Citric powder for oral solution 22.13g x 10 sachets — Made in Germany — Free Delivery

There may be an increased risk of hypertension and other cardiovascular side effects.

The simultaneous use of phenylephrine with digoxin and cardiac glycosides increases the risk of irregular heartbeat or heart attack.

The simultaneous use of phenylephrine with ergot alkaloids (ergotamine and methysergide) increases the risk of developing ergotism.

Oral ascorbic acid enhances the absorption of penicillin, iron, reduces the effectiveness of heparin and indirect anticoagulants, increases the risk of crystalluria in the treatment of salicylates and the risk of glaucoma in the treatment of corticosteroids, high doses reduce the effectiveness of tricyclic antidepressants. Antidepressants, antiparkinsonian and antipsychotic preparations, phenothiazine derivatives increase the risk of urinary retention, dry mouth, and constipation. Ascorbic acid can be taken only 2 hours after the injection of deferoxamine, since their simultaneous intake increases the toxicity of iron, especially in the myocardium. Long-term use of high doses during treatment with disulfiram inhibits the disulfiram-alcohol reaction.

In case of an overdose of the preparation, the symptoms caused by paracetamol will be most pronounced.

Symptoms caused by the use of paracetamol: hepatotoxic effect, in severe cases, liver necrosis develops. Paracetamol overdose, including a high total dose that has been received over a long period, can cause analgesic-induced nephropathy with irreversible liver dysfunction.

Liver damage is possible in adults who have taken 10 g or more of paracetamol, and in children who have taken more than 150 mg / kg of body weight. In patients with risk factors: regular excessive consumption of ethanol, glutathione cachexia (digestive disorders, cystic fibrosis, HIV infection, cachexia) - the use of 5 g or more of paracetamol can lead to liver damage.

There is a risk of poisoning, especially in elderly patients, young children, patients with liver disease, patients with chronic malnutrition and patients receiving liver enzyme inducers (long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John's wort). In severe poisoning, liver failure can progress to encephalopathy, coma, and be fatal.

With prolonged use of the preparation in high doses on the part of the blood-forming organs, aplastic anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia may develop. When taking high doses from the central nervous system - dizziness, psychomotor agitation and disorientation; from the urinary system - nephrotoxicity (renal colic, interstitial nephritis, capillary necrosis).

Symptoms of a paracetamol overdose, which appear in the first 24 hours, are as follows: pallor, nausea, vomiting and lack of appetite. The first sign of liver damage may be abdominal pain, which does not always appear in the first 24–48 hours, but may occur later, within a period of up to 4–6 days after using the preparation. Liver damage usually occurs within 72–96 hours after preparation administration. There may be deviations from the norm on the part of glucose metabolism (hypoglycemia) and metabolic acidosis, hemorrhages. ARF with acute tubular necrosis can develop even in the absence of severe liver damage and manifest as severe back pain, hematuria, proteinuria. Cases of cardiac arrhythmias and pancreatitis have been reported.

Treatment. In case of an overdose of paracetamol, emergency medical attention is needed. Perhaps the appointment of N-acetylcysteine ​​in / in or orally as an antidote to paracetamol at an early stage. Gastric lavage and / or oral methionine may be beneficial up to 48 hours after overdose.

Taking activated charcoal and monitoring respiration and circulation may be helpful. Diazepam can be used if seizures occur.