Citramon pharmacological action. What do citramon p tablets help with - instructions for use and indications, composition and analogues

Medical drug"Citramon" is one of the most famous remedies for headaches. It contains the following components: phenacetin, caffeine, acetylsalicylic acid. The drug is very effective and quickly relieves pain. However, you should consult your doctor before use. The medicine "Citramon" has contraindications. Elderly people prone to high blood pressure should be especially careful when using this product.

Citramon. Possible side effects of the drug

Side effects from the drug "Citramon" usually occur with long-term use. Complications are possible from gastrointestinal tract. contained in medical device, contributes to the destruction of organ mucosa. This may cause abdominal pain, nausea, and heartburn. In severe cases - stomach bleeding. In addition, there is a toxic effect on liver cells.

As a result of long-term use of the drug "Citramon", side effects are observed: platelet synthesis decreases, which contributes to its dilution. Although, a positive factor can be noted here: the process of blood circulation in small vessels improves, and they are enriched with oxygen.

The side effect of Citramon can manifest itself in the form of an allergic reaction. skin reaction, Quincke's edema, damage to the mucous membranes. In such cases, the use of the drug is discontinued. Negative reaction the human body, most often, occurs due to the component of “Citramon” - aspirin.

The kidneys can also be negatively affected by the drug, including cell necrosis (death). Any disruption of the functioning of the organ precludes the use of the drug "Citramon". Contraindications require careful analysis of its purpose.

During pregnancy, it is better not to take the drug at all, in order to avoid fetal deformities. During breastfeeding, side effects can spread to the baby.

Sometimes there is dizziness, headache, hearing when taking the drug "Citramon". Contraindications indicate that the product should be used with extreme caution, having first consulted with a medical specialist.

Due to the negative effect of the component - phenacetin, the composition of the drug has changed. Instead of harmful substance They started adding paracetamol. It has a gentler effect on the kidneys and liver and has an antipyretic effect.

Indications for use

"Citramon" is prescribed for headaches, severe migraine attacks, dental and menstrual pain, pain in joints and muscles. The remedy is also indicated for high body temperature due to cold infections. Indications for use are also rheumatic diseases. "Citramon" acts in this case role of the lung

Citramon and alcohol

During the period of use of the drug, you should avoid drinking alcohol. This is due to the fact that under the influence of the drug the toxicity of a person increases. Damage to the gastric mucosa occurs with all the negative consequences (erosion, ulcer, cancer).

Citramon. Contraindications

Contraindications to taking the drug are as follows: 1) Stomach ulcer and duodenum; 2) Bleeding (gastrointestinal); 3) Violation of the normal functioning of the kidneys and liver; 4) Poor blood clotting; 5) Glaucoma; 6) Age up to 15 years; 7) Pregnancy, breastfeeding; 8) Preparatory, preoperative period.

You should not take the drug without a doctor's advice for more than three days. Citramon may enhance the effect of other medications. Therefore, consultation with a specialist is necessary. Despite its high efficiency, uncontrolled use of Citramon can lead to severe consequences. Correct dosage and the advice of your doctor will help you avoid negative influence the drug, and your health will not only be maintained, but also improved.

In this medical article You can familiarize yourself with the drug Citramon. The instructions for use will explain in what cases the tablets can be taken, what the medicine helps with, what are the indications for use, contraindications and side effects. The annotation presents the forms of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Citramon, from which you can find out whether the medicine helped in the treatment of headaches and toothaches, lowering fever in adults and children, for which it is also prescribed. The instructions list analogues of Citramon, prices of the drug in pharmacies, as well as its use during pregnancy.

The instructions for use of the drug Citramon belong to the group of non-steroidal anti-inflammatory drugs. Tablets, including Ultra film-coated ones, are prescribed for headaches, inflammation, elevated temperature. The drug is not recommended for hypertensive patients.

Release form and composition

The drug Citramon is available in dosage form tablets for oral administration. They have round shape, flat-cylindrical surface, and light brown color. The composition of this medicine includes several main active components, their content in 1 tablet is:

Caffeine – 30 mg.
Paracetamol – 180 mg.
Acetylsalicylic acid – 240 mg.

Citramon tablets are packaged in blister packs of 10 pieces. The cardboard pack contains 1 or 2 blisters, as well as instructions for use.

Ultra-coated tablets are also produced.

pharmachologic effect

Citramon is a combination medication and him therapeutic effect due to the properties of the active components included in its composition:

Acetylsalicylic acid - has anti-inflammatory and antipyretic effects, relieves pain caused by inflammation, to a certain extent reduces blood clotting and improves blood circulation at the site of the inflammatory process;

Caffeine has an stimulating effect on the central nervous system and stimulates the functioning of the psychomotor centers of the central nervous system. It increases the lumen of blood vessels and reduces the feeling of drowsiness and fatigue. Caffeine is also known for the stimulating effect it has on physical and mental performance. It has caffeine and a mild analgesic effect.

– a drug with analgesic, antipyretic and moderate anti-inflammatory properties.

Indications for use

What does Citramon help with? Main medical indication for taking tablets Citramon (P) is symptomatic treatment fever and pain inflammatory origin in various pathological conditions:

Pain in muscles (myalgia) and joints (arthralgia).
Toothache.
Increased body temperature in acute respiratory viral pathology and influenza.
Headache medium degree manifestations of various origins.
Reducing the severity of discomfort during painful menstruation among women.
Painful sensations, the development of which is provoked by aseptic inflammation of the peripheral nerves (neuralgia).

At what pressure is it prescribed?

Citramon contains caffeine. As a result of taking it, your blood pressure may increase. This fact must be taken into account by patients suffering from high blood pressure.

Instructions for use

Citramon is taken orally (during or after meals) 1 tablet every 4 hours, with pain syndrome— 1-2 tablets; average daily dose- 3-4 tablets, maximum daily dose - 8 tablets. The course of treatment is no more than 7-10 days.

The drug should not be taken for more than 5 days as an analgesic and for more than 3 days as an antipyretic (without prescription and medical supervision). Other dosages and regimens of use are determined by the doctor.

Contraindications

The instructions list the following contraindications for taking Citramon:

concomitant use of anticoagulants;
complete or partial combination of recurrent nasal polyposis/paranasal sinuses, bronchial asthma and intolerance to NSAIDs or ASA (including a history);
portal hypertension;
hemorrhagic diathesis;
vitamin deficiency K;
sleep disorders;
increased excitability;
deficiency of the cytosolic enzyme G6PD;
renal failure;
erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
hemophilia;
Severe ischemic heart disease;
surgical interventions accompanied by bleeding;
hypersensitivity to the components of the tablets;
lactation;
childhood(in children under fifteen years of age with hyperthermia against the background viral infection there is a high probability of developing Reye's syndrome);
stomach or intestinal bleeding;
dissecting aortic aneurysm;
glaucoma;
hypoprothrombinemia;
severe arterial hypertension;
pregnancy (especially its first and last trimesters).

Relative contraindications are gout and existing liver pathologies.

Side effects

During the use of Citramon, various side effects from the outside individual organs and systems:

headaches, dizziness - from the central nervous system;
epigastric pain, nausea and vomiting, development erosive gastritis(with long-term use of the drug) – from the digestive system;
kidney/liver dysfunction; various manifestations of allergic reactions (in particular itching and skin rash, Stevens-Johnson syndrome, urticaria, Lyell's syndrome, Reye's syndrome, anaphylactic shock etc.);
the occurrence of tinnitus, visual disturbances;
decreased blood clotting, increased duration of bleeding - from the hematopoietic system.

To minimize the risk of developing side effects The drug should be taken strictly according to the instructions.

Children, pregnancy and breastfeeding

Citramon is contraindicated in the first and third trimester of pregnancy. Acetylsalicylic acid, which is part of it, has a teratogenic effect, which can lead to the development congenital anomalies fetus

Use in the third trimester promotes premature closure of the aortic duct and increases the risk of bleeding during childbirth. In the second trimester, indications for Citramon should be carefully assessed by a doctor. The drug can be used only in cases where the expected benefit from the treatment significantly outweighs the potential risk of impact on fetal development.

The use of ASA-containing drugs for the treatment of ARVI in children (with or without hyperthermia) is contraindicated without prior consultation with a doctor.

For some viral infections (particularly infections caused by a virus chickenpox or influenza A or B viruses) there is a possibility of developing acute hepatic encephalopathy (Reye's syndrome), which requires immediate medical intervention. One of the signs of Reye's syndrome is prolonged vomiting.

Taking into account the above reasons, the use of tablets in patients under sixteen years of age is contraindicated. Since the drug has a large amount side effects, for children with a headache or toothache, it is better to choose safer remedies.

special instructions

Before you start taking Citramon tablets, you should carefully read the instructions for the drug, and also pay attention to several precautions:

Patients with concomitant allergic pathology This medicine may be used with caution.

Acetylsalicylic acid, which is part of the drug, when taken by children with acute respiratory viral pathology, can provoke the development of Raynaud's syndrome.

The drug does not have a direct effect on the functional state nervous system.

Long-term use of this drug requires periodic laboratory monitoring functional state liver, kidneys, as well as peripheral blood patterns.

Long-term use of Citramon tablets can cause a decrease in excretion uric acid from the body and an attack of gout in patients with metabolic disorders.

The active components of the drug may interact with drugs of other pharmacological groups(anticoagulants, glucocorticosteroids), so about them possible application a medical professional should be notified.

In patients before surgery, the drug should be discontinued as it reduces blood clotting.

Drug interactions

Citramon can enhance the effect of hypoglycemic and steroid drugs, indirect anticoagulants. When taken together with Methotrexate and other non-steroidal anti-inflammatory drugs, the risk of side effects increases sharply.

According to the instructions, Citramon should not be prescribed simultaneously with antiepileptic drugs, Rifampicin and barbiturates, because in this case in large quantities formation of hepatotoxic metabolites occurs.

Analogues of the drug Citramon

Analogues are determined by structure:

Coficil plus.
Aquacitramon.
Migrenol Extra.
Excedrin.
Citramon P.
Citramon Forte.
Acifein.
Askofen.
Citrapar.
Citramon Borimed (Ultra; LekT; MFF).
Citramarine.

Analogues of drugs for the treatment of headaches include:

Betaserk.
Oxadol.
Brustan.
Noshpalgin.
Migrenol.
Vinpocetine.
Khairumath.
Spasmonet.
Aldolor.
Memoplant.
Analgin.
Citrapar.
Nalgesin.
Solpadeine.
Flamax.
Katadolon.
Cavinton.
Insti.
Betahistine.
Solpaflex.
Stugeron.
Vestibo.
Nikoshpan.
Idebenone.
Paracetamol.
Amitriptyline.
Pentalgin.
Kaffetin.
Piracetam.
Acetaminophen.
MIG 400.
MIG 200.
Lupocet.
Aminalon.
Askofen.
Anopyrine.
Unispaz.
Tsefekon D.
Febricet.

Vacation conditions and price

The average cost of Citramon P (tablets No. 10) in Moscow is 10 rubles. The pharmacy chain dispenses the medication without a doctor's prescription. It is recommended to consult a medical specialist before taking them.

The shelf life of Citramon tablets is 4 years. They must be stored in their entire packaging, in a dark, dry place, out of reach of children, at an air temperature not exceeding +25 C.

LSR-005236/09

Trade name of the drug:

CITRAMON P

INN or group name:

Acetylsalicylic acid + Caffeine + Paracetamol.

Dosage form:

pills

Compound:

1 tablet contains:
active substances: acetylsalicylic acid – 240 mg, paracetamol – 180 mg, caffeine (in terms of monohydrate) – 30 mg; ;
Excipients: cocoa powder – 22.5 mg, citric acid monohydrate – 5.0 mg, potato starch – 64.2 mg, talc – 4.9 mg, calcium stearate – 2.8 mg, polysorbate-80 – 0.6 mg.

Description:
Pills light brown with inclusions, flat-cylindrical shape with a notch and a chamfer, with the smell of cocoa.

Pharmacotherapeutic group:

Combined analgesic drug (NSAID + analgesic non-narcotic drug + psychostimulant drug).

ATX code: N02BA71

Pharmacological properties

Combined drug.
Acetylsalicylic acid has an antipyretic and anti-inflammatory effect, relieves pain, especially caused by inflammatory process, and also moderately inhibits platelet aggregation and thrombus formation, improves microcirculation in the area of inflammation.
Paracetamol has an analgesic, antipyretic and weak anti-inflammatory effect, which is associated with its effect on the thermoregulation center in the hypothalamus and a weak ability to inhibit the synthesis of prostaglandins (Pg) in peripheral tissues.
Caffeine increases reflex excitability spinal cord, stimulates the respiratory and vasomotor centers, expands blood vessels skeletal muscles, brain, heart, kidneys, reduces platelet aggregation; reduces drowsiness, feeling of fatigue. In this combination, caffeine in a small dose has virtually no stimulating effect on the central nervous system, but helps regulate cerebral vascular tone.

Indications for use

Pain syndrome of mild to moderate severity ( of various origins): headache, migraine, toothache, neuralgia, myalgia, arthralgia, algodismenorrhea. Fever syndrome: for acute respiratory diseases, including influenza.

Contraindications

hypersensitivity to the components of the drug;
erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
gastrointestinal bleeding (including history);
complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or non-steroidal anti-inflammatory drugs (including a history);
severe dysfunction of the liver and/or kidneys;
hemorrhagic diathesis, hypocoagulation, hemophilia, hypoprothrombinemia;
pregnancy (I and III trimesters); - period breastfeeding;
surgical interventions accompanied heavy bleeding;
deficiency of glucose-6-phosphate dehydrogenase;
glaucoma;
pronounced arterial hypertension;
portal hypertension;
severe course coronary disease hearts;
vitamin deficiency K;
children under 15 years of age (risk of developing Reye's syndrome in children with hyperthermia due to a viral disease);
increased excitability, sleep disturbance.

Carefully: Mild to moderate renal failure, liver disease, alcoholism, epilepsy and tendency to seizures, elderly age, gout, pregnancy (II trimester).

Use during pregnancy and breastfeeding

During pregnancy (I and III trimesters) and during breastfeeding, the drug is contraindicated. In the second trimester of pregnancy, the drug should be used with caution, balancing the expected benefits for the mother and the potential risk for the fetus.

Directions for use and doses

Orally (during or after meals), 1 tablet every 4 hours, for pain – 1-2 tablets; the average daily dose is 3-4 tablets, the maximum daily dose is 8 tablets.
Use the drug for no more than 7-10 days. To reduce the irritating effect on the gastrointestinal tract, you should take the tablet with milk or alkaline mineral water.

Side effect

May be observed adverse reactions, characteristic of acetylsalicylic acid, paracetamol and caffeine: anorexia, nausea, vomiting, gastralgia (decreased platelet aggregation), erosive and ulcerative lesions of the gastrointestinal tract, gastrointestinal bleeding, allergic reactions, bronchospasm, multiforme exudative erythema(including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), renal failure, liver failure, dizziness, tachycardia, increased blood pressure.
With long-term use, dizziness, headache, blurred vision, tinnitus, decreased platelet aggregation, hypocoagulation, hemorrhagic syndrome are possible ( nose bleed, bleeding gums, purpura, etc.) kidney damage with papillary necrosis; deafness, Reye's syndrome in children (hyperpyrexia, metabolic acidosis, nervous system and mental disorders, vomiting, liver dysfunction).

Overdose

Do not exceed the recommended dose and duration of use.
Overdose symptoms are caused by acetylsalicylic acid.
Symptoms:

for mild intoxications: nausea, vomiting, stomach pain, dizziness, ringing in the ears;
in case of severe intoxication: lethargy, drowsiness, collapse, convulsions, difficulty breathing, anuria, bleeding.

Treatment: gastric lavage using activated carbon, symptomatic therapy, depending on the metabolic state - administration of sodium bicarbonate, sodium citrate or sodium lactate, which enhances the excretion of acetylsalicylic acid due to alkalinization of urine.

Interaction with others medicines

Strengthens the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs. Simultaneous use with other non-steroidal anti-inflammatory drugs, methotrexate increases the risk of side effects.
Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, as well as anti-gout drugs that promote the excretion of uric acid.
Barbiturates, rifampicin, salicylamide, antiepileptics medicines and other stimulants of microsomal oxidation contribute to the formation of toxic paracetamol metabolites that affect liver function.
Metoclopramide accelerates the absorption of paracetamol.
Under the influence of paracetamol, the half-life (T½) of chloramphenicol increases 5 times. When taken repeatedly, paracetamol may enhance the effect of anticoagulants (dicoumarin derivatives).
Caffeine accelerates the absorption of ergotamine.
At simultaneous administration drug and alcohol-containing liquids increases the risk toxic damage liver.

special instructions

Acetylsalicylic acid slows down blood clotting. If the patient is to surgical intervention, you should warn your doctor about taking the drug.
With prolonged use of the drug, monitoring of peripheral blood and the functional state of the liver is necessary.
Patients with hypersensitivity or with asthmatic reactions to salicylic acid and its derivatives, including acetylsalicylic acid, can be prescribed only with special precautions (in service conditions emergency care).
In patients with a predisposition to the accumulation of uric acid, taking the drug may provoke an attack of gout. During use, you should refrain from drinking alcohol (increased risk of gastrointestinal bleeding and toxic liver damage).
Acetylsalicylic acid has a teratogenic effect; when used in the first trimester leads to malformation - clefting upper sky; in the third trimester – to inhibition labor activity(inhibition of Pg synthesis), to the closure of the ductus arteriosus in the fetus, which causes pulmonary vascular hyperplasia and hypertension in the vessels of the pulmonary circulation. Stands out with breast milk, which increases the risk of bleeding in a child due to impaired platelet function.
Children under 15 years of age should not be prescribed medications containing acetylsalicylic acid, since in the case of a viral infection they can increase the risk of Reye's syndrome. Symptoms of Reye's syndrome are prolonged vomiting, acute encephalopathy, and liver enlargement.

Impact on management vehicles and for the maintenance of machines and mechanisms that require concentration.
There is no data on the effect on driving vehicles and servicing machines and mechanisms that require concentration.

Release form

Pills.
10 tablets per blister pack.
30 tablets per jar made of polymer materials.
1 or 2 blister packs or 1 jar made of polymeric materials with instructions for medical use placed in a cardboard pack.

Storage conditions

Store in a dry place, at a temperature not exceeding 25°C.
Keep out of the reach of children.

Best before date

4 years.
After the expiration date, do not use the drug.

Conditions for dispensing from pharmacies

Over the counter.

Manufacturer/organization accepting claims
LLC Anzhero-Sudzhensky Chemical and Pharmaceutical Plant.
652473, Russia, Kemerovo region, Anzhero-Sudzhensk, st. Herzen, 7.

One of the most common and cheapest drugs is Citramon, everyone knows what it helps with and how to take it. However, the use of this seemingly ordinary drug has its pitfalls. First of all, few people know what is included in Citramon, and it is quite complex. This means that it may have contraindications for use in certain diseases. The most commonly known treatment is taking Citramon from the head. However, it can eliminate other types of pain. The instructions for use will tell you the details.

Chemical composition of the drug

Citramon is a combined non-narcotic non-hormonal analgesic. It has a pronounced anti-inflammatory, analgesic and antipyretic effect. Citramon contains:

Acetylsalicylic acid(Acidum acetylsalicylicum, aspirin) is a non-steroidal anti-inflammatory drug. It effectively thins the blood, reduces capillary permeability, and during inflammation it has a suppressive effect on pain sensitivity centers.
Caffeine(Caffeine) is an alkaloid that stimulates the central nervous system. It activates the work of the heart muscle by dilating blood vessels and increasing blood flow. Caffeine increases heart rate, increases physical and mental activity, performance. Significantly reduces symptoms of fatigue, drowsiness, and apathy. Has a diuretic effect.
Paracetamol(Paracetamolum) - prostaglandin blocker, causing pain. The substance also actively affects the centers of pain and thermoregulation.
Cocoa- an antidepressant that has a stimulating effect on the central nervous system.
Lemon acid- a substance involved in the biochemical reactions of the body.

Citramon tablets are easily recognized by their heterogeneous brownish tint with speckles, slight odor cocoa and sour taste.

In what cases is Citramon taken?

Citramon tablets have a pronounced anti-inflammatory, analgesic and antiviral effect. Their ability to normalize blood pressure in hypotensive patients is also known. Instructions for use indicate that Citramon tablets can be taken in the following cases:

Headache of various etiologies . The drug is considered to be one of the most effective and available medicines to get rid of this disease. Moreover, being a non-narcotic drug, it is not addictive. But it is important not to combine Citramon with other analgesics.
Migraine- Experts note the positive effects of Citramon even with a single dose.
Pain and inflammation in the joints, including both chronic rheumatic pain and situational (bruise, inflammation).
Muscle tension , especially after intense physical activity.
A sharp drop in blood pressure. Thanks to the caffeine it contains, Citramon can normalize low blood pressure. But this is, rather, an emergency remedy, and not a permanent hypotonic drug.
Heat , especially at the beginning infectious diseases.
Viral diseases upper respiratory tract (no longer than 3 days).
Toothache, but not more than 4 tablets per day.
Menstrual pain(It is acceptable to take Citramon for 2-3 days).
Neuralgia.

How and how much to drink Citramon

Considering that the drug contains aspirin, which cannot be taken orally on an empty stomach, Citramon is consumed only 15-20 minutes after a meal, washed down with a large amount clean water. It is not recommended to use any other liquid (tea, coffee, milk, juices). The maximum daily dose is 6 tablets. The effect of the drug will begin 30-40 minutes after administration. The next appointment is possible only after 8 hours.

Experts advise not to take the drug for more than 2 weeks in a row - the components of the drug can negatively affect the condition of the gastrointestinal mucosa.

Citramon and alcohol

Many people wonder how Citramon and alcohol are compatible with each other. The instructions for use do not indicate what effect the combined use of these substances has. It would seem that the analgesic effect that these tablets have can also relieve a hangover headache. However, many years of research prove that the content active ingredients 1-2 tablets are not enough to relieve a hangover. And an overdose is fraught with complications for internal organs.

If you take citramon for a hangover, you may experience:

Severe gastrointestinal upset. Taking even 1 tablet can cause vomiting, diarrhea, severe nausea. If a person already has gastrointestinal diseases (gastritis, duodenal or stomach ulcers), the components of the drug may cause bleeding. Citramon slows down blood clotting, so such an exacerbation of the digestive system is quite predictable.
Toxic liver damage. A one-time dose of Citramon after an alcoholic libation may not cause harm to the liver. However, if this habit becomes part of the system, negative consequences cannot be avoided.
Allergy. Under the influence of salicylates of the drug in combination with alcohol, urticaria, itching, and, in severe cases, Quincke's edema or anaphylactic shock, which sometimes lead to fatal outcome.
Critical decrease in blood sugar. Taking Citramon tablets after alcohol increases the risk of exacerbation of all endocrine diseases, including diabetes.
Sudden jump pressure. Alcohol itself increases blood pressure, especially if taken beyond the safe limit. Caffeine and paracetamol can increase readings by several tens of units, up to the occurrence of a hypertensive crisis. Therefore, you should absolutely not use this drug if you have high blood pressure.

Considering everything Negative consequences problems that can be caused by consuming Citramon with alcohol, you need to think more than once whether it’s worth doing. There are other, more effective and safe, drugs to relieve hangover headaches.

Contraindications

The instructions for use clearly indicate in which cases it is better not to take Citramon so as not to cause side effects:

with medications such as antibiotics (in most cases), sleeping pills, anticonvulsants, salicylates, their compatibility with the components of Citramon is zero;
for diseases of the gastrointestinal tract, especially in the acute stage;
at hypertension;
for glaucoma;
with coronary heart disease;
with a tendency to bleeding and reduced blood clotting, hemophilia;
in case of individual intolerance to the components of the drug;
pregnant women and nursing mothers;
children under 15 years old.

Citramon can serve as a good analgesic, effectively relieving primarily headaches. The drug is sold without a prescription at any pharmacy and is inexpensive. However, when using it, it is important to follow basic recommendations. It is better for persons with contraindications not to experiment with their own health and give preference to other drugs. Under no circumstances should you take Citramon when hangover syndrome. Do not use the medicine for longer than prescribed and in higher doses. Then Citramon can bring tangible benefits to the body, and not harm.

Combined drug.

Acetylsalicylic acid has an antipyretic and anti-inflammatory effect, relieves pain, especially caused by the inflammatory process, and also moderately inhibits platelet aggregation and thrombus formation, improves microcirculation at the site of inflammation.

Paracetamol has an analgesic, antipyretic and weak anti-inflammatory effect, which is associated with its effect on the thermoregulation center in the hypothalamus and a weak ability to inhibit the synthesis of prostaglandins (Pg) in peripheral tissues.

Caffeine increases the reflex excitability of the spinal cord, stimulates the respiratory and vasomotor centers, dilates the blood vessels of skeletal muscles, brain, heart, kidneys, reduces platelet aggregation; reduces drowsiness, feeling of fatigue. In this combination, caffeine in a small dose has virtually no stimulating effect on the central nervous system, but helps regulate cerebral vascular tone.

Release form

Tablets are light brown with inclusions, flat-cylindrical, scored and chamfered, with the smell of cocoa.

Excipients: cocoa powder - 22.5 mg, citric acid monohydrate - 5 mg, potato starch - 64.2 mg, talc - 4.9 mg, calcium stearate - 2.8 mg, polysorbate 80 - 0.6 mg.

6 pcs. - cellless contour packages (900) - cardboard boxes.
10 pieces. - cellless contour packages (600) - cardboard boxes.
10 pieces. - contour cell packaging (2) - cardboard packs.
10 pieces. - contour cell packaging (1000) - cardboard boxes.

Dosage

Orally (during or after meals), 1 tablet. every 4 hours, for pain - 1-2 tablets; the average daily dose is 3-4 tablets, the maximum daily dose is 8 tablets. Use the drug for no more than 7-10 days.

To reduce the irritant effect on the gastrointestinal tract, you should take the tablet with milk or alkaline mineral water.

Overdose

Overdose symptoms are caused by acetylsalicylic acid.

Symptoms:

For mild intoxications: nausea, vomiting, stomach pain, dizziness, ringing in the ears;

In case of severe intoxication: lethargy, drowsiness, collapse, convulsions, difficulty breathing, anuria, bleeding.

Treatment: gastric lavage using activated charcoal, symptomatic therapy, depending on the metabolic state - administration of sodium bicarbonate, sodium citrate or sodium lactate, which enhances the excretion of acetylsalicylic acid due to alkalinization of urine.

Interaction

Strengthens the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs.

Concomitant use with other non-steroidal anti-inflammatory drugs and methotrexate increases the risk of side effects.

Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, as well as anti-gout drugs that promote the excretion of uric acid.

Barbiturates, rifampicin, salicylamide, antiepileptic drugs and other stimulants of microsomal oxidation contribute to the formation of toxic paracetamol metabolites that affect liver function.

Metoclopramide accelerates the absorption of paracetamol. Under the influence of paracetamol, T1/2 of chloramphenicol increases 5 times. When taken repeatedly, paracetamol may enhance the effect of anticoagulants (dicoumarin derivatives).

Caffeine accelerates the absorption of ergotamine.

When taking the drug and alcohol-containing liquids simultaneously, the risk of liver toxicity increases.

Side effects

Adverse reactions characteristic of acetylsalicylic acid, paracetamol and caffeine may be observed: anorexia, nausea, vomiting, gastralgia (decreased platelet aggregation), erosive and ulcerative lesions of the gastrointestinal tract, gastrointestinal bleeding, allergic reactions, bronchospasm, exudative erythema multiforme (including including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), renal failure, liver failure, dizziness, tachycardia, increased blood pressure.

With long-term use, dizziness, headache, visual impairment, tinnitus, decreased platelet aggregation, hypocoagulation, hemorrhagic syndrome (epistaxis, bleeding gums, purpura, etc.), kidney damage with papillary necrosis are possible; deafness, Reye's syndrome in children (hyperpyrexia, metabolic acidosis, nervous system and mental disorders, vomiting, liver dysfunction).

Indications

pain syndrome of mild and moderate severity (of various origins): headache, migraine, toothache, neuralgia, myalgia, arthralgia, algodismenorrhea;
febrile syndrome: for acute respiratory diseases, incl. flu

Contraindications

hypersensitivity to the components of the drug;
erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
gastrointestinal bleeding (including history);
complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses, intolerance to acetylsalicylic acid or non-steroidal anti-inflammatory drugs (including a history);
severe dysfunction of the liver and/or kidneys;
hemorrhagic diathesis, hypocoagulation, hemophilia, hypoprothrombinemia;
pregnancy (I and III trimesters);
breastfeeding period;
surgical interventions accompanied by heavy bleeding;
deficiency of glucose-6-phosphate dehydrogenase;
glaucoma;
severe arterial hypertension;
portal hypertension;
severe course of coronary heart disease;
vitamin deficiency K;
children under 15 years of age (risk of developing Reye's syndrome in children with hyperthermia due to a viral disease);
increased excitability, sleep disturbance.

Carefully

Mild to moderate renal failure, liver disease, alcoholism, epilepsy and tendency to seizures, old age, gout, pregnancy (II trimester).

Features of application

Use during pregnancy and breastfeeding

Use for liver dysfunction

The use of the drug in patients with severe liver dysfunction is prohibited.

Use for renal impairment

The use of the drug in patients with severe renal impairment is prohibited.

Be careful when renal failure mild to moderate.

Use in children

The use of the drug in children under 15 years of age is prohibited (the risk of developing Reye's syndrome in children with hyperthermia due to a viral disease);

special instructions

Acetylsalicylic acid slows down blood clotting. If the patient is undergoing surgery, the doctor should be informed about taking the drug.

With prolonged use of the drug, monitoring of peripheral blood and the functional state of the liver is necessary.

Patients with hypersensitivity or asthmatic reactions to salicylic acid and its derivatives, including acetylsalicylic acid, should only be prescribed with special precautions (in an emergency setting).

In patients with a predisposition to the accumulation of uric acid, taking the drug may provoke an attack of gout.

During use, you should refrain from drinking alcohol (increased risk of gastrointestinal bleeding and toxic liver damage).

Acetylsalicylic acid has a teratogenic effect; when used in the first trimester, it leads to a developmental defect - cleft palate; in the third trimester - to inhibition of labor (inhibition of Pg synthesis), to closure of the ductus arteriosus in the fetus, which causes hyperplasia of the pulmonary vessels and hypertension in the vessels of the pulmonary circulation. It is excreted in breast milk, which increases the risk of bleeding in the baby due to impaired platelet function.

Children under 15 years of age should not be prescribed medications containing acetylsalicylic acid, since in the case of a viral infection they can increase the risk of Reye's syndrome. Symptoms of Reye's syndrome are prolonged vomiting, acute encephalopathy, and liver enlargement.

Impact on driving vehicles and servicing machines and mechanisms that require concentration

There is no data on the effect on driving vehicles and servicing machines and mechanisms that require concentration.