Cerucal antiemetic injection for children. Cerucal. What is Cerucal used for?

One of the most effective drugs for vomiting is Cerucal. It acts on the vomiting center of the brain, reduces its sensitivity and prevents the occurrence of vomiting. This drug should be taken only after consulting a doctor, in some cases it is contraindicated.

Despite the fact that among the possible contraindications there is a child under two years of age, in emergency cases it can relieve the symptoms of frequent vomiting. How Cerucal is used to eliminate vomiting in children will tell our article.

Description of the drug and mechanism of action

The drug belongs to the group of prokinetics - it stimulates the motility of the digestive tract. It has been invented and used for a long time, so the mechanism of action and possible side effects are well studied.

In terms of intensity of exposure and suppression of vomiting attacks, it practically has no worthy analogues. However, its use can cause numerous side effects, and the frequency of occurrence of such effects is directly related to the age of the patient.

The main active ingredient is metoclopramide, which has a predominantly local effect in the stomach. It blocks impulses from the muscles to the vomiting center.

A specialist may prescribe this remedy to children of two years of age if the expected benefit in controlling vomiting outweighs the potential harm to the baby.

The product is available in two forms. Tablets are taken orally, but if vomiting is repeated and frequent, intramuscular administration has shown the greatest effectiveness. That is why the second dosage form of the drug is an injection solution.

In the form of injections, it is used only in stationary conditions and under the supervision of a doctor. In case of emergency assistance with incessant vomiting, a single administration is permissible, but only after assessing all possible risks and individual characteristics of the course of the disease.

Can children give Cerucal when vomiting?

The use of this prokinetic is allowed for gastrointestinal diseases, accompanied by frequent and abundant. Self-administration is excluded in any situation, therefore, for advice on the application, you should definitely visit a doctor.

Indications for use:

1. Pyloric stenosis.
2. Frequent and prolonged hiccups.
3. Decreased tone of the digestive tract.
4. Strong flatulence.

For children, this drug is used from the age of two years. Due to the fact that in younger patients side effects may occur after administration, self-administration of the drug for treatment is unacceptable. At the same time, there is no special form of Cerucal for children.

The tool is universal, and the dosage is calculated based on the weight of the patient.

Contraindications

The main disadvantage of this drug is considered to be a limited list of uses and the likelihood of side effects. In emergency cases, Cerucal injections are prescribed for children under two years old, but only under the supervision of a doctor and in a hospital setting.

Do not use this remedy for vomiting caused by neurological problems, as well as of unknown origin.

Other contraindications of the drug:

• Internal in the digestive tract.
• Perforation of the stomach.
• Tumors in the digestive tract.
• Peritonitis.
• Movement disorders.
• Glaucoma.
• Individual intolerance.
• Children's age up to two years.

With caution, this remedy is prescribed to patients with renal and hepatic disorders, with hypertension and diabetes mellitus. Treatment in this case should be carried out in stationary conditions, where there is the possibility of a quick response in case of a non-specific reaction of the body.

Dosage

The use of the drug is advisable for gastrointestinal disorders, accompanied by indomitable vomiting.

The dosage for patients aged 2 to 14 years is 0.1 mg of the active ingredient of the drug for each kilogram of weight. The maximum daily dose should not exceed 0.5 mg per kilogram of body weight.

The daily dosage is divided into two or three doses, the duration of the course of treatment is 4-6 weeks.

In tablet form it contains 10 mg of the active substance, in the ampoule the same dosage. When choosing the appropriate form of use, it should be noted that Cerucal injections provide a quick but short-term effect, while tablets are characterized by prolonged action (the effect lasts up to six hours after administration).

Side effects of the drug are quite diverse. It may be an allergic rash (), jumps in blood pressure. Often there are reactions from the digestive tract: constipation, a feeling of dryness and a bitter taste in the mouth.

In adolescence, girls may have problems with menstrual irregularities, and boys may have breast enlargement. In such cases, the drug is stopped, and further treatment is aimed at stabilizing the condition.

A time-tested prokinetic that has a predominantly local effect in the organs of the gastrointestinal tract. Despite the fact that it is sold without a prescription in pharmacies, it is imperative to agree on the regimen of administration and the need to use this particular drug before use.

Pharmacodynamics. Blocker of dopamine and serotonin receptors, inhibits brain chemoreceptors, weakens the sensitivity of visceral nerves that transmit impulses from the pylorus and duodenum to the vomiting center. Through the hypothalamus and the parasympathetic division of the autonomic nervous system, it regulates and coordinates the motor activity of the upper digestive tract. Increases the tone of the stomach and intestines, accelerates gastric emptying, reduces gastrostasis, prevents pyloric and esophageal reflux, stimulates intestinal motility. It has an antiemetic effect in vomiting of various origins (except for vomiting of a psychogenic and vestibular nature). Normalizes the secretion of bile, reduces spasm of the sphincter of Oddi, does not change its tone, eliminates dyskinesia of the gallbladder.
Pharmacokinetics. Rapidly and completely absorbed after oral administration. The maximum plasma concentration is reached within 30-120 minutes after ingestion. The onset of action on the digestive tract is noted 20-40 minutes after ingestion. The antiemetic effect persists for 12 hours. 13-30% of metoproclamide binds to plasma proteins. The volume of distribution is 3.5 l / kg. Metabolized in the liver. The half-life is 4-6 hours. During 24-72 hours, up to 80% of the administered dose is excreted in the urine, about 30% is unchanged. Penetrates through the BBB and the placental barrier, excreted in breast milk.
With intravenous administration, the onset of action on the digestive tract is noted after 1-3 minutes, with intramuscular administration - after 10-15 minutes.

Indications for the use of the drug Cerucal

Upper GI dysmotility (eg, irritable stomach syndrome, heartburn, reflux esophagitis, and functional pyloric stenosis); nausea, urge to vomit and vomiting (with diseases of the liver and kidneys, traumatic brain injury, migraine and due to hypersensitivity to drugs); paresis of the stomach of diabetic origin; when conducting radiodiagnosis of diseases of the stomach and small intestine.

The use of the drug Cerucal

Tablets
Adults and adolescents over the age of 14 are prescribed orally 10 mg 3-4 times a day.
For children aged 3 to 14 years, the recommended single dose is 0.1 mg/kg, the maximum daily dose is 0.5 mg/kg.
Tablets are taken orally, approximately 30 minutes before meals.
The duration of the course of treatment depends on the severity and course of the disease. The usual duration of treatment is 4-6 weeks. In some cases, treatment can be continued up to 6 months. In the presence of renal insufficiency, the dose of the drug is selected taking into account the severity of impaired renal function.
Injection
The injection solution is administered intramuscularly or intravenously slowly. Adults and adolescents over the age of 14 years old intramuscularly and intravenously are administered 2 ml of Cerucal solution 3-4 times a day (single dose is 10 mg, daily dose is 30-40 mg of metoclopramide).
For children aged 3 to 14 years, the recommended single dose is 0.1 mg/kg of body weight, the maximum daily dose is 0.5 mg/kg.
The appointment of metoclopramide in high doses for nausea and vomiting caused by the use of cytostatic agents:
Dosing schedule 1
By short-term intravenous drip infusion (over 15 minutes), Cerucal is administered at a dose of 2 mg / kg 30 minutes before the start of the administration of a cytostatic agent, and also after 1.5; 3.5; 5.5 and 8.5 hours after the application of the cytostatic agent.
Dosing schedule 2
By continuous intravenous drip infusion, Cerucal is administered at a dose of 1 (0.5) mg / kg for an hour, starting 2 hours before the use of a cytostatic agent, then at a dose of 0.5 (0.25) mg / kg for an hour within 24 hours after the use of a cytostatic agent.
Cerucal is used throughout the entire period of treatment with a cytostatic agent. Each short-term intravenous drip infusion is carried out for 15 minutes after the previous dilution of the Cerucal dose in 50 ml of the infusion solution. Cerucal for injection can be dissolved with isotonic sodium chloride solution or 5% glucose solution.
Note
The solution of Cerucal for injections must not be mixed with alkaline infusion solutions.

Contraindications to the use of the drug Cerucal

Hypersensitivity to the drug; pheochromocytoma; mechanical intestinal obstruction; intestinal perforation and gastrointestinal bleeding; prolactin-dependent tumors; in patients with epilepsy or in patients with increased convulsive readiness (extrapyramidal movement disorders); the first trimester of pregnancy and the period of breastfeeding; in newborns and children under the age of 3 years.
For children aged 3-14 years, as well as for pregnant women in the II-III trimester, metoclopramide is prescribed only for health reasons.
In patients with reduced renal function, the drug is prescribed in reduced doses.
Due to the content of sodium sulfite, Cerucal injectable solution should not be administered to patients with asthma with hypersensitivity to sulfite.

Side effects of the drug Cerucal

Occasionally, mainly with the use of metoclopramide in higher doses, patients may experience a feeling of fatigue, headache, dizziness, fear, anxiety and diarrhea.
In some cases, mainly in children, dyskinetic syndrome (involuntary tic-like twitching of the muscles of the face, neck or shoulders) may develop.
After discontinuation of the drug, these phenomena are weakened after a few hours; it is possible to eliminate them immediately in / in the introduction of biperiden (the manufacturer's recommendations should be taken into account). For a sedative effect, the introduction of diazepam is indicated.
After prolonged treatment with metoclopramide, some elderly patients developed parkinsonism (tremor, muscle twitching, limited mobility) and tardive dyskinesia.
After longer use of the drug, occasionally, due to stimulation of prolactin secretion, gynecomastia in men, galactorrhea or menstrual irregularities may occur; with the development of these phenomena, the use of metoclopramide is stopped.
In adolescents and patients with severely impaired renal function, the occurrence of side effects should be especially carefully monitored, and if they develop, the drug should be stopped immediately.

Special instructions for the use of the drug Cerucal

Influence on the ability to drive vehicles.
Even when taken as directed, metoclopramide can significantly impair reaction time and ability to drive vehicles or operate potentially dangerous machinery. This effect is especially pronounced with the simultaneous use of alcohol.
Due to the content of sodium sulfite in the injection solution of Cerucal, in some cases, mainly in patients with asthma, hypersensitivity reactions to the drug may occur, which are manifested by nausea, diarrhea, shortness of breath, an acute attack of asthma, impaired consciousness or anaphylactic shock. The severity of these reactions is purely individual, in some cases they can pose a threat to the life of the patient.

Interactions of the drug Cerucal

Anticholinergics may reduce the effect of metoclopramide. Metoclopramide may interfere with the absorption of other medicinal products. On the one hand, there may be a slowdown in the absorption of digoxin and cimetidine, on the other hand, an acceleration of the absorption of antibiotics, paracetamol and alcohol.
In addition, metoclopramide may enhance the effects of alcohol and sedatives. In order to prevent a possible increase in the severity of extrapyramidal disorders, antipsychotics should not be prescribed simultaneously with metoclopramide.
Metoclopramide may interfere with the action of tricyclic antidepressants, MAO inhibitors and sympathomimetic agents.
Due to the content of sodium sulfite in the injection solution, thiamine (vitamin B1), taken simultaneously with Cerucal, can be quickly broken down in the body.

Cerucal overdose, symptoms and treatment

Symptoms: drowsiness, confusion, irritability, restlessness, convulsions, extrapyramidal movement disorders, dysfunction of the cardiovascular system with bradycardia and an increase or decrease in blood pressure.
Treatment: with extrapyramidal disorders, biperiden is slowly injected intravenously. Control over the vital functions of the body is carried out until the symptoms of intoxication disappear completely.

Storage conditions of the drug Cerucal

Tablets: in a place protected from light at a temperature not exceeding 25 ° C.
Solution for injection: in a place protected from light at a temperature not exceeding 30 ° C.
Ready infusion solution can be stored at room temperature for 24 hours.
Ampoules taken from the package should not be left in sunlight for a long time.

List of pharmacies where you can buy Cerucal:

• St. Petersburg

Vomiting in people of any age is a natural reaction of the body under certain conditions. These are various poisonings, pathological conditions in the gastrointestinal tract, a reaction to certain medications, and stressful situations.

Working with older patients is easy. They understand their condition and can, if necessary, restrain their natural impulses. With children, it's much more difficult. Their gag reflex works automatically, and it is almost impossible to stop it by willpower.

Nausea and vomiting often make effective treatment difficult. Modern pharmacy offers a variety of drugs that, if necessary, suppress nausea and gag reflex. One of the drugs of choice is "".

Cerucal is an excellent drug for suppressing nausea and vomiting.

The drug is produced in 2 forms - tablets and solution for infusion. The main active ingredient is metoclopramide. The components of the drug block dopamine receptors in the central nervous system.

This raises the threshold of sensitivity of the vomiting center in the brain. Thanks to this, nausea is reduced, hiccups disappear. Metoclopramide acts on receptors, reducing the motor activity of the latter. Under the action of the drug, food is absorbed faster and passes through all parts of the intestine, but diarrhea does not occur.

The outflow of bile is normalized, removed. Tableting forms begin to act 30 minutes after ingestion. When administered intravenously or intramuscularly directly during infusion. The drug is excreted from the body during the day.

Cerucal. Indications and contraindications for the appointment

Cerucal is also used to treat reflux disease.

The drug is prescribed for the following pathological conditions:

• Nausea
• Postoperative hypotension and atony of the system
• Bile duct dyskinesia
• Reflux disease
• Narrowing (stenosis) of the pylorus - a section of the intestine that separates the duodenum and the pyloric part of the stomach
• X-ray examination of the gastrointestinal tract
• Paresis of the stomach
• When conducting studies of the gastrointestinal tract

The drug is not prescribed in the following cases:

1. Individual intolerance.
2. Pheochromocytoma and other prolactin-dependent neoplasms. The drug promotes increased production of this hormone.
3. Physical pathologies in the gastrointestinal tract - volvulus, perforation and in any of the departments.
4. Epilepsy.
5. Various movement disorders.
6. Pregnancy up to 12 weeks. In the future, the use of the drug is allowed if the benefit to the mother is higher than the expected harm to the baby.

Does not work with vomiting and nausea of ​​the vestibular type.

Cerucal and children. Effective dosages

Cerucal should be taken half an hour before meals.

This drug for children should be prescribed by the attending physician and only according to indications! Independent is unacceptable! Effective dosage of "Cerukal" for children of different ages:

• Up to 2 years - the drug is not prescribed in any form.
• From 2 to 14 years - tablet forms are not used. From 14 years - no more than 1 tablet 3 times a day.
• From 3 years to 14 - injectable forms - the dose is calculated based on the weight of the child. The effective volume of the drug is 0.1 mg per 1 kg of the weight of a toddler or teenager. But not more than 0.5 mg per 1 kg during the day.
• From 14 years and older - 1 ampoule 3 to 4 times a day.

Patients with impaired renal function should be reduced and the effective dose selected individually.

Tablets are taken half an hour before meals with plenty of water. Injection forms are administered drip for 15 minutes. The drug is diluted in 50 ml of saline or 5% glucose.

Side effects and overdose of Cerucal

A side effect of the remedy may be dry mouth.

The drug is aimed at reducing from drugs and unpleasant physiological conditions. But this does not mean that Cerucal itself does not have side effects. Side effects of the drug:

1. Neurological disorders - fear, anxiety, headaches, various tics, increased fatigue. Children may develop dyskinetic syndrome.
2. various neuroleptic conditions. This is expressed in an increase in the body, pressure surges, impaired consciousness.
3. Defecation disorder, dry mouth.
4. Gynecomastia (in boys), galactorrhea (in girls), menstrual disorders.
5. Violation of the heart rhythm - bradycardia, tachycardia.
6. With the development of side effects, Cerucal is canceled.

The symptoms of a drug overdose are similar to the side effects of the drug. Most often it is a violation of consciousness, the development of seizures, dyskinetic disorders. In mild cases, signs of an overdose are not treated, since metoclopramide is excreted on its own within a day. In severe cases, a slow introduction of biperiden is prescribed. This drug blocks the transmission of impulses to the central nervous system.

Cerucal and other drugs. Undesirable impact

Cerucal should never be taken with cimetidine.

Before starting treatment with this remedy, tell your doctor about other medicines that you regularly take. Otherwise, instead of improving your well-being, you risk getting worse. Important! Do not take the following drugs with "Cercal":

• Any solutions with an alkaline environment.
• Enhances the effect of tetracycline and similar ones, ampicillin.
• Accelerates the absorption of levodopa, drugs based on paracetamol, ethyl alcohol. Children's preparations containing ethanol should be excluded for the duration of treatment with Cerucal.
• Do not use cardiac glycosides such as Digoxin or Cimetidine with drugs of the group.
• When taken simultaneously with alcoholic beverages, it enhances the inhibitory effect of ethanol on the central nervous system. Do not use syrups or tinctures containing ethyl alcohol.
• Do not use with neuroleptics.
• During treatment, do not take group B. The latter quickly disintegrate against the background of Cerucal.
• The drug may affect the rate of the reaction. Therefore, during treatment, you need to give up driving, working with precise mechanisms.

When taking Cerucal, the results of liver function tests may be distorted. Therefore, the laboratory assistant should be warned before blood sampling.

Important! Do not take Cerucal without a doctor's prescription and quality, especially when treating children. In this case, it is better to additionally consult with a pediatrician, and then make a decision on taking the drug.

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Active substance

Metoclopramide hydrochloride (metoclopramide)

Release form, composition and packaging

Solution for intravenous and intramuscular administration transparent, colorless.

Excipients: sodium sulfite, disodium edetate (disodium ethylenediaminetetraacetate), water for injection.

2 ml - colorless glass ampoules (5) - blister packs (2) - cardboard packs.

pharmachologic effect

A specific blocker of dopamine receptors, weakens the sensitivity of the visceral nerves that transmit impulses from the pylorus and duodenum 12 to the vomiting center. Through the hypothalamus and parasympathetic nervous system, it has a regulating and coordinating effect on the tone and motor activity of the upper gastrointestinal tract (including the tone of the lower digestive sphincter at rest). Increases the tone of the stomach and intestines, accelerates gastric emptying, reduces hyperacid stasis, prevents pyloric and esophageal reflux, stimulates intestinal motility.

Pharmacokinetics

V d is 2.2 - 3.4 l / kg.

Metabolized in the liver. The half-life is from 3 to 5 hours, in chronic renal failure - 14 hours. It is excreted by the kidneys during the first 24 hours unchanged and as metabolites (about 80% and a single dose). It easily crosses the blood-brain barrier and is excreted in breast milk.

Indications

- vomiting and nausea of ​​various origins;

- atony and hypotension of the stomach and intestines (in particular, postoperative);

- biliary dyskinesia, reflux esophagitis, functional pyloric stenosis;

- to enhance peristalsis during radiopaque studies of the gastrointestinal tract;

- paresis of the stomach in diabetes mellitus;

- as a means of facilitating duodenal sounding (to accelerate the emptying of the stomach and the promotion of food through the small intestine).

Contraindications

- hypersensitivity to metoclopramide;

- pheochromocytoma (possible hypertensive crisis, due to the release of catecholamines);

- intestinal obstruction, intestinal perforation and gastrointestinal bleeding;

- prolactin-dependent tumor;

- epilepsy and extrapyramidal movement disorders, first trimester of pregnancy and lactation, age up to 2 years.

Carefully: with arterial hypertension, impaired liver function, hypersensitivity to procaine and procainamide, children aged 2 to 14 years

During the 2nd and 3rd trimester of pregnancy, the drug is prescribed only for health reasons.

In patients with reduced renal function, the drug is prescribed in reduced doses.

Dosage

In / m or slowly in / in.

Adults and teenagers over 14 years of age: 1 ampoule (10 mg metoclopramide) 3-4 times a day.

Children from 3 to 14 years old: The therapeutic dose is 0.1 mg metoclopramide/kg body weight, the maximum daily dose is 0.5 mg metoclopramide/kg body weight.

In case of impaired renal function, the dose of the drug is selected according to the severity of renal dysfunction.

Prevention and treatment of nausea and vomiting caused by the use of cytostatics:

Scheme 1.

Short-term drip infusion (within 15 minutes) at a dose of 2 mg / kg half an hour before the start of treatment with a cytostatic agent, and then 1.5 hours, 3.5 hours, 5.5 hours and 8.5 hours after the use of cytostatics.

Scheme 2.

Long-term drip infusion at a dose of 1.0 or 0.5 mc / kg per hour, starting 2 hours before the use of a cytostatic agent, then at a dose of 0.5 or 0.25 mg / kg per hour for the next 24 hours after the use of a cytostatic agent.

Drip infusion is carried out for a short time within 15 minutes after the preliminary dilution of the dose in 50 ml of the infusion solution.

Cerucal injection solution can be diluted with isotonic sodium chloride solution or 5% glucose solution.

Cerucal is used during the entire period of treatment with cytostatic agents.

Side effects

From the nervous system: sometimes there may be a feeling of fatigue, headaches, dizziness, fear, anxiety, depression, drowsiness, tinnitus; in some cases, mainly in children, dyskinetic syndrome (involuntary tic-like twitching of the muscles of the face, neck or shoulders) may develop. Perhaps the appearance of extrapyramidal disorders: spasm of the facial muscles, trismus, rhythmic protrusion of the tongue, bulbar type of speech, spasm of extraocular muscles (including oculogiric crisis), spastic torticollis, opisthotonus, muscle hypertonicity. Parkinsonism (tremor, muscle twitching, limited mobility, the risk of development in children and adolescents increases when the dose is exceeded 0.5 mg / kg / day) and tardive dyskinesia (in elderly patients with chronic renal failure). In rare cases, severe neuroleptic syndrome may develop.

With long-term treatment with cerucal in elderly patients, symptoms of parkinsonism (tremor, muscle twitching, limited mobility) and tardive dyskinesia may develop.

From the hematopoietic system: agranulocytosis.

From the side of the cardiovascular system: supraventricular tachycardia, hypotension, hypertension.

From the gastrointestinal tract: constipation, diarrhea, dry mouth.

From the endocrine system: with prolonged use of the drug, gynecomastia (enlargement of the mammary glands in men), galactorrhea (spontaneous flow of milk from the mammary glands) or menstrual irregularities may occur; with the development of these phenomena cancel.

Overdose

Symptoms: drowsiness, confusion, irritability, anxiety, convulsions, extrapyramidal movement disorders, dysfunction of the cardiovascular system with bradycardia and arterial hypo- or hypertension. In mild forms of poisoning, symptoms disappear 24 hours after drug withdrawal. Depending on the severity of the symptoms, it is recommended to establish monitoring of the patient's vital functions. Fatal cases of poisoning due to overdose have not yet been identified.

Treatment: symptomatic. Extrapyramidal disorders are eliminated by the slow administration of biperiden (adult doses - 2.5 - 5 mg; manufacturer's recommendations should be followed). Perhaps the use of diazepam.

drug interaction

Incompatible with infusion solutions having an alkaline environment.

Decreased action of anticholinesterase agents.

Enhances the absorption of antibiotics (, ampicillin), paracetamol, levodopa, lithium and alcohol.

Reduces the absorption of digoxin and cimetidine.

Enhances the effect of alcohol and drugs that depress the central nervous system.

Antipsychotic drugs should not be administered concomitantly with metoclopramide in order to avoid a possible increase in extrapyramidal disorders.

May interfere with the action of tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and symptomatic agents.

Reduces the effectiveness of therapy with H 2 -histamine blockers.

Increased risk of hepatotoxicity when combined with hepatotoxic agents.

Reduces the effectiveness of pergolide, levodopa.

Increases bioavailability, which may require control of its concentration.

Increases the concentration of bromocriptine.

With the simultaneous appointment of cerucal with thiamine (Vitamin B1), the latter quickly disintegrates.

special instructions

During the period of treatment, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

During treatment, patients are prohibited from drinking alcohol.

In adolescents and in patients with severely impaired renal function, the possible development of side effects is monitored, if they occur, the drug is canceled.

Not effective for vomiting of vestibular origin.

Against the background of the use of metoclopramide, distortions of the data of laboratory parameters of liver function and the determination of the concentration of aldosterone and prolactin are possible.

Pregnancy and lactation

It is contraindicated to use in the first trimester of pregnancy and lactation.

In the II and III trimesters of pregnancy, the drug is prescribed only for health reasons.

Application in childhood

Do not administer to children under 2 years of age.

Be wary appoint children aged 2 to 14 years. In adolescents, the possible development of side effects is monitored, if they occur, the drug is canceled.

For impaired renal function

In patients with reduced renal function, the drug is prescribed in reduced doses. In patients with severely impaired renal function, the possible development of side effects is monitored, if they occur, the drug is canceled.

For impaired liver function

Use this drug with caution in case of impaired liver function.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

List B.

The drug should be stored in a place protected from light, at a temperature not exceeding 30°C.

Keep out of the reach of children.

Shelf life 5 years. Do not use after the expiration date.