Milistan multisymptomic oral suspension 100 ml — Made in India — Free Delivery

Pharmacological properties

Paracetamol has analgesic, antipyretic and mild anti-inflammatory effects. the mechanism of action is due to the inhibition of the synthesis of prostaglandins and the predominant effect on the center of thermoregulation in the hypothalamus.

Cetirizine hydrochloride is a selective antagonist of peripheral H1-histamine receptors, a metabolite of hydroxyzine. Possesses antiallergic properties due to inhibition of the late phase of cell migration, which are involved in the inflammatory response (mainly eosinophilic granulocytes); also reduces the expression of adhesion molecules such as ICAM-1 and VCAM-1, which are markers of allergic inflammation. It inhibits the action of other mediators and inducers of histamine secretion, such as platelet activation factor and substance R. Virtually does not cause anticholinergic and antiserotonin effects. In therapeutic doses, it does not have a sedative effect.

Dextromethorphan hydrobromide is an antitussive agent that is effective for unproductive coughs that result from bronchial irritation. The mechanism of action is due to the effect on the cough center in the medulla oblongata.

Chlorpheniramine (chlorphenamine) maleate - antiallergic agent, blocker of H1 receptors. It has a moderately pronounced sedative effect.

Suction. After oral administration, the preparation is rapidly and almost completely absorbed from the digestive tract.

Output. The half-life of paracetamol is 1-4 hours. In patients with cirrhosis of the liver, the half-life is increased. Plasma protein binding is variable.

The renal clearance of paracetamol is 5%. It is excreted in the urine mainly in the form of glucuronic and sulfate conjugates.

After a single use of cetirizine hydrochloride, the half-life is approximately 10:00, 2/3 of the preparation is excreted unchanged by the kidneys and about 10% - with feces. Systemic clearance - 53 ml / min.

The half-life of dextromethorphan hydrobromide is approximately 4:00, the preparation is excreted through the kidneys unchanged and as demethylated metabolites (including dextrorphan). The active ingredients of the preparation penetrate the placenta and into breast milk.

Indications

Symptomatic treatment of influenza and other acute respiratory viral infections, accompanied by dry irritating cough, fever, muscle and joint pain, headache, nasal congestion, runny nose, lacrimation; including those accompanied by allergies.

Contraindications

Hypersensitivity to the components of the preparation, to hydroxyzine or to any piperazine derivative, antihistamines.

Severe renal dysfunction.

Severe liver dysfunctions, congenital hyperbilirubinemia, alcoholism, Gilbert's syndrome.

Blood diseases, deficiency of glucose-6-phosphate dehydrogenase, severe anemia, leukopenia, hypocoagulation.

Angular glaucoma.

The risk of urinary retention due to diseases of the urethra and prostate, obstruction of the bladder neck.

Pyloroduodenal stenosis, intestinal obstruction.

Severe hypertension, disease of the coronary arteries of the heart, arrhythmias. Diabetes mellitus, hyperthyroidism.

Epilepsy.

Patients at risk of respiratory failure.

Do not use together with MAO inhibitors (MAO) and within 2 weeks after discontinuation of MAO inhibitors, antidepressants with serotonin reuptake (fluoxetine, paroxetine).

Method of administration and dosage

For children over 12 years old, the preparation should be administered orally, 1 caplet 1 time per day. The maximum duration of treatment is 5-7 days.

The maximum period of use for children without consulting a doctor is 3 days.

For patients with a moderately severe form of renal insufficiency, the preparation should be used in half the dose.

For elderly patients with normal renal function, dose adjustment is not required.

children

Contraindicated in children under 12 years of age.

Overdose

Symptoms

Signs and symptoms of an overdose of individual components of the preparation Milistan. Multisymptoms can be distributed as follows:

Related to paracetamol.

Liver damage is possible in adults, they took 10 g or more of paracetamol, and in children, they took more than 150 mg / kg of body weight. In patients with risk factors (long-term use of carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John's wort or other preparations, induce liver enzymes, alcohol abuse, deficiency of the glutathione system, for example: digestive disorders, HIV infection, starvation, cystic fibrosis, cachexia) 5 g or more of paracetamol may cause liver damage.

Overdose symptoms in the first 24 hours: pallor, nausea, vomiting, loss of appetite and abdominal pain. Liver damage can occur 12-48 hours after an overdose. Disorders of glucose metabolism and metabolic acidosis may occur. In severe poisoning, liver failure can progress to encephalopathy, hemorrhage, hypoglycemia, commas and be fatal. Acute renal failure 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 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 are possible; from the urinary system - nephrotoxicity (renal colic, interstitial nephritis, capillary necrosis).

Cetirizine hydrochloride related.

Cetirizine overdose is mainly associated with effects on the central nervous system or with effects that may indicate an anticholinergic effect. Side effects reported after dosing exceeded at least 5 times the recommended daily dose include: confusion, diarrhea, dizziness, fatigue, headache, malaise, mydriasis, itching, anxiety, sedation, drowsiness, stupor, tachycardia, tremors and urinary retention.

Chlorphenamine related.

The estimated lethal dose of chlorphenamine is 25 to 50 mg / kg body weight. In case of an overdose, the condition can vary from depressed to agitated (anxiety and convulsions). Atropine-like symptoms can be observed, including mydriasis, photophobia, dry skin and mucous membranes, fever, intestinal atony, depression of the central nervous system accompanied by respiratory disorders and disorders of the cardiovascular system.

Dextromethorphan hydrobromide related

Symptoms of an overdose of dextromethorphan hydrobromide nausea and vomiting, CNS depression, dizziness, dysarthria, ataxia, blurred vision, myoclonus, nystagmus, drowsiness, tremor, agitation, hyperactivity, confusion, psychotic disorders (psychosis) and respiratory depression.

Treatment

In case of an overdose, an ambulance is needed. The patient should be taken to hospital 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 overdose was taken within 1:00. The concentration of paracetamol in blood plasma should be measured 4:00 or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine ​​can be applied within 24 hours after taking the preparation, but the maximum protective effect occurs when it is used within 8:00 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 current recommendations. In the absence of vomiting, oral methionine can be used as an appropriate alternative in remote areas outside the hospital.

In addition to the above, symptomatic or supportive therapy is recommended.

Structure

active ingredients: 1 caplet contains paracetamol 325 mg, cetirizine hydrochloride 10 mg, chlorpheniramine maleate 2 mg, dextromethorphan hydrobromide 15 mg

excipients: corn starch, microcrystalline cellulose, methylparaben (E 218), propylparaben (E 216), magnesium stearate, talc, colloidal silicon dioxide, sodium lauryl sulfate, sodium starch glycolate (type A), hypromellose, propylene glycol, polyethylene 4000 E 171).

Storage conditions

Store at a temperature not exceeding 25 ° C in its original packaging, out of the reach of children.

Shelf life is 3 years.