Citramon: instructions for use, tablets increase or decrease blood pressure, composition

Compound

The composition of Citramon tablets traditionally included: 240 mg of acetylsalicylic acid (ASA), 180 mg of phenacetin , 30 mg of caffeine , 15 mg of cocoa, 20 mg of citric acid.
However, at present, the classic recipe for making the drug is not used due to the withdrawal of one of its active components, phenacetin, (this is due to the high nephrotoxicity of the substance).

Numerous manufacturers produce medicines whose names contain the word “Citramon”, but they all have a slightly modified composition, in which paracetamol is used phenacetin .

Tablets from different manufacturers maintain the same uniformity of active ingredients, but the concentration of each of them may differ.

Citramon P, Citramon U and Citramon M contain active components (ASA, paracetamol and caffeine) in the same concentration as in the original drug. But in Citramon-Forte their concentration is different: each tablet contains 320 mg of ASA, 240 mg of paracetamol and 40 mg of caffeine.

Citramon Borimed tablets contain 220 mg of ASA, 200 mg of paracetamol and 27 mg of caffeine. The concentration of these substances in Citramon-LekT tablets is, respectively, 240 mg, 180 mg and 27.5 mg.

But the main difference between Citramon Ultra and Citramon is the presence of a film shell, which makes the tablet easier to swallow, acts as a reliable barrier between the mucous membrane of the digestive canal and the active substances contained in the tablets (in particular, the shell protects the stomach from the aggressive effects of ASA) and accelerates the absorption of the drug.

"Citramon": composition and other characteristics

"Citramon" is an anesthetic that prevents inflammatory processes and also has an antipyretic effect. The only form of release is tablets. They are packaged in cardboard packages, each containing 10 or 6 pieces.

The active ingredient is acetylsalicylic acid (240 mg per tablet). The following are used as auxiliary components:

citric acid (20 mg);
phenacetin (180 mg);
caffeine (20 mg).

The composition and dosage of components may vary significantly, as determined by manufacturers. The features of the tablet may also differ. For example, “Citramon Ultra”, unlike the classic “Citramon”, is a drug with film-coated tablets. This makes oral administration easier.

The effect on the body is complex:

Acetylsalicylic acid reduces temperature and resists inflammatory processes.
Caffeine stimulates excitation processes in the central nervous system and activates the brain.
In combination with acetylsalicylic acid and paracetamol, the drug has a pronounced analgesic effect.

The product is available freely and does not require a prescription. Stored at normal room temperature up to 25 degrees. The shelf life is 2 years from the date of production.

For reference

One of the common types of the drug is Citramon P. Along with the main components, it contains paracetamol, which enhances the analgesic and antipyretic effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Citramon is a combined drug, the effect of which is determined by the properties of the components it contains (non-narcotic analgesic, psychostimulant and NSAID).

ASA relieves fever and inflammation, relieves pain (especially if the pain is caused by an inflammatory process), has a moderate antiplatelet effect, prevents the formation of blood clots, and helps improve microcirculation in the area of inflammation.

Paracetamol reduces the intensity of pain, reduces fever, and has a weak anti-inflammatory effect. The properties of this substance are associated with its influence on the thermoregulation center located in the hypothalamic region and a weakly expressed ability to inhibit the formation of Pg in peripheral tissues.

Caffeine has a direct stimulating effect on the central nervous system, which manifests itself in the form of increased excitation processes in the cerebral cortex, vasomotor and respiratory centers, increased motor activity and strengthened positive conditioned reflexes.

Stimulates mental activity, temporarily reducing or eliminating drowsiness and fatigue, and shortens reaction time. Reduces platelet aggregation.

Citramon tablets contain caffeine in low concentrations. Because of this, the substance has virtually no stimulating effect on the central nervous system, but improves cerebral vascular tone and helps accelerate blood flow.

The combination of ASA and paracetamol potentiates the analgesic effect of the drug. Both the analgesic and antipyretic effects of ASA and paracetamol are enhanced when these substances are used simultaneously with caffeine.

Pharmacokinetics

After oral administration, the components contained in the tablets are absorbed quickly and almost completely. At the same time, caffeine helps to increase F (bioavailability) of ASA and paracetamol.

During absorption, it and ASA are intensively biotransformed with the formation of pharmacologically active metabolites. Salicylic acid is formed from ASA through the process of deacetylation in the liver and intestinal wall .

Under the influence of the hepatic isoenzyme CYP1A2, caffeine forms dimethylxanthines ( paraxanthine and theophylline ).

The maximum duration of all active components of Citramon is from 0.3 to 1 hour. In blood plasma, from 10 to 15% of paracetamol and approximately 80% of the taken dose of ASA are in an albumin state.

All components of the tablets easily penetrate into any fluids and tissues of the body (including easily crossing the placental barrier and entering breast milk). Minor concentrations of salicylates are found in brain tissue, while levels of caffeine and paracetamol are comparable to plasma levels.

With the development of acidosis, ASA turns into a non-ionized form, due to which its penetration into the tissues of the NS increases.

Metabolism of active substances occurs in the liver. ASA has 4 metabolites (gentisuronic and gentisic acids, salicylophenolic glucuronide, salicylurate). Paracetamol forms sulfate (80% of the total amount) and paracetamol glucuronide (both are pharmacologically inactive), as well as a potentially toxic substance - N-acetyl-benziminoquinone (about 17% of the total amount).

Caffeine metabolites are uridine , mono- and dimethylxanthines, mono- and dimethyluric acid, di- and trimethylallantoin.

Caffeine affects the pharmacokinetics of paracetamol, slightly increasing (up to 20-25%) the formation of N-acetyl-benziminoquinone.

Metabolites are excreted by the kidneys. About 5% of paracetamol, about 10% of caffeine and about 60% of salicylates are excreted unchanged.

The half-life of elimination is from 2 to 4.5 hours (all components of the drug are excreted at approximately the same rate). Increasing the dose of Citramon leads to a slower elimination of ASA compared to other substances by up to 15 hours.

In smokers, on the contrary, there is an accelerated elimination of caffeine in comparison with other components of the drug.

Low pressure exposure

Among the list of medical symptoms of low blood pressure are: dizziness, problems with the quality of vision - this is especially felt when driving a car. All of these symptoms indicate low blood pressure and can cause loss of concentration and sluggish reactions. The symptoms can be easily suppressed with Citramon.

Low blood pressure indicates other pathologies. A list of popular diseases and conditions is presented below:

excessive bleeding
complex course of infection,
dehydration,
heart attack or heart failure,
severe allergic reaction,
diseases of the endocrine system affecting the thyroid gland, low blood sugar, and the formation of diabetes mellitus.

I wonder if Citramon increases or decreases blood pressure ? Doctors do not recommend taking the drug frequently to improve blood pressure levels. The drug has a short-term effect and is not indicated for long-term treatment. Thanks to the caffeine it contains, the medicine increases blood pressure rather than lowers it. Caffeine is present in many common foods that people consume every day. Coffee fans feel addicted to it. A similar condition occurs with frequent use:

strong black tea,
sweet soda,
energy workers.

People who prefer these drinks feel a constant need for caffeine. The use of tablets that contain it does not affect intracranial pressure and does not increase it.

Indications for use of Citramon

What is Citramon P for?

When asked what Citramon P helps with, the manufacturer answers in the annotation for the drug that the use of tablets is advisable for relieving mild and moderate pain, as well as for alleviating the patient’s condition during febrile syndrome , which is accompanied by ARVI and influenza .

Citramon is effective for the head (including during migraine attacks), for joint and muscle pain, and algodismenorrhea .

What are Citramon-LekT tablets for?

Indications for the use of Citramon-LekT are the same as for other drugs based on ASA, paracetamol and caffeine, namely: pain syndrome due to algodismenorrhea , neuralgia , myalgia , arthralgia , headache, toothache, migraine.

The drug can also be used as a remedy for fever during acute respiratory viral and influenza .

Does Citramon help with toothache?

Toothache is one of the indications for using the drug. The effectiveness of Citramon is due to the properties of its constituent NSAIDs, non-narcotic analgesic and psychostimulant.

Strengthening each other's action, these components have a complex effect on the body, relieving any pain (including toothache), especially if it is associated with inflammation. During exacerbation of chronic pulpitis , against which the temperature often rises, Citramon not only helps relieve pain and reduce the severity of inflammation, but also has an antipyretic effect.

What do Citramon tablets help with?

The main purpose of the drug is to relieve moderate and mild pain in the presence of concomitant diseases:

ARVI;
flu;
general malaise;
febrile syndrome;
neuralgia;
arthralgia;
algodysmenorrhea;
migraine;
myalgia;

The drug is used to treat headaches, muscle pain, dental pain, and joint pain. "Citramon" is effective in relieving any pain that is associated with inflammatory processes. It contains several active components that mutually enhance each other's actions.

Contraindications

The instructions list the following contraindications for Citramon:

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

Relative contraindications are gout and existing liver pathologies.

Contraindications for use

Restrictions associated with the use of the product contain a fairly large list of disorders and diseases:

nasal polyposis;
bronchial asthma;
hypersensitivity to one or more components;
bleeding of the gastrointestinal tract;
diathesis of hemorrhagic type;
erosion, ulcer of the gastrointestinal tract (in the acute stage);
portal hypertension"
severe course of coronary heart disease;
hemophilia;
renal failure;
increased nervous excitability;
kidney failure;
sleep problems;
bleeding during operations;
severe hypertension;
glaucoma;
simultaneous use of anticoagulant drugs;
aortic aneurysm;
pregnancy period (especially during the 1st and 3rd trimesters);
feeding period (any stage);
children up to 15 years old inclusive.

There are also relative contraindications in which Citramon should be taken with caution. These are liver dysfunctions, as well as gout.

Side effects

Side effects of Citramon:

gastralgia , anorexia , nausea, formation of erosions and ulcerative elements on the mucous membrane of the digestive canal, gastric and intestinal bleeding;
liver failure;
hypersensitivity reactions (including the development of symptoms of the Fernand-Vidal triad );
interstitial nephritis , nephrotic syndrome , necrotizing papillitis , with long-term use - renal failure ;
anemia , thrombocytopenia , leukopenia ;
acute fatty hepatosis , toxic hepatitis , acute hepatic encephalopathy ( Reye's syndrome );
worsening heart failure , manifestation of its latent forms (with long-term use);
dizziness, insomnia, agitation, anxiety, headache, tinnitus, hearing and vision impairment, aseptic meningitis ;
increased blood pressure, arrhythmia , tachycardia ;
development of tolerance and weak psychological dependence (with long-term use of high doses of the drug);
drug-induced headache after discontinuation of Citramon (if the drug was used for a long time).

Experiments on animals also demonstrated the teratogenic effect of the drug on the fetus.

Citramon tablets, instructions for use

Preparations from different manufacturers have different compositions, and since they often contain active substances in different concentrations, you should read the instructions very carefully so as not to mistakenly exceed the permissible daily dose.

What all drugs have in common is that they can be used as an analgesic for a maximum of five days, and as an antipyretic for three days.

Instructions for use Citramon P and Citramon-LekT

Citramon P and Citramon-LekT can be taken from the age of fifteen. Take one tablet 2-4 times a day (during or after meals). The break between doses should be at least four hours. The average dose is 3-4 tablets per day.

Citramon for headaches (as well as in other cases when it is necessary to relieve severe pain) can be taken 2 pieces at once. The permissible upper limit of the daily dose is 8 tablets.

Treatment lasts from one week to ten days.

If necessary, the doctor may prescribe a different dose of the drug or select a different treatment regimen.

Instructions for use Citramon Forte

Citramon-Forte is used in patients over sixteen years of age. The daily dose is 2-3 tablets. You need to take them one at a time, 2 or 3 times a day. To relieve an attack of acute pain, you should immediately take two tablets.

The permissible upper limit of the daily dose is 6 tablets.

Citramon-Darnitsa is taken according to a similar regimen (the only difference between the drug is the age limit - these tablets are prescribed from 15 years of age).

Instructions for use Citramon-Borimed

It is preferable to take Citramon-Borimed immediately after meals or between meals. The drug can be used in adults and adolescents over fifteen years of age. Take one tablet 2-3 times a day, maintaining intervals of at least 6-8 hours between doses. The highest single dose is 2 tablets, the daily dose is 4.

It is used as an antipyretic at temperatures exceeding 38.5 °C (if there is a tendency to febrile convulsions - at temperatures above 37.5 °C). Single dose - 1-2 tablets.

Instructions for use of Citramon Ultra

Citramon Ultra is prescribed from the age of fifteen. Daily dose - 1-3 tablets. If necessary, you can take up to 6 tablets during the day.

Overdose

A slight overdose manifests itself in the form of nausea, dizziness, increased pallor of the skin, gastralgia, vomiting, and ringing in the ears.

Symptoms of severe intoxication of the body: impaired circulation and breathing, anuria , anxiety, stupor, nausea, headache, hyperthermia , tremor , drowsiness, anxiety, sweating, collapse , bleeding, convulsions (with pathological increased tendon reflexes), coma .

If signs of overdose appear, taking the tablets should be stopped. To prevent the absorption of the drug in the digestive canal, the patient's stomach is washed, enterosorbents and a saline laxative are given.

If the plasma concentration of salicylates in a child exceeds 300 mg/l, and in an adult - 500 mg/l, it is advisable to carry out forced alkaline diuresis. To maintain urine pH at 7.5-8, alkalizing agents are administered.

Measures are taken to restore the bcc and acid-base balance.

In case of cerebral edema, mechanical ventilation with an oxygen-enriched mixture is prescribed in the mode of creating PEEP (positive end-expiratory pressure). Hyperventilation should be carried out in combination with the use of osmotic diuretics .

If there are signs of liver damage, N-acetylcysteine, which is a specific antidote to paracetamol, should be administered. The solution is used orally and injected into a vein. In total, the patient needs to administer seventeen doses: the first - 140 mg/kg, all subsequent doses - 70 mg/kg.

The most effective therapy is started in the first ten hours after the development of intoxication. If more than 36 hours have passed, treatment is ineffective.

When the prothrombin index (PTI) value increases to 1.5-3, the use of phytomenadione ( vitamin K ) in a dose of 1 to 10 mg is indicated. If the PTI exceeds 3.0, infusion of clotting factor concentrate or native plasma should be started.

Carrying out hemodialysis, using antihistamines , corticosteroids or acetazolamide (to alkalinize urine) during intoxication with Citramon is contraindicated.

These measures can provoke the development of acidemia and increase the toxic effect of ASA on the patient’s body.

Instructions for use CITRAMONUM-BORIMED

Symptoms.

Symptoms of paracetamol overdose. Liver damage is possible in adults who took 10 g or more of paracetamol, and in children who took the drug more than 150 mg/kg body weight. In the first 24 hours:

pallor, nausea, vomiting, anorexia and headache, hepatonecrosis, increased activity of “liver” transaminases, increased prothrombin index. Liver damage may appear 12-48 hours after taking excess doses of the drug. Impaired glucose metabolism and metabolic acidosis may occur. In severe poisoning, liver failure can lead to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis can develop even in the absence of severe kidney damage. Cardiac arrhythmia was also noted. With long-term use of high doses, aplastic anemia, thrombocytopenia, pancytopenia, agranulocytosis, neutropenia, leukopenia are possible.

Symptoms of caffeine overdose. Large doses of caffeine can cause pain in the epigastric region, vomiting, diuresis, rapid breathing, extrasystole, tachycardia or cardiac arrhythmia, and affect the central nervous system (dizziness, insomnia, nervous agitation, irritability, state of passion, anxiety, tremor, convulsions).

Symptoms of an overdose of acetylsalicylic acid. In case of an overdose of salicylates, chronic intoxication resulting from long-term therapy is possible (use of the drug more than 100 mg/kg/day for more than 2 days can lead to toxic effects), as well as acute intoxication, the causes of which may be accidental use by children or an unintentional overdose.

Chronic poisoning with salicylates can be hidden, since its symptoms are nonspecific. Moderate chronic intoxication caused by salicylates occurs, as a rule, only after repeated doses of large doses.

Symptoms Impaired balance, dizziness, ringing in the ears, deafness, increased sweating, nausea and vomiting, headache, confusion. These symptoms can be controlled by reducing the dose. Tinnitus can occur when the concentration of salicylates in the blood plasma is more than 150-300 mcg/ml. Serious adverse reactions occur when the concentration of salicylates in the blood plasma is more than 300 mcg/ml. Acute intoxication is indicated by a pronounced change in the acid-base balance, which may differ depending on the age and severity of intoxication. The severity of the condition cannot be determined solely on the basis of the concentration of salicylates in the blood plasma.

Treatment:

discontinuation of the drug, gastric lavage with activated charcoal and administration of saline laxatives (magnesium sulfate) to prevent absorption of the drug in the stomach and intestines. Introduction of alkalizing agents to maintain urine pH values at 7.5-8.0. When the level of salicylates in plasma exceeds 300 mg/l (2.2 mmol/l) in children and 500 mg/l (3.6 mmol/l) in adults, forced alkaline diuresis is indicated (provided by intravenous infusion of sodium bicarbonate 88 mEq/l and 5% glucose at a rate of 10-15 ml/kg/h with furosemide 40-60 mg). The volume of circulating blood is restored and the acid-base state is corrected. In case of cerebral edema, artificial ventilation of the lungs with an oxygen-enriched mixture in positive end-expiratory pressure mode is indicated. For cerebral edema, hyperventilation is performed in combination with the administration of osmotic diuretics.

In the presence of liver damage, a specific antidote of paracetamol, N-acetylcysteine, is administered. A 20% solution of N-acetylcysteine is used intravenously and orally:

first dose 140 mg/kg (0.7 ml/kg), then 70 mg/kg (0.35 ml/kg). A total of 17 doses are administered. The most effective treatment is started in the first 10 hours after the development of intoxication. If more than 36 hours have passed since intoxication, treatment is ineffective.

If the prothrombin index increases by more than 1.5, vitamin K1 (phytomenadione) 1-10 mg is used; if the prothrombin index increases to more than 3.0, it is necessary to begin infusion of native plasma or a concentrate of coagulation factors (1-2 units).

When treating intoxication, hemodialysis is contraindicated. It is unacceptable to use antihistamines and glucocorticosteroids. It is not recommended to use acetazolamide to alkalinize urine in the treatment of intoxication due to the possibility of developing acidemia and increasing the toxic effect of salicylate on the patient's body.

Interaction

It is strictly forbidden to prescribe in combination with Citramon with:

MAO inhibitors (when used simultaneously with caffeine , these drugs can lead to a dangerous increase in blood pressure);
Methotrexate at a dose exceeding 15 mg/week. (this combination increases the hematological toxicity of methotrexate).

Citramon also enhances the toxicity of barbiturates and valproic acid , the effects of opioid analgesics, oral hypoglycemic and sulfonamide agents, Digoxin and triiodothyronine .

Phenytoin , ethanol , COCs, Rifampicin , tricyclic antidepressants, barbiturates, Phenylbutazone increase the toxicity of paracetamol to the liver.

Macrolides ( Erythromycin , Clarithromycin ), interferon preparations, antimycotic agents ( Fluconazole , Ketoconazole ) slow down the metabolism of the active substances of Citramon tablets and lead to an increase in their concentration in plasma.

The use of the drug in combination with platelet , indirect anticoagulants and thrombolytic agents increases the risk of bleeding.

By inhibiting the synthesis of Pg in the kidneys, it weakens the effect of potassium-sparing and loop diuretics, as well as antihypertensive drugs from the group of ACE inhibitors.

GCS increase the toxicity of the components of the tablets on the gastric mucosa, increase the clearance of ASA and reduce its plasma concentration.

In combination with beta-adrenergic agonists ( Fenoterol , Salbutamol , salmeterol ) in high doses, the risk of developing hypokalemia ; with methylxanthines , the level of theophylline in plasma increases and the risk of its toxic effect increases; with Li salts, the plasma concentration of Li+ ions increases.

Due to the competitive excretion of uric acid in the nephron tubules, it weakens the effect of uricosuric drugs.

Characteristics of the drug

The main component in the composition is caffeine. It activates the central nervous system, increases the degree of arousal, and is used for:

activation of respiratory, brain, vasomotor centers,
reducing the lumens of blood vessels,
increased breathing,
muscle relaxation,
stabilization of the heart, diuresis.

Citramon is approved to block several types of headaches. It is used to increase blood pressure levels in a single dose if there are no signs of hypertension. Caffeine allows you to gently gain weight and normalize sleep. Allowed for complex therapy in combination with ergot alkaloids and analgesics.

The second substance is acetylsalicylic acid. Aspirin relieves mild to moderate pain and is used to block the inflammatory process and reduce fever. Can be used as a medicine to prevent arterial or venous thrombosis. The substance helps to temporarily relieve discomfort associated with chronic lupus, rheumatoid arthritis, and osteoarthritis. Included in a complex to reduce the risk of death, the formation of unstable angina or myocardial infarction.

The third substance is paracetamol. The substance is used to eliminate pain and reduce fever. It does not have anti-inflammatory or antiplatelet effects. The substance is added to many medications and eliminates acute respiratory infections in the early stages of their occurrence.

We studied the composition of Citramon. It is aimed at influencing intracranial pressure in the direction of growth. The product does not cause dilation of blood vessels. Citramon increases low blood pressure .

Citramon increases or decreases blood pressure

special instructions

Abuse of caffeine-containing products during treatment with Citramon can provoke overdose symptoms.

Elderly people, people suffering from gout , impaired renal and/or liver function with benign hyperbilirubinemia should be careful when taking tablets.

In patients with allergic complications (allergic rhinitis, asthma, urticaria ), when they are combined with respiratory tract infections, as well as with increased sensitivity to NSAIDs during treatment, bronchospasm or asthma attacks are possible.

With long-term (more than five days in a row) use of Citramon, monitoring of the functional state of the liver and peripheral blood patterns is necessary.

Long-term use of tablets containing paracetamol in high cumulative doses in some cases can cause drug-induced nephropathy or irreversible renal failure .

Long-term use of painkillers to treat headaches often leads to chronic headaches.

Taking Citramon can distort laboratory test indicators such as: plasma concentration of uric acid, plasma concentration of Heparin , plasma concentration of theophylline, blood sugar level, concentration of amino acids in the urine.

The drug may alter doping control tests in athletes. It complicates the diagnosis of “acute abdomen”.

In case of long-term treatment with Citramon, you should consult a doctor before taking Ibuprofen .

The use of drugs containing ASA during surgical interventions (including dental operations) increases the likelihood of the occurrence/intensification of bleeding.

The drug may affect the rate of neuromuscular transmission, and therefore during the period of treatment they should refrain from driving a vehicle or operating dangerous machinery.

The effect of the drug on blood pressure. Do Citramon tablets increase or decrease blood pressure?

Headaches are a fairly common occurrence in people prone to changes in blood pressure. Therefore, questions naturally arise here: is it possible to take the medicine with high blood pressure, is the drug harmful for hypotensive patients, how are Citramon and blood pressure related?

The analgesic effect for headaches is provided primarily due to the presence of ASA and paracetamol in the tablets.

The third component of the drug - caffeine - increases the flow of oxygen to tissues, stimulates blood circulation in the brain and increases blood pressure, thus helping to reduce the intensity of headaches and enhancing the effects of other components of Citramon.

High doses of caffeine provoke depression of the central nervous system. When taking small doses (as, for example, in Citramon), the stimulating effect predominates.

It should be noted that while caffeine increases blood pressure, which is reduced during hypotension, it does not change normal blood pressure.

Citramon P

Are common

This medicine should not be taken at the same time as medicines containing ASA or paracetamol.

As with other migraine treatments, caution should be exercised to rule out other potentially serious neurological disorders before initiating treatment for suspected migraine in patients who have not previously been diagnosed with migraine or in those whose migraine presents with atypical symptoms.

If patients vomit during >20% of migraine attacks or require bed rest during >50% of migraine attacks, the drug should not be used.

If the migraine does not stop after taking the first two tablets of the drug, you should seek medical help.

The drug should not be used if the patient has had more than 10 headache attacks per month for at least the last three months. In this case, headache due to excessive use of drugs should be suspected and treatment should be discontinued. Additionally, patients should seek medical attention. Caution should be used in patients with risk factors for dehydration, such as vomiting, diarrhea, or before or after major surgery.

Due to its pharmacodynamic properties, the drug can. mask signs and symptoms of infection.

Due to the content of acetylsalicylic acid in the drug

The drug should be used with caution in patients with gout, impaired renal or hepatic function, dehydration, uncontrolled hypertension, glucose-6-phosphate dehydrogenase deficiency and diabetes mellitus.

Due to ASA inhibition of platelet aggregation, the drug may lead to an increase in bleeding time during and after surgical interventions (including minor ones, such as tooth extraction).

The drug should not be used simultaneously with anticoagulants and other drugs that interfere with blood clotting, without medical supervision (see section “Interaction with other drugs”). Patients with bleeding disorders should be closely monitored. Caution should be exercised in case of metro- or menorrhagia.

If a patient develops bleeding or ulceration of the gastrointestinal tract while taking the drug, it must be discontinued immediately. Potentially fatal bleeding, ulceration, and perforation of the gastrointestinal tract may occur at any time during treatment with any NSAID, with or without a history of precursors and severe gastrointestinal complications. These complications tend to be more severe in older patients.

Alcohol, corticosteroids and NSAIDs may increase the risk of gastrointestinal bleeding (see section "Interaction with other drugs").

The drug may contribute to the development of bronchospasm and the occurrence of exacerbation of bronchial asthma (including bronchial asthma caused by intolerance to analgesics) or other hypersensitivity reactions. Risk factors include bronchial asthma, seasonal allergic rhinitis, nasal polyposis, chronic obstructive pulmonary disease, chronic respiratory tract infections (especially those associated with symptoms characteristic of allergic rhinitis). Such effects may also occur in patients with allergic reactions (eg, skin reactions, including itching and urticaria) to other substances. Particular caution is recommended in such patients.

Children under 18 years of age should not be prescribed medications containing acetylsalicylic acid as an antipyretic, since in the case of a viral infection they can increase the risk of Reye's syndrome. Symptoms of Reye's syndrome are hyperpyrexia, prolonged vomiting, metabolic acidosis, nervous system and mental disorders, hepatomegaly and liver dysfunction, acute encephalopathy, respiratory failure, convulsions, coma.

ASA may distort the results of laboratory tests of thyroid function due to false-positive low concentrations of levothyroxine (T4) and triiodothyronine (T3) (see section "Interaction with other drugs").

Due to the content of paracetamol in the preparation

Caution should be exercised when prescribing the drug to patients with impaired renal or hepatic function or alcohol dependence.

The risk of paracetamol poisoning is increased in patients taking other potentially hepatotoxic drugs or drugs that induce liver microsomal enzymes (eg, rifampicin, isoniazid, chloramphenicol, hypnotics and anticonvulsants including phenobarbital, phenytoin and carbamazepine).

Patients with a history of alcoholism are at particular risk for liver damage (see section “Interaction with other drugs”).

When using the drug, serious skin reactions may develop, such as acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis, which can be fatal. Patients should be informed of the signs of serious skin reactions. The drug should be discontinued at the first manifestation of skin reactions or any other signs of hypersensitivity.

Due to the caffeine content of the product

The drug should be prescribed with caution to patients with gout, hyperthyroidism and arrhythmia.

When using the drug, you should limit your consumption of products containing caffeine, since excess caffeine intake can lead to nervousness, irritability, insomnia and, in some cases, increased heart rate.

Analogs

Level 4 ATC code matches:
Acetylsalicylic acid

Aspirin-S

Citropak

Aspirin

Coficil-Plus

Farmadol

Askofen-P

Cefekon N

Aquacitramon

Upsarin UPSA

Citrapack

Alca Prim

Thrombopol

Citrapar

Analogs with the same composition of active ingredients:

Citramon-Darnitsa
Citramon-Borimed
Citramon-Ultra
Citramon-LekT
Aquacitramon
Atsepar
Askofen-P
Cofficil-plus
Citrapar
Excedrin
Migrenol Extra

Can children take Citramon?

The use of ASA-containing drugs for the treatment of ARVI in children (with or without hyperthermia

With some viral infections (particularly those caused by varicella zoster or influenza A or B ), there is a risk of developing acute hepatic encephalopathy ( Reye's syndrome ), which requires immediate medical attention. 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 number of side effects, it is better for children with a headache or toothache to choose safer remedies.

Alcohol compatibility

During treatment with Citramon, you should avoid drinking alcohol, since alcohol increases the likelihood of a toxic effect of paracetamol on the liver and ASA on the gastrointestinal tract.

The use of ethyl alcohol with ASA contributes to damage to the mucous membrane of the digestive canal. The synergism of alcohol and ASA also results in prolongation of bleeding time.

Citramon for hangover

Citramon for a hangover is not the most advantageous option, since the use of this drug allows you to relieve headaches only temporarily, but does not eliminate the main causes of poor health - imbalance of water and electrolytes, as well as intoxication.

The headache that accompanies hangover syndrome is associated with impaired venous outflow from the head, tissue swelling (in particular, swelling of the meninges ) and inhibition of the analgesic (antinociceptive) system, part of which is the action of serotonin and dopamine.

ASA partially unloads the membranes of the brain, caffeine stimulates metabolism in neurons and has an invigorating effect, cocoa reduces the relative deficiency of intracerebral serotonin and dopamine, citric acid reduces the severity of symptoms of alcohol intoxication.

However, the paracetamol contained in the tablets puts a lot of strain on the liver, which, in combination with alcohol breakdown products, can aggravate hangover symptoms and damage the body.

Use for high blood pressure

In Citramon, the instructions for increasing or lowering blood pressure detail all available contraindications for taking Citramon. The guidelines note that treatment is prohibited in the presence of persistently elevated intracranial pressure. Taking it aggravates the condition; before starting therapy, it is necessary to conduct a laboratory diagnostic study and find out why the headache hurts.

Medical signs of high blood pressure include:

cephalalgia - pressing, dull,
impaired visual acuity with a feeling of blurriness,
nosebleeds,
dizziness.

The following symptoms appear with low blood pressure:

dizziness,
short-term fainting,
decreased vision,
weakness,
vomit,
nausea.

Certain medical manifestations are observed with both high and low blood pressure. To correctly assess the condition, you should take into account the following data:

The use of the product is permitted in case of pale skin, thirst and hunger, chills (only with low intracranial pressure).
The product should not be taken if you have symptoms of a hypertensive crisis, headaches, or throbbing in the temples.

Therapy with Citramon in the latter situation will cause aggravation of cephalalgia. Treatment is necessary only for low blood pressure, otherwise the body's reaction to the drug will be unpredictable. Doctors recommend not to take any medications uncontrollably, especially if you feel pain. Without diagnosis and proper identification of the causes of poor health, you can make things worse and provoke an exacerbation of hidden pathological processes. Headaches of the pathological type require complex therapy, and not temporary relief of symptoms with analgesics. People are interested in whether Citramon is for high or low blood pressure ? If you experience low blood pressure, this drug increases it.

Citramon during pregnancy and lactation

Can pregnant women drink Citramon?

During pregnancy, you should avoid taking Citramon tablets, since the ASA they contain has a teratogenic effect.

The use of Citramon during pregnancy in the 1st trimester can cause cleft palate ; the use of the drug in the 3rd trimester leads to a deterioration in labor (suppression of Pg synthesis) and closure of the ductus arteriosus in the fetus. This in turn provokes hyperplasia of the pulmonary vessels and increased pressure in the vessels of the pulmonary (pulmonary) circulation.

Thus, the answer to questions like “Can I drink Citramon during pregnancy?” and “Can pregnant women take Citramon?” unambiguous - impossible.

Can a nursing mother take Citramon while breastfeeding?

The use of the drug during hepatitis B is contraindicated. The active components of the tablets and their metabolites are excreted into breast milk, which increases the likelihood of platelet dysfunction and bleeding in the baby.

Side effects

Citramon for high or low blood pressure is prescribed without a prescription; it can be bought at any pharmacy. Despite its harmless composition, it has side effects.

Citramon side effects

A person may notice the following conditions:

If there is an overdose, then dyspeptic disorders appear: vomiting, diarrhea, nausea.
The composition contains acetylsalicylic acid, which has an irritating effect on the mucous membrane of the stomach and intestines. Therefore, when using Citramon, pain, abdominal discomfort, and ulcers in the gastrointestinal tract may appear.
The appearance of nosebleeds or stomach bleeding. If bleeding is minimal, you should stop taking the drug and use a hemostatic agent. If there is massive blood loss and the condition worsens, you should urgently call an ambulance.
Large dosages of Citramon with long-term use have a negative effect on the liver. One of the substances of this drug (paracetamol) has a hepatotoxic effect. At a moderate dosage, the drug does not have a negative effect on the body.

Reviews

Most people, despite the fact that the drug is considered potentially unsafe, leave good reviews about Citramon, calling it their savior from headaches (including migraine attacks).

Although there are also those that mention the dangers of tablets for the liver and gastrointestinal tract, and also that with long-term use they cause a kind of addiction (patients can no longer do without Citramon for a long time and experience a constant need for it).

Based on all available reviews, the following conclusion can be drawn: the pills should be taken taking into account existing contraindications, as well as having previously compared the expected benefits from them and potential risks.

One or two tablets taken to relieve an attack of pain are not capable of harming the body; systematic, uncontrolled use, of course, threatens with very serious consequences.

Citramon price

The price of Citramon depends on which company produced the drug. So, for example, the price of Citramon P is from 15 rubles, and the price of Citramon Ultra is from 50 rubles.

In Ukraine, a package of tablets can be purchased from 5 to 20 UAH.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
Online pharmacies in KazakhstanKazakhstan

ZdravCity

Citramon P tablets 20 pcs. AO Update PFK
87 rub. order
Citramon P tablets 10 pcs. JSC "PFK Obnovlenye"
51 RUR order
Citramon-ExtraCap capsules 240mg+27.45mg+180mg 10 pcsPharmstandard-Leksredstva OJSC
71 RUR order
Citramon-LekT tab. 20pcs JSC "Tyumen Chemical Plant"
42 RUR order
Citramon P tablets 20 pcs. JSC Dalkhimfarm
38 rub. order

Pharmacy Dialogue

Citramon-P tablets No. 20Update PFK CJSC
83 RUR order
Citramon-P Update tablet No. 10Update PFK CJSC
60 rub. order
Citramon-ultra tablets No. 20PharmVilar
71 RUR order
Citramon-ultra tablets No. 10 Obolenskoe pharmaceutical company.
55 rub. order
Citramon-P (tab. No. 20)Updating PFC CJSC
87 RUR order

Pharmacy24

Citramon-M No. 6 tablets PAT "Khimpharmzavod" Chervona Zirka", Kharkov, Ukraine
4 UAH. order
Citramon Fitofarm forte N12 capsules PRAT "Fitofarm", Ukraine
20 UAH order
Citramon-M No. 10 tablets PAT "Khimpharmzavod" Chervona Zirka", Kharkov, Ukraine
5 UAH order
Citramon Euro N10 tablets Mibe GmbH Arznam., Germany
32 UAH order
Citramon-forte No. 100 tablets PAT "Lubnipharm", Ukraine
85 UAH order

PaniPharmacy

Citramon In tablet Citramon In tablet. No. 6 Ukraine, Lubnyfarm PJSC
3 UAH order
Citramon F tablets Citramon tablets. No. 6 Ukraine, Fitofarm ChAO
4 UAH order
Citramon M tablets Citramon-M tablets. No. 10 Ukraine, Red Star JSC
6 UAH order
Citramon tablets Citramon-Darnitsa tablets No. 6 Ukraine, Darnitsa ChAO
7 UAH order
Citramon tablets Citramon-Darnitsa tablets No. 10 Ukraine, Darnitsa ChAO
13 UAH order