Grippostad C, 2p x 10 capsules — Made in Germany — Free Deliver

(Grippostad C)

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Brand: STADA

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Description Grippostad C, 2p x 10 capsules — Made in Germany — Free Deliver

Indications

To reduce the severity of cold symptoms.

Application

The preparation is intended for oral administration. The dose for adults and children over the age of 12 is 2 capsules 3 times a day: in the morning, afternoon and evening, the interval between doses is at least 4 hours. The preparation is taken regardless of food, drinking plenty of water.

The maximum period of independent use of the preparation is 3-5 days. When prescribed by a doctor, the course of treatment is 5-7 days.

Patients with mild to moderate hepatic and / or renal impairment. In patients with moderate impairment of liver and / or kidney function, the dose should be adjusted or the interval between doses should be increased.

Do not exceed the recommended dose.

Do not take with other medicines containing paracetamol.

Contraindications

Hypersensitivity to paracetamol or any other component of the drug; severe liver and / or kidney dysfunction, Gilbert's syndrome, Dubin-Johnson syndrome, severe hyperbilirubinemia, glucose-6-phosphate dehydrogenase deficiency; hereditary forms of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption; alcoholism; blood diseases, severe anemia, leukopenia; hematopoietic disorders; thrombosis, thrombophlebitis; increased excitability, sleep disturbance; severe hypertension, a tendency to vasospasm, with organic diseases of the cardiovascular system (including atherosclerosis), decompensated heart failure, severe cardiac conduction disorders and arrhythmias; epilepsy; hyperthyroidism; prostatic hypertrophy, bladder neck obstruction; diabetes; glaucoma; acute pancreatitis, gastric and duodenal ulcers in the acute stage, pyloroduodenal obstruction.

Do not use together with MAO inhibitors and within 2 weeks after discontinuation of MAO inhibitors, do not use with tricyclic antidepressants or β-adrenergic receptor blockers.

Elderly age. During pregnancy and breastfeeding. Children under 12 years of age.

Side effects

Laboratory values: unknown - paracetamol use may affect uric acid levels, as measured by phosphoric tungstic acid, and blood glucose, as measured by peroxidase oxidase.

With the use of the appropriate recommended dose of ascorbic acid, an increase in the concentration of ascorbic acid in the urine may interfere with the adequate assessment of some clinical and chemical parameters (glucose, uric acid, creatinine, inorganic phosphates, occult blood in feces). The validity of methods based on color reactions may vary.

Also, chlorphenamine maleate can reduce the intensity of reactions during skin allergy tests.

From the side of the cardiovascular system: tachycardia, reflex bradycardia, shortness of breath, heart pain, arrhythmia, hypertension.

From the blood and lymphatic system: anemia, sulfhemoglobinemia, hemolytic anemia, thrombocytopenia, leukopenia, neutropenia, agranulocytosis, pancytopenia, methemoglobinopathy.

From the digestive system: nausea, vomiting, dry mouth, discomfort and pain in the epigastric region, hypersalivation, loss of appetite, heartburn, diarrhea.

From the endocrine system: hypoglycemia, up to hypoglycemic coma.

From the hepatobiliary system: an increase in the level of liver transaminases, hepatonecrosis (dose-dependent effect).

From the immune system: acute hypersensitivity reactions (angioedema, dyspnea, increased sweating, nausea, arterial hypotension, circulatory failure and anaphylactic shock); bullous skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis / Lyell's syndrome), anaphylaxis.

From the nervous system: headache, dizziness, psychomotor agitation and disorientation, dyskinesia, anxiety, sedation, drowsiness, a feeling of fear, sleep disorders, confusion, in some cases - coma, convulsions, change in behavior.

From the side of the kidneys: renal colic, interstitial nephritis, difficulty urinating.

From the respiratory system: respiratory hypersensitivity, bronchospasm (analginic asthma) in predisposed patients.

On the part of the skin and subcutaneous tissue: allergic reactions of the skin (erythema, rash), which may be accompanied by an increase in body temperature (preparation fever), and damage to the mucous membranes.

Metabolic disorders: increased appetite.

From the side of the psyche: psychotic reactions, internal anxiety, insomnia.

From the side of the organ of vision: initiation of glaucoma (angle-closure glaucoma), impaired vision and accommodation, dry eyes, mydriasis.

With prolonged use in high doses, damage to the glomerular apparatus of the kidneys, the formation of urate and / or oxalate calculi in the kidneys and urinary tract, renal failure are possible; damage to the insular apparatus of the pancreas (hyperglycemia, glucosuria) and impaired glycogen synthesis up to the onset of diabetes mellitus; myocardial dystrophy; thrombocytosis, thrombosis, hyperthrombinemia, erythrocytopenia, neutrophilic leukocytosis, decreased capillary permeability (possibly worsening tissue trophism, increased blood pressure); in patients with a deficiency of glucose-6-phosphate dehydrogenase, hemolysis of erythrocytes may occur; dysbiosis of the oral cavity; violation of the metabolism of zinc, copper.

Concomitant use of the preparation Grippostad C in recommended doses with products containing caffeine can increase the side effects caused by caffeine, such as dizziness, irritability, insomnia, anxiety, anxiety, irritability, headache, gastrointestinal disorders and tachycardia.

special instructions

It is necessary to consult a doctor regarding the possibility of using the preparation in patients with impaired renal or liver function.

Before using the drug, it is necessary to consult a doctor if the patient is using warfarin or similar drugs that have an anticoagulant effect.

Consider that in patients with alcoholic liver damage, the risk of the hepatotoxic effect of paracetamol increases; the preparation may affect the results of laboratory tests on the content of glucose and uric acid in the blood.

Patients taking analgesics daily for mild arthritis should consult a doctor.

The preparation contains lactose, so it should not be used in patients with rare hereditary diseases such as galactose intolerance, lactase deficiency or glucose-galactase malabsorption syndrome.

Do not exceed the indicated doses.

Do not take this medicine with other products containing paracetamol.

If symptoms persist, you should see your doctor.

If the headache becomes persistent, you should see your doctor.

There is a risk of calcium oxolate stones formation when using high doses of ascorbic acid in patients who have a tendency to form kidney stones.

Avoid the simultaneous use of other drugs intended for the symptomatic treatment of acute respiratory viral infections and influenza, vasoconstrictor drugs for the treatment of rhinitis, as well as drugs containing paracetamol.

Use with caution for the treatment of patients with mild to moderate impaired renal and liver function, epilepsy, prostate adenoma, urinary disorders, urolithiasis after consulting a doctor. When taking high doses and long-term use of the drug, it is necessary to monitor the function of the kidneys and liver, the level of blood pressure, as well as the function of the pancreas.

The preparation may affect the results of laboratory tests on the content of glucose and uric acid in the blood.

If the signs of the disease do not disappear within 3 days of preparation treatment or, conversely, the health condition worsens, you should consult a doctor.

Ascorbic acid can affect the results of various laboratory tests, for example, when determining the blood glucose, bilirubin, transaminase activity, LDH, etc.

Since ascorbic acid increases the absorption of iron, its use in high doses can be dangerous for patients with hemochromatosis, thalassemia, polycythemia, leukemia and sideroblastic anemia. Patients with a high iron content in the body should take the preparation in minimal doses.

During treatment, it is not recommended to consume excessive amounts of drinks containing caffeine (eg coffee, tea). It can cause dizziness, irritability, insomnia, restlessness, anxiety, irritability, headache, gastrointestinal disturbances, and tachycardia. In patients with severe infections, such as sepsis, accompanied by a decrease in glutathione levels, the risk of metabolic acidosis increases with paracetamol. The symptoms of metabolic acidosis are deep, rapid or labored breathing, nausea, vomiting, and loss of appetite. You should immediately consult a doctor if these symptoms appear.

Use during pregnancy and lactation. Contraindicated.

Children. The preparation is used in children over the age of 12 years.

The ability to influence the reaction rate when driving or operating other mechanisms. In cases of dizziness or other neurological manifestations that interfere with concentration, one should refrain from driving vehicles or working with other mechanisms during the period of use of the drug.

Interactions

Paracetamol. when used simultaneously with drugs that slow down the evacuation of gastric contents, such as propantheline, absorption and, in turn, the effectiveness of paracetamol may decrease.

With simultaneous use with drugs that accelerate the evacuation of gastric contents, such as metoclopramide, absorption and, in turn, the effect of paracetamol may increase.

With simultaneous use with zidovudine, the risk of developing neutropenia increases. Therefore, Grippostad C should be used with zidovudine only after consulting a doctor.

Simultaneous use with probenecid inhibits the binding of paracetamol to glucuronic acid and leads to a decrease in the clearance of paracetamol by about 2 times. With simultaneous use with probenecid, the dose of paracetamol should be reduced.

Salicylates can lengthen the T½ of paracetamol.

Caution should be exercised when used simultaneously with enzyme inducers.

Repeated use of paracetamol for several weeks increases the effect of anticoagulants.

Cholestyramine reduces the absorption of paracetamol.

The absorption rate of paracetamol can be increased by domperidone and decreased by cholestyramine.

The anticoagulant effect of warfarin and other coumarins can be enhanced with the simultaneous long-term regular daily use of paracetamol, with an increased risk of bleeding. Periodic intake has no significant effect.

Barbiturates reduce the antipyretic effect of paracetamol.

Anticonvulsants (including phenytoin, barbiturates, carbamazepine), which stimulate the activity of liver microsomal enzymes, can increase the toxic effect of paracetamol on the liver due to an increase in the conversion of the preparation to hepatotoxic metabolites.

With the simultaneous use of paracetamol with hepatotoxic agents, the toxic effect of drugs on the liver increases.

The simultaneous use of high doses of paracetamol with isoniazid increases the risk of developing hepatotoxic syndrome.

Paracetamol reduces the effectiveness of diuretics.

Do not use simultaneously with alcohol.

Chlorphenamine maleate. The simultaneous use of the preparation with the following drugs can significantly increase the severity of the inhibitory effect of chlorphenamine maleate: hypnotics; antipsychotics; tranquilizers. Chlorphenamine enhances the anticholinergic effect of atropine, antispasmodics, tricyclic antidepressants, antiparkinsonian drugs.

Simultaneous use with sedatives of central action or alcohol potentiates the sedative effect.

Caffeine. Caffeine can reduce the sedative effect of barbiturates, antihistamines.

Caffeine has a synergistic effect with sympathomimetics, thyroxine (increases heart rate).

When used simultaneously with theophylline, it reduces the elimination of the latter.

Caffeine enhances the additive potential of ephedrine-type substances.

When combined with drugs with a broad spectrum of action (for example, benzodiazepines), various and unpredictable reactions can develop.

Oral contraceptives, cimetidine and disulfiram reduce the breakdown of caffeine in the liver; barbiturates and nicotine enhance it.

Concomitant use of quinolone carboxylgyrase inhibitors can reduce the elimination of caffeine and its metabolite paraxanthine.

Caffeine enhances the effect (improves bioavailability) of analgesics-antipyretics, potentiates the effects of xanthine derivatives, α- and β-adrenergic agonists, psychostimulants.

Cimetidine, hormonal contraceptives, isoniazid enhance the effects of caffeine.

Caffeine reduces the effect of opioid analgesics, anxiolytics, hypnotics and sedatives, is an antagonist of drugs for anesthesia and other drugs that depress the central nervous system, a competitive antagonist of drugs adenosine, ATP.

With the simultaneous use of caffeine with ergotamine, the absorption of ergotamine in the gastrointestinal tract improves, with thyroid-stimulating agents - the thyroid effect increases.

Caffeine lowers the concentration of lithium in the blood.

Vitamin C. The absorption of ascorbic acid is reduced with the simultaneous use of oral contraceptives, the use of fruit or vegetable juices, and alkaline drinks; when administered orally, ascorbic acid increases the absorption of penicillin, tetracycline, iron, reduces the effectiveness of heparin and indirect anticoagulants, increases the risk of crystalluria during treatment with salicylates; the simultaneous intake of ascorbic acid and deferoxamine increases the tissue toxicity of iron, especially in the heart muscle, which can lead to decompensation of the circulatory system. Ascorbic acid increases the total clearance of ethyl alcohol; drugs of the quinoline series, calcium chloride, salicylates, corticosteroids, with prolonged use, reduce the reserves of ascorbic acid in the body.

Overdose

Symptoms of an overdose of the preparation gripostad are due to the action of each individual component of the drug.

Paracetamol. 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 (long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. )) the use of ≥5 g of paracetamol may lead to liver damage.

Overdose symptoms in the first 24 hours: pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage can occur 12–48 hours after overdose. Disorders of glucose metabolism and metabolic acidosis may occur. In severe poisoning, liver failure can progress to encephalopathy, hemorrhage, hypoglycemia, coma and death. ARF with acute tubular necrosis can present with severe low back pain, hematuria, proteinuria and develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have also been reported.

With prolonged use of the preparation in high doses on the part of the hematopoietic 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).

In case of an overdose, emergency care is needed. The patient should be hospitalized immediately, even if there are no early symptoms of overdose. Symptoms may be limited to nausea and vomiting, or may not reflect the severity of the overdose or the risk of organ damage. Treatment with activated charcoal should be considered if an excessive dose of paracetamol was taken within 1 hour. The plasma concentration of paracetamol should be measured 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine can be applied within 24 hours after taking paracetamol, but the maximum protective effect occurs when it is used within 8 hours after administration. The effectiveness of the antidote decreases sharply after this time. If necessary, the patient should be injected intravenously with N-acetylcysteine according to the established list of doses. In the absence of vomiting, oral methionine can be used as an appropriate alternative in remote areas outside the clinic.

Chlorphenamine maleate. After an overdose, anticholinergic components cause symptoms similar to those caused by atropine: blush, congealed dilated pupils, ataxia, tremors, fever, dry mouth, and constipation. Then signs of intoxication from the central nervous system (hallucinations, impaired coordination of movements and convulsions) may appear. The final symptoms are coma, respiratory failure, and cardiovascular collapse.

Caffeine. When using ≥1 g of caffeine in a short period, symptoms of intoxication may develop: tremor, disorders of the central nervous system, cardiovascular disorders (tachycardia, myocardial damage), pain in the epigastric region, vomiting, diuresis, rapid breathing.

Treatment: there is no specific antidote, but supportive measures, such as the use of β-adrenergic receptor antagonists, can reduce the severity of the cardiotoxic effect. It is necessary to flush the stomach, apply oxygen therapy, for convulsions - diazepam. Symptomatic therapy.

Vitamin C. In case of an overdose of ascorbic acid, pain in the epigastric region, nausea, vomiting, diarrhea, itching and rash, increased irritability may occur. There is a risk of hemolysis and kidney stones. In the case of a single dose ≥3 g, transient osmotic diarrhea and symptoms from the digestive system may develop.

Treatment: rinse the stomach, prescribe an alkaline drink, activated carbon or other adsorbents to the patient.

Storage conditions

In its original packaging at a temperature not exceeding 30 ° C.

Tags: Grippostad

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