pain, vascular permeability and other processes that provide anesthetic, distracting and antipruritic effects. Antiseptic activity is manifested by indiscriminate damage to microbial cells. The irritating (distracting) effect helps to reduce pain. Local action is accompanied by vasoconstriction, a feeling of cold, which is replaced by a sensation of slight burning and tingling. Skin-visceral reflexes (the reflex arc bypasses the brain) improve tissue trophism (according to the zones of innervation). The tone of the vessels, both superficial and deeply located in tissues and internal organs, changes reflexively.
Camphor has an antiseptic, local irritant, analgesic, antiplatelet effect. Reflexively stimulates the vasomotor and respiratory centers, revealing analeptic activity. Possesses peripheral vasopressor activity. Inhibits platelet aggregation. Excreted from the body through the respiratory tract, it promotes the expectoration of sputum. With local application, it has a distracting effect.
Timol is an antiseptic and disinfectant. By destroying enzymes important for the viability of microorganisms, it prevents the spread of the decay process and delays it at the very beginning. Thymol is used in the form of inhalation for bronchitis and other respiratory diseases, accompanied by sputum production. It stimulates the mucous membranes of the respiratory system, reduces the production of phlegm, dilutes it, greatly reduces the amount of mucus in it, eliminates a specific odor, prevents excessive secretion, thus preventing sepsis.
Methyl salicylate has an anti-inflammatory, analgesic effect. It non-selectively inhibits COX, reduces the synthesis of prostaglandins. Normalizes increased capillary permeability, improves microcirculation, reduces edema and infiltration of inflamed tissues.
Eucalyptus oil has an antiseptic and disinfectant effect. When applied topically, weakens sensitivity. Eucalyptus oil also stimulates the heart.
Turpentine oil is used topically as a distracting and warming agent.
Pharmacokinetics. After absorption, menthol is biotransformed in the liver and excreted in the urine and bile in the form of glucuronides.
Camphor is easily absorbed from all application surfaces, is hydroxylated in the liver to hydroxycamphoric metabolites that bind to glucuronic acid, and excreted in the urine. Camphor crosses the placenta.
Methyl salicylate quickly penetrates into the deep layers of the skin, absorbed, hydrolyzed, converted into the anion of salicylic acid and excreted in the urine. The clearance of salicylates depends on the pH of the urine.
For diseases of the respiratory tract, apply a thick layer to the skin in the chest and neck area and rub. If desired, cover the area of application with a warm, dry cloth, but it should not be applied tightly to allow the fumes to reach the nose and throat.
For pain in muscles and joints, apply a thick layer to the area of muscles or joints and rub gently.
In adults and children aged 2–12 years, the preparation is used up to 3 times a day or as directed by a doctor.
The duration of treatment is no more than 7 days. If cold symptoms persist, the preparation should be discontinued.
Epilepsy or increased convulsive readiness, as strong odors can trigger an attack; children under the age of 2; during pregnancy, since camphor and eucalyptus oil easily penetrate the skin and the placental barrier.
Moderate local irritation, erythema, rashes, peeling and itching of the skin in the area of application of the ointment are possible. There may also be mild transient discoloration of the skin and the appearance of spots on the fabric.
Menthol can cause hives, erythema, or other skin lesions (dermatitis).
With prolonged use, the sensitivity to the preparation and the analgesic effect may decrease.
Avoid contact with eyes and mucous membranes.
In case of local irritation, the use of the preparation is discontinued, appropriate therapy is applied.
The preparation should be applied only to intact skin, it should not be applied to open wounds.
Do not use for nasopharyngeal lubrication in children.
A persistent cough can be a sign of a serious illness. If the cough does not disappear within 1 week, recurs or is accompanied by fever, rashes, persistent headache, treatment tactics should be reviewed.
Do not use the preparation in case of prolonged or chronic cough in smokers, asthma, emphysema, or if the cough is accompanied by profuse sputum production.
Do not apply the preparation to large areas of the skin.
The preparation is not recommended for use during breastfeeding.
There are no reports of the interaction of Combigripp ointment with other preparations.
Possible increased severity of side effects, ataxia, drowsiness, reflex respiratory arrest.
In a dry, dark place at a temperature of 15-25 ° c. do not freeze CombiGrip ointment.
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