Pharmacodynamics and pharmacokinetics
The effect of this combination drug is determined by the components that are present in its composition.
Paracetamol is able to exhibit an analgesic and antipyretic effect by influencing central thermoregulation in the hypothalamus. This also lowers body temperature and eliminates headaches and other painful sensations.
Ascorbic acid is one of the regulators of redox processes, tissue regeneration, GCS production, blood , carbohydrate metabolism, procollagen and collagen , and helps normalize capillary permeability. The use of this vitamin increases the body's resistance by stimulating the immune system.
The substance pheniramine is a H1-histamine receptor blocker. With its help, the manifestations of rhinorrhea, nasal congestion, lacrimation, sneezing, redness and itching of the eyes are reduced.
Inside the body, the drug undergoes rapid and complete absorption. Its maximum concentration in plasma is detected 30-60 minutes after application. Good distribution in tissues and physiological fluids, but also penetration through the BBB was noted. The connection with plasma proteins is completely insignificant. Metabolism occurs within the liver, resulting in the formation of inactive metabolites . The components of Fervex are excreted through the kidneys.
Fervex raspberry powder with sugar pack 8 pcs
Pharmacological group:
A remedy for eliminating the symptoms of acute respiratory diseases (ARI) and “colds” (non-narcotic analgesic + Hi-histamine receptor blocker + vitamin) ATX code: N02BE51 Pharmacodynamics
:
Fervex® is a combination drug that contains paracetamol, pheniramine and ascorbic acid. Paracetamol is a non-narcotic analgesic that blocks cyclooxygenase, mainly in the central nervous system, affecting the centers of pain and thermoregulation; has analgesic and antipyretic effects.
Pheniramine is a blocker of H1-histamine receptors, reduces rhinorrhea and lacrimation, eliminates spastic phenomena, swelling and hyperemia of the mucous membrane of the nasal cavity, nasopharynx and paranasal sinuses.
Ascorbic acid is a cofactor in some hydroxylation and amidation reactions - it transfers electrons to enzymes, providing them with a reducing equivalent. Participates in the reactions of hydroxylation of proline and lysine residues of procollagen with the formation of hydroxyproline and hydroxylysine (post-translational modification of collagen), oxidation of lysine side chains in proteins with the formation of hydroxytrimethyllysine (in the process of carnitine synthesis), oxidation of folic acid to folinic acid, metabolism of drugs in liver microsomes and hydroxylation dopamine to form norepinephrine. Increases the activity of amidating enzymes involved in the synthesis of oxytocin, adrenocorticotropic hormone and cholecystokinin. Participates in steroidogenesis in the adrenal glands.
Pharmacokinetics:
Paracetamol: Absorption is high. The time required to achieve maximum concentration (TCmax) is 0.5-2 hours; maximum concentration (Cmax) - 5-20 μg/ml. Communication with plasma proteins - 15%. Penetrates the blood-brain barrier (BBB). Metabolized in the liver in three main ways: conjugation with glucuronides, conjugation with sulfates, oxidation by microsomal liver enzymes. In the latter case, toxic intermediate metabolites are formed, which are subsequently conjugated with glutathione, and then with cysteine and mercapturic acid. The main isoenzymes of cytochrome P450 for this metabolic pathway are the isoenzyme CYP2E1 (mainly), CYP1A2 and CYP3A4 (minor role). With glutathione deficiency, these metabolites can cause damage and necrosis of hepatocytes. Additional metabolic pathways include hydroxylation to 3-hydroxyparacetamol and methoxylation to 3-methoxyparacetamol, which are subsequently conjugated to glucuronides or sulfates. Conjugated metabolites of paracetamol (glucuronides, sulfates and conjugates with glutathione) have low pharmacological (including toxic) activity. The half-life (T1/2) is 1-4 hours. It is excreted by the kidneys in the form of metabolites, mainly conjugates, only 3% unchanged. In elderly patients, drug clearance decreases and T1/2 increases.
Pheniramine: Well absorbed from the digestive tract. The half-life from blood plasma ranges from one to one and a half hours. It is excreted from the body primarily through the kidneys.
Ascorbic acid: Well absorbed in the digestive tract. The time to create the maximum therapeutic concentration (TCmax) after oral administration is 4 hours. Metabolized primarily in the liver. It is excreted by the kidneys, through the intestines, with sweat, unchanged and in the form of metabolites. Communication with plasma proteins - 25%. Easily penetrates into leukocytes, platelets, and then into all tissues; the highest concentration is achieved in the glandular organs, leukocytes, liver and lens of the eye; penetrates the placenta. The concentration of ascorbic acid in leukocytes and platelets is higher than in erythrocytes and plasma. In deficiency states, leukocyte concentrations decline later and more slowly and are considered a better measure of deficiency than plasma concentrations. Metabolized primarily in the liver into deoxyascorbic acid and further into oxaloacetic acid and ascorbate-2-sulfate. It is excreted by the kidneys, through the intestines, with sweat, breast milk unchanged and in the form of metabolites. Excreted during hemodialysis.
Contraindications
Contraindications to the use of Fervex:
- sensitivity to the drug;
- erosions and ulcers of the gastrointestinal tract;
- renal failure;
- alcoholism;
- portal hypertension;
- deficiency of the enzyme glucose-6-phosphate dehydrogenase;
- age up to 15 years;
- lactation, pregnancy.
Fervex for children is contraindicated for:
- sensitivity to it;
- severe liver and kidney disorders;
- lactation , pregnancy ;
- deficiency of the enzyme glucose-6-phosphate dehydrogenase;
- blood diseases;
- children under 6 years of age.
Use with extreme caution is allowed for benign hyperbilirubinemia and diabetes mellitus .
Side effects
When treated with Fervex, side effects develop quite rarely, especially if you follow the recommended dosages. However, the manifestation of: nausea, abdominal pain, allergic reactions - skin rash, itching, urticaria, Quincke's edema is possible.
When the drug is contraindicated
Fervex, like any other drug, has a number of contraindications. If you take it in recommended dosages, there will be no side effects. In case of overdose, renal dysfunction, chronic fatigue and drowsiness are possible.
In addition, Fervex cannot be combined with its analogues - drugs based on paracetamol. Other contraindications include:
- Chronic diseases of the gastrointestinal tract;
- Hepatitis, liver cirrhosis, pyelonephritis;
- Allergic reactions.
Instructions for use of Fervex (Method and dosage)
This drug is intended for oral administration. First, the contents of the sachet are completely dissolved in a glass of water and immediately drunk. The optimal time to take it is between meals.
It is recommended to take 1 sachet no more than 2-3 times a day. In this case, an interval of 4 hours must be observed. For elderly patients and those suffering from liver or kidney disorders, this interval is 8 hours.
The course of treatment is no more than 5 days.
Instructions for use of Fervex for children also recommend taking it orally, after thoroughly dissolving the powder in 200 ml of water.
In this case, children's Fervex is prescribed taking into account the age of the small patient. Therefore, Fervex for children 6-10 years old is recommended in a daily dosage of 1 sachet for 2 doses. At the age of 10-12 years you can take one sachet 3 times a day, and at 12-15 years old - one sachet up to 4 times a day.
The instructions for children advise maintaining an interval of 4 hours between doses. The duration of therapy is no more than 3 days.
The danger of Fervex
Fervex is contraindicated for use in the first trimester, when vital organs are just beginning to form in the fetus. Paracetamol can provoke fetal developmental abnormalities or cause spontaneous miscarriage. But with the beginning of the second trimester, when the placenta is fully formed and can provide reliable protection for the fetus from toxic effects, therapists allow drug treatment using tablets and medicinal powders. Since high temperature poses a greater danger to the fetus than the effect of the chemical drug.
Patients suffering from gestational diabetes mellitus should take into account that 1 serving of the drug contains approximately 11.5 g of sugar.
Before using Fervex, you must additionally consult with your gynecologist at the antenatal clinic.
Overdose
When taking Fervex for a long time in an increased dosage, symptoms such as pale skin, decreased appetite , hepatonecrosis, nausea, and vomiting may appear. , liver failure may occur .
Treatment includes mandatory measures in such cases: gastric lavage, use of SH-group donors or precursors for the production of glutathione-methionine 8-9 hours after the overdose. If the overdose period is 12 hours, then N-acetylcysteine is administered. At the same time, other accompanying measures are carried out, which depend on the symptoms that appear.
Interaction
Combination with antidepressants, antiparkinsonian and antipsychotic drugs may increase the risk of side effects.
Simultaneous use with inducers of microsomal oxidation in the liver, for example, with Phenytoin, barbiturates, Rifampicin, Phenylbutazone and tricyclic antidepressants , can increase the production of hydroxylated active metabolites, which may result in the development of severe intoxications .
Fervex®
Ethanol enhances the sedative effect of antihistamines (pheniramine), so its use should be avoided during treatment with Fervex®. In addition, ethanol, when used simultaneously with pheniramine, contributes to the development of acute pancreatitis.
Pheniramine enhances the effect of sedatives: morphine derivatives, barbiturates, benzodiazepines and other tranquilizers, neuroleptics (meprobamate, phenothiazine derivatives), antidepressants (amitriptyline, mirtazapine, mianserin), centrally acting antihypertensive drugs, sedatives belonging to the group of H1-blockers, baclofen; this not only increases the sedative effect, but also increases the risk of developing side effects of the drug (urinary retention, dry mouth, constipation).
The possibility of enhancing central m-anticholinergic effects when used in combination with other drugs with m-anticholinergic activity (other H1-histamine receptor blockers, tricyclic antidepressants, phenothiazine neuroleptics, antispasmodics and antiparkinsonian drugs with m-anticholinergic activity, disopyramide) should be taken into account.
When using the drug together with inducers of microsomal oxidation: barbiturates, tricyclic antidepressants, anticonvulsants (phenytoin), flumecinol, phenylbutazone, rifampicin and ethanol, the risk of hepatotoxicity increases significantly (due to paracetamol included in the composition).
Glucocorticosteroids, when used simultaneously, increase the risk of developing glaucoma.
Concomitant use with salicylates increases the risk of nephrotoxicity.
When used simultaneously with chloramphenicol (chloramphenicol), the toxicity of the latter increases.
Paracetamol enhances the effect of indirect anticoagulants and reduces the effectiveness of uricosuric drugs.
Ascorbic acid increases the concentration of benzylpenicillin and tetracyclines in the blood; at a dose of 1 g/day increases the bioavailability of ethinyl estradiol (part of oral contraceptives).
Improves the absorption of iron preparations in the intestines (converts ferric iron to divalent iron); may increase iron excretion when used concomitantly with deferoxamine.
Reduces the effectiveness of heparin and indirect anticoagulants.
When used simultaneously with acetylsalicylic acid (ASA), the urinary excretion of ascorbic acid increases and the excretion of ASA decreases. ASA reduces the absorption of ascorbic acid by approximately 30%.
Increases the risk of developing crystalluria during treatment with salicylates and short-acting sulfonamides, slows down the excretion of acids by the kidneys, increases the excretion of drugs that have an alkaline reaction (including alkaloids), and reduces the concentration of oral contraceptives in the blood.
Increases the overall clearance of ethanol, which in turn reduces the concentration of ascorbic acid in the body.
Quinoline drugs, calcium chloride, salicylates, and glucocorticosteroids deplete ascorbic acid reserves when used for a long time.
When used simultaneously, ascorbic acid reduces the chronotropic effect of isoprenaline.
With long-term use or use in high doses, it may interfere with the interaction of disulfiram and ethanol.
In high doses, it increases the excretion of mexiletine by the kidneys.
Barbiturates and primidone increase the excretion of ascorbic acid in the urine.
Reduces the therapeutic effect of neuroleptics - phenothiazine derivatives, tubular reabsorption of amphetamine and tricyclic antidepressants.
Fervex's analogues
Level 4 ATC code matches:
Phenacetin
Combiflu
Chlorphenamine
Coldflu
Calpol
Panadol Extra
Panadol for children
Panadol
Solpadeine
Efferalgan
Milistan
Coldrex Maxgripp
Coldrex Hotrem
Coldrex
AntiGrippin
Unispaz
Pentalgin Plus
Rapidol
Maxicold
Perfalgan
The main analogues of Fervex: Bioparox, Sinupret, Teraflu, Coldrex.
Which is better – Fervex or Theraflu?
Each of these drugs has a similar composition and indications for use. However, Theraflu effect is not reduced.
In this case, the antipyretic and analgesic effect manifests itself almost equally.
What is Fervex?
The drug Fervex is a dry powder for preparing a solution, which includes:
- Paracetamol is an antipyretic, analgesic and anti-inflammatory agent.
- Ascorbic acid or vitamin C is a supplement that strengthens the walls of blood vessels and improves immunity.
- Pheniramine is an antihistamine (antiallergic) component.
The main substance in the drug is paracetamol, the action of which does not pose a danger to the developing fetus from a certain stage of development.
It can be argued that Fervex is a mixture of regular paracetamol and ascorbic acid in powder, packaged in bright packaging.
Pheniramine has antiallergic properties, eliminates nasal congestion and itching, but it does not cure, but blocks severe symptoms. Doctors do not have reliable information about the safety of Fervex during pregnancy, so you should not use it often.
Reviews about Fervex
There are a lot of reviews about Fervex on medical forums. According to users, if you take this drug at the first sign of a cold, the development of the disease can be quickly stopped. At the same time, great importance is given to bed rest, drinking plenty of fluids and proper rest - all this, together with the drug, provides good support to the body, increasing its resistance to viral infection.
Users often discuss Fervex for children, which can be taken by young patients from 6 years of age. At this age, it is difficult for children to give pills, but they take drugs in the form of suspensions, sweet solutions and syrups more willingly. The effectiveness of this drug is also maximal when it is started when the first symptoms of the disease appear.
Among the positive opinions, there are reviews of Fervex that report the development of side effects. drowsiness is especially often mentioned , which, however, is also typical for viral infections.
You can also find reports that treatment with this drug turned out to be completely useless. After therapy for several days, the cold symptoms not only did not decrease, but, on the contrary, became more complicated. In addition, inflammation in the throat, muscle aches and headaches increased.
Unfortunately, many people consider colds to be commonplace and do not make special efforts to treat them. They often try to suppress the symptoms that appear, but this approach often leads to complications, the treatment of which requires radical measures, including taking antibiotics .
Therefore, if it was not possible to reduce the manifestation of a cold within 2-3 days, you need to consult a doctor. The specialist will prescribe appropriate medications and additional examination, which will help to achieve a quick recovery.
Fervex price, where to buy
The price of Fervex for children starts from 250 rubles.
The price of Fervex (1 sachet) varies between 25-35 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Fervex powder for intravenous injection solution.
approx. with sah. raspberries 13.1g 8 pcs. UPSA SAS RUR 337 order - Fervex powder for intravenous injection solution. approx. with sah. lemon 13.1g 8 pcs.UPSA SAS
RUB 351 order
- Fervex for children powder for injection solution for internal use. approx. raspberry 8pcsUPSA SAS
RUB 295 order
Pharmacy Dialogue
- Fervex sachets No. 8 with sugarBristol Myers
RUB 355 order
- Fervex sachets No. 8 with sugarUPSA
RUB 343 order
- Fervex bags No. 8 with raspberry sugarBristol Myers
RUB 345 order
- Fervex bags for children No. 8UPSA
320 rub. order
- Fervex sachets No. 8 without sugarUPSA
RUB 188 order
show more
PaniPharmacy
- Fervex Fervex for adults.
package No. 8 France, BMS 137 UAH. order - Fervex Fervex for adults. raspberry package No. 8 France, UPSA
146 UAH order
- Fervex for children. package No. 8 Ukraine, BMS
138 UAH order
- Fervex Fervex for adults. used sugar package No. 8 France, UPSA
146 UAH order
show more
Recommended dosage
The manufacturer produces 2 versions of the drug: with and without sugar (for patients with diabetes). The finished solution is very aromatic with a pleasant taste of lemon, orange or raspberry.
It is recommended to dissolve the powder in warm, but not hot water. You should drink it no more than 3 times a day with breaks of 4-5 hours.
If a pregnant woman does not have a high temperature (38+), a fruit drink will help reduce the fever; linden tea with honey, lemon juice, raspberry jam or other herbal teas will maintain strength until an appointment with an obstetrician-gynecologist.
