Pharmacitron powder for flu and colds, 23g x 10 sachets — Made in Canada — Free Delivery
(Pharmacitron )
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Description Pharmacitron powder for flu and colds, 23g x 10 sachets — Made in Canada — Free Delivery
Pharmacodynamics
Paracetamol has antipyretic, analgesic and mild anti-inflammatory effects. Suppresses the synthesis of prostaglandins in the central nervous system (CNS), and blocks the conduction of pain impulses.
Pheniramine maleate - blocker of H1-receptors, reduces vascular permeability, eliminates lacrimation, itching of the eyes and nose.
Phenylephrine hydrochloride is an α-adrenergic agonist, has a vasoconstrictor effect, reduces swelling of the nasal mucosa and paranasal sinuses.
Ascorbic acid enhances the body's nonspecific resistance.
Pharmacokinetics
Paracetamol is well absorbed, penetrates the placental barrier, slightly penetrates into breast milk, is metabolized by the cytochrome P450 system, is excreted by the kidneys, the half-life is 1-4 hours. The duration of action is 3-4 hours.
Pheniramine maleate is well absorbed from the digestive tract. It is metabolized in the liver by the cytochrome P450 system, the half-life is 16-18 hours, 70-83% is excreted by the kidneys.
The effect of phenylephrine hydrochloride occurs quickly and lasts about 20 minutes. It is metabolized in the liver or in the gastrointestinal tract, excreted by the kidneys.
Ascorbic acid is rapidly absorbed in the digestive tract, metabolized in the liver, and excreted by the kidneys.
Indications
Symptomatic treatment of acute respiratory infections and influenza:
- increased body temperature;
- headache;
- nasal congestion;
- runny nose;
- muscle aches and pains.
Contraindications
Hypersensitivity to the components of the preparation; severe impairment of liver and / or kidney function.
Congenital hyperbilirubinemia.
Deficiency of glucose-6-phosphate dehydrogenase.
Phenylketonuria, alcoholism, blood diseases leukopenia anemia severe arrhythmias, arterial hypertension, atherosclerosis, ischemic heart disease, hyperthyroidism acute pancreatitis prostate hypertrophy with urinary retention obstruction of the bladder neck pyloroduodenal obstruction.
Bronchial asthma.
Glaucoma.
Pheochromocytoma.
Thrombosis.
Thrombophlebitis.
Diabetes mellitus, epilepsy, states of increased excitement.
Sleep disturbance, concomitant treatment with tricyclic antidepressants, β-blockers, other sympathomimetics, preparations that suppress or increase appetite and amphetamine-like psychostimulants.
Concomitant treatment and 2 weeks after the use of MAO inhibitors.
Composition
Active ingredients: paracetamol (acetaminophen), phenylephrine hydrochloride, pheniramine maleate, ascorbic acid;
1 packet contains paracetamol (acetaminophen) 500 mg, phenylephrine hydrochloride 10 mg, pheniramine maleate 20 mg, ascorbic acid 50 mg;
Excipients: sodium, citric acid, artificial lemon flavor, yellow dye D & C No. 10 (E 104), red dye FD & C No. 40 (E 129), silicon dioxide, sucrose, sugar.
Interaction with other medicinal products and other types of interactions
The absorption rate of paracetamol may increase when used with metoclopramide and domperidone and decrease with cholestyramine (this effect is insignificant if cholestyramine is used after 1 hour). With prolonged use of paracetamol, the anticoagulant effect of warfarin and other coumarin derivatives may increase and the risk of bleeding may increase. With occasional use of paracetamol, this effect is not pronounced. Barbiturates reduce the antipyretic effect of paracetamol. Hepatotoxic preparations increase the likelihood of paracetamol cumulation and overdose. The risk of hepatotoxicity of paracetamol increases when taking preparations , induce microsomal liver enzymes (barbiturates; anticonvulsants - phenytoin, phenobarbital, carbamazepine and anti-tuberculosis - rifampicin, isoniazid).
Paracetamol: reduces the effectiveness of diuretics, may lengthen the half-life of chloramphenicol; can induce the metabolism of lamotrigine in the liver, and therefore its bioavailability and effectiveness are reduced. With regular use of paracetamol and zidovudine, neutropenia and an increased risk of liver damage are possible. When taking probenecid, the dose of paracetamol should be reduced, as it affects the metabolism of paracetamol. Paracetamol can affect the results of determining the level of uric acid by the phosphorus-tungsten acid method. The hepatotoxicity of paracetamol may increase with prolonged or excessive alcohol use. Do not use concomitantly with alcohol.
The interaction of phenylephrine with MAO inhibitors causes a hypertensive effect, tricyclic antidepressants (amitriptyline) - increases the risk of cardiovascular side effects, with digoxin and cardiac glycosides - leads to arrhythmias and heart attack, with other sympathomimetics increases the risk of cardiovascular side reactions and hypertension, can reduce the effectiveness of β-blockers and other antihypertensive preparations (reserpine, methyldopa, debrisoquine, guanethidine) with an increased risk of hypertension and adverse cardiovascular reactions. The simultaneous use of phenylephrine with ergot alkaloids (ergotamine and methysergide) may increase the risk of ergotism.
Ascorbic acid, when taken orally, enhances the absorption of iron, increases the level of ethinyl estradiol, penicillin, tetracycline; reduces the level of antipsychotic preparations, phenothiazine derivatives in the blood; 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; large doses decrease the effectiveness of tricyclic antidepressants. 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, which can lead to cardiac decompensation. Long-term use of large doses in the treatment of disulfiram inhibits the disulfiram-alcohol reaction. The absorption of ascorbic acid is reduced when taking oral contraceptives, using fruit or vegetable juices, and alkaline drinks.
Pheniramine enhances the anticholinergic effect of atropine, antispasmodics, tricyclic antidepressants, antiparkinsonian preparations, inhibits the effect of anticoagulants. The simultaneous use of feniramine with sleeping pills, barbiturates, sedatives, antipsychotics, tranquilizers, anesthetics, narcotic analgesics, alcohol can significantly increase its suppressed effect.
Application features
Do not exceed the recommended doses. If symptoms do not improve within 5 days or are accompanied by a high fever, fever for more than 3 days, rash or prolonged headache, you should consult your doctor as these may be symptoms of a more serious medical condition.
Due to the risk of severe liver damage in case of overdose, do not use concurrently with other preparations for the symptomatic treatment of colds and rhinitis (vasoconstrictor, paracetamol-free). Prescribe with caution in Raynaud's disease, arterial hypertension, heart disease, arrhythmias, bradycardia, thyroid, liver and kidney diseases, acute hepatitis, glaucoma, chronic lung diseases, prostate hypertrophy (since there is a risk of urinary retention), the elderly, with increased coagulation, hemolytic anemia, chronic malnutrition, dehydration, stenosing peptic ulcer. The risk of hepatotoxicity increases in individuals with alcoholic liver damage and alcohol abusers.
The preparation contains phenylephrine, which can lead to an attack of angina pectoris; sucrose, which is contraindicated in patients with intolerance and malabsorption of fructose, glucose-galactose or sucrose-isomaltose. If the patient has an intolerance to some sugars, you should consult your doctor before taking this preparation, use with caution in patients with diabetes mellitus. May be harmful to teeth.
Before using the preparation, you should consult a doctor for: liver disease, kidney disease; taking warfarin or similar anticoagulants; taking analgesics every day for mild arthritis; bronchopulmonary diseases (asthma, emphysema, chronic bronchitis).
The preparation can affect the results of laboratory tests on the content of glucose, uric acid, creatinine, inorganic phosphates in the blood. There may be a negative fecal occult blood test.
In patients with severe infections (sepsis), in which the level of glutathione decreases, when taking paracetamol, the risk of metabolic acidosis increases, its symptoms are deep, rapid or difficult breathing, nausea, vomiting, loss of appetite, in which case, you should immediately consult a doctor.
It is not recommended to take the preparation at the end of the day, since ascorbic acid in large doses has a slight stimulating effect. Due to the stimulating effect of ascorbic acid on the formation of corticosteroid hormones, it is necessary to control renal function and blood pressure.
Use with extreme caution in patients with impaired iron metabolism (hemosiderosis, hemochromatosis, thalassemia), with a history of nephrolithiasis (risk of hyperoxaluria and oxalate sediment in the urinary tract after taking large doses of ascorbic acid).
Long-term use of large doses of ascorbic acid can accelerate its own metabolism, which is why, after discontinuation of treatment, paradoxical hypovitaminosis is possible. It should not be used concurrently with other preparations containing vitamin C. The absorption of ascorbic acid may be altered by impaired intestinal motility, enteritis or decreased gastric secretion.
The ability to influence the reaction rate when driving or operating machinery
Since the preparation can cause drowsiness and other adverse reactions from the nervous system and organs of vision, it is not recommended to drive a car and work with mechanisms during its use.
Application during pregnancy or lactation
The preparation is contraindicated during pregnancy or lactation.
The effect on fertility has not been specifically investigated. Preclinical studies have not revealed any particular effect of paracetamol on fertility when used in therapeutic doses. Appropriate studies of the effect of phenylephrine and pheniramine on reproductive toxicity in animals have not been performed.
Method of administration and dosage
Dissolve the contents of the package in a glass of hot water (not boiling water) and drink. The preparation can be taken every 3-4 hours, but not more than 3 packets per day.
The maximum application period is 5 days.
Children
The preparation is contraindicated in children under the age of 14.
Overdose
Paracetamol: Pale skin, nausea, vomiting, anorexia, and abdominal pain appear in the first 24 hours. When taking large doses, disorientation disorders, psychomotor agitation, dizziness, sleep disturbances, heart rhythm disturbances, pancreatitis, hepatonecrosis can be observed.
The first sign of liver damage may be abdominal pain, which does not always appear in the first 12-48 hours, and may occur later, up to 4-6 days after the preparation is used. Liver damage usually occurs within 72-96 hours after taking the preparation. Disorders of glucose metabolism and metabolic acidosis, hemorrhages may occur. With prolonged use of high doses, aplastic anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia are possible.
In rare cases, acute renal failure with tubular necrosis has been reported, which is possible even in the absence of severe liver damage, manifested by severe low back pain, hematuria, proteinuria. Possible nephrotoxicity: renal colic, interstitial nephritis, capillary necrosis.
The use by adults of 10 g or more of paracetamol and more than 150 mg / kg of body weight by a child, especially with alcohol, can lead to hepatocellular necrosis with the development of encephalopathy, hemorrhage, hypoglycemia, hepatic coma and death. In patients with risk factors (long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John's wort or other preparations that induce liver enzymes, alcohol abuse, glutathione cachexia (digestive disorders, cystic fibrosis, HIV infection, hunger, cachexia), use 5 g or more paracetamol may cause liver damage.
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. In the first hour after an overdose, you should take activated charcoal. The concentration of paracetamol in the blood should be measured 4 hours or later after ingestion (earlier concentrations are not reliable). Treatment with N-acetylcysteine can be used within 24 hours after taking paracetamol, but the maximum effect occurs when applied in the first 8 hours, after which its effectiveness decreases sharply. If it is necessary to administer N-acetylcysteine, it should be administered in accordance with the established list of doses. Alternatively, methionine may be administered orally if vomiting is not available in remote locations.
Phenylephrine: hyperhidrosis, psychomotor agitation or depression of the central nervous system, headache, dizziness, drowsiness, impaired consciousness, arrhythmias, tremors, hyperreflexia, convulsions, nausea, vomiting, irritability, anxiety, arterial hypertension, in severe cases - coma. To eliminate hypertensive effects, you can use intravenous alpha-receptor blocker in court - diazepam.
Pheniramine: atropine-like symptoms occur: mydriasis, photophobia, dry skin and mucous membranes, hyperthermia, intestinal atony. Inhibition of the central nervous system leads to disruption of the respiratory and cardiovascular systems (bradycardia, arterial hypotension, collapse). Symptoms due to the mutual potentiation of the parasympatholytic effect of pheniramine and the sympathomimetic effect of phenylephrine: drowsiness, followed by excitement (especially in children) or CNS depression, visual impairment, rash, persistent headache, nervousness, insomnia, hyperreflexia, irritability, circulatory disorders, bradycardia ...
There is no specific antidote for treating an overdose of antihistamines. The patient should be given the usual emergency care, including charcoal, saline laxative, and standard cardiorespiratory support. Stimulants are not allowed; vasoconstrictors can be used to treat hypotension.
Ascorbic acid occurs nausea, vomiting or diarrhea (which disappear after its withdrawal) bloating and abdominal pain, itching, skin rashes, irritability. Doses over 3000 mg can cause temporary osmotic diarrhea and gastrointestinal disorders, impaired metabolism of zinc, copper, myocardial dystrophy, with prolonged use in large doses, it is possible to suppress the function of the insular apparatus of the pancreas and glucosuria. Overdose can lead to changes in renal excretion of ascorbic and uric acids during acetylation of urine with precipitation of oxalate calculi.
Treatment is symptomatic: during the first 6 hours, it is necessary to flush the stomach, and within the first 8 hours - orally administer methionine or intravenously - cysteamine or N-acetylcysteine.
Adverse Reactions
Skin and subcutaneous tissue disorders: rash, itching, dermatitis, urticaria, exudative erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome.
From the immune system: hypersensitivity reactions, including anaphylactic shock, angioedema.
Neurological disorders: headache, dizziness, tremors, anxiety, nervousness, irritability, fear, insomnia, drowsiness, confusion, hallucinations, psychomotor agitation, disorientation, depressive states, paresthesias, tinnitus, in some cases - coma, convulsions , dyskinesia, behavior changes.
From the respiratory system: bronchospasm in patients sensitive to acetylsalicylic acid and NSAIDs.
From the side of the organs of vision: visual impairment and accommodation, mydriasis, increased intraocular pressure, dry eyes.
From the gastrointestinal tract: nausea, vomiting, heartburn, dry mouth, discomfort and abdominal pain, constipation, diarrhea, flatulence, aphthae, hypersalivation, hemorrhages, irritation of the mucous membranes.
From the digestive system: impaired liver function, hypertransaminasemia, usually without jaundice, hepatonecrosis (when using high doses).
From the endocrine system: hypoglycemia, up to hypoglycemic coma.
On the part of the blood and lymphatic system: anemia, incl. hemolytic, sulfhemoglobinemia and methemoglobinemia (cyanosis, shortness of breath, pain in the heart), bruising or bleeding, thrombocytopenia, neutropenia, agranulocytosis, leukopenia, pancytopenia;
From the kidneys and urinary system: nephrotoxicity, interstitial nephritis, capillary necrosis, dysuria, urinary retention and difficulty urinating, renal colic, renal failure.
Cardiac disorders: arterial hypertension, tachycardia, bradycardia, tachycardia, arrhythmia, shortness of breath, heart pain, angina attacks.
Others: general weakness, malaise.
Unlike second generation antihistamines, the use of pheniramine is not associated with prolongation of the QT interval and cardiac arrhythmias.
Shelf life
3 years.
Storage conditions
Keep out of the reach of children, at a temperature not exceeding 30 ° C.
Tags: Pharmacitron
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