Theraflu - a powerful force against flu and cold symptoms

Composition and release form

The drug is available as a topical spray and powder for oral administration. The latter has the smell of berries, a loose base of homogeneous granules of various colors. Packaged in cardboard packaging of 10 sachets with a volume of 11.5 g.

The spray is a clear solution with a mint smell. Sold in a spray bottle. The set includes instructions for use.

The active ingredients are paracetamol, pheniramine maleate, phenylephrine hydrochloride in the powder. And benzoxonium chloride, lidocoine hydrochloride in the aerosol base. Excipients: dyes, flavors, silicon dioxide, sucrose, citric acid, calcium phosphate, sodium dihydrate, acesulfame potassium, glycerin, menthol, peppermint, ethanol and pure water.

Pharmacological properties of the drug Theraflu extra

Combined drug. It has antipyretic, decongestive, analgesic and antiallergic effects. Paracetamol has analgesic, antipyretic and minor anti-inflammatory effects. The therapeutic effect is due to inhibition of COX enzymes. Phenylephrine hydrochloride is a sympathomimetic amine, acting primarily through a direct effect on α-adrenergic receptors. Causes vasoconstriction, reduces swelling and hyperemia of the mucous membrane of the nasal cavity and paranasal sinuses. Pheniramine maleate, an H1 receptor blocker, has an antiallergic effect, reduces the severity of local exudative manifestations, eliminates lacrimation and rhinorrhea. After oral administration, paracetamol is quickly absorbed into the gastrointestinal tract. The maximum concentration in blood plasma is reached after 30–60 minutes. When used in a therapeutic dose, the half-life is 1–4 hours. Paracetamol is metabolized in the liver mainly through the conjugation reaction. Depending on the concentration in the blood plasma, it is partially amenable to deacetylation or hydroxylation. The main route of elimination is in the urine (90–100% over 24 hours), in the form of glucuronide conjugates (60%), sulfates (35%) or cysteine ​​(3%). The maximum concentration of pheniramine maleate in blood plasma is achieved after 1–2.5 hours; The half-life is 16–19 hours. 70–83% of the dose taken orally is excreted in the urine unchanged or in the form of metabolites. The half-life of phenylephrine after oral administration is 2.1–3.4 hours. Phenylephrine has limited bioavailability due to insufficient absorption in the gastrointestinal tract and a presystemic effect in the intestines and liver, which are caused by the action of MAO.

pharmachologic effect

The drug belongs to combination drugs with a large list of pharmacological activities. It has an antihistamine, sedative, vasoconstrictor, and antitussive effect. It also lowers temperature and suppresses pain.

As a result of using the medicine, there is a decrease in the symptoms of acute respiratory infections and colds. Improves nasal breathing and overall well-being. The drug helps fight a runny nose, tonsillitis, swelling, and local allergic symptoms. Suppresses the development of the inflammatory process, pain and normalizes body temperature.

Due to the content of benzoxonium chloride in local form, the product has an antibacterial effect against gram-positive and gram-negative pathogens. In addition, it eliminates viruses and fungi, in particular helps in the treatment of influenza, parainfluenza and herpes infections.

The therapeutic effect of Theraflu occurs 15-20 minutes after administration and lasts up to 5 hours.

What is Theraflu medicine for?

Indications for taking Theraflu are:

1. ARVI, ARZ.
2. Symptoms of influenza and colds include chills, high fever, headache, runny nose, impaired nasal breathing, fever, malaise and muscle aches.
3. Pharyngitis, laryngitis.
4. Stomatitis of various forms.
5. Sore throat, catarrhal and chronic.
6. Gingivitis.
7. Sinusitis.
8. Vasomotor and allergic rhinitis.
9. Rhinorrhea.
10. Hay fever.
11. Rhinosinusopathy.

Overdose of Theraflu Extra, symptoms and treatment

Symptoms of paracetamol overdose: hepatotoxic effect, in severe cases liver necrosis develops. The first symptoms may appear 24–48 hours or later after overdose and include nausea, vomiting and epigastric pain. Symptoms of phenylephrine overdose: drowsiness followed by agitation (especially in children); visual impairment; nausea; vomit; headache; circulatory disorders; coma; convulsions; behavior change; AH (arterial hypertension); bradycardia, atropine-like psychosis. Treatment: timely intravenous or oral administration of N-acetylcysteine ​​as an antidote to paracetamol, gastric lavage, use of activated charcoal, monitoring the condition of the respiratory and circulatory systems (epinephrine should not be used). If seizures occur, diazepam and symptomatic therapy are prescribed.

Contraindications

Absolute contraindications to prescribing the drug are: hypersensitivity of the body to the components of the drug, children under 12 years of age, women during pregnancy and breastfeeding.

Antipyretic medication should be used with caution in the following cases:

1. Severe dysfunction of the liver and kidneys.
2. Glaucoma.
3. Bronchitis in the chronic stage.
4. Diabetes mellitus of any type.
5. Thyroid dysfunction.
6. Emphysema.
7. High blood pressure.
8. Diseases of the heart and vascular system.
9. Hyperbilirubinemia.

Theraflu Lemon

TheraFlu for colds and flu

Registration number: P N012063/01

Trade name: TheraFlu for colds and flu

Group name: Paracetamol + Phenylephrine + Pheniramine + Ascorbic acid

Dosage form: powder for oral solution [lemon].

Composition: One sachet contains: Active ingredients: paracetamol 325 mg, phenylephrine hydrochloride 10 mg, pheniramine maleate 20 mg, ascorbic acid 50 mg. Excipients: sodium citrate dihydrate 120.74 mg, malic acid 50.31 mg, sunset yellow dye 0.098 mg, quinoline yellow dye 0.094 mg, titanium dioxide 3.16 mg, lemon flavor 208.42 mg, tribasic calcium phosphate 82 mg , citric acid 1221.79 mg, sucrose 20000 mg.

Description: Free-flowing white granular powder with yellow inclusions without foreign particles with a citrus odor. Soft lumps are allowed.

Pharmacotherapeutic group: acute respiratory infections and “cold” symptoms remedy (non-narcotic analgesic + alpha-adrenergic agonist + H1-histamine receptor blocker + vitamin).

ATX code: N02BE51

Pharmacological properties The combined agent, the effect of which is determined by the components included in its composition, has an antipyretic, mild anti-inflammatory, anti-edematous, analgesic, anti-allergic, vasoconstrictor effect, and eliminates the symptoms of “colds”. Constricts the vessels of the nose, eliminates swelling of the mucous membrane of the nasal cavity and nasopharynx.

Pharmacodynamics Paracetamol Paracetamol has an analgesic and antipyretic effect by suppressing the synthesis of prostaglandins in the central nervous system. Does not affect platelet function and hemostasis.

Pheniramine Pheniramine is an antiallergic drug - a blocker of H1-histamine receptors. Eliminates allergic symptoms, has a moderate sedative effect and also exhibits antimuscarinic activity.

Phenylephrine Phenylephrine is a sympathomimetic agent; when applied topically, it has a moderate vasoconstrictor effect (due to stimulation of alpha1-adrenergic receptors), reduces swelling and hyperemia of the nasal mucosa.

Pharmacokinetics of Paracetamol Absorption Paracetamol is rapidly and almost completely absorbed from the gastrointestinal tract. After taking the drug orally, the maximum concentration of paracetamol in plasma is reached within 10-60 minutes.

Distribution Paracetamol is distributed in most body tissues, crosses the placenta and is present in breast milk. At therapeutic concentrations, binding to plasma proteins is insignificant and increases with increasing concentration.

Metabolism: It undergoes primary metabolism in the liver and is excreted mainly in the urine in the form of glucuronide and sulfate compounds. The half-life is 1-3 hours.

Elimination: Less than 5% of the dose taken is excreted in the form of unchanged paracetamol.

Pheniramine Absorption The maximum concentration of pheniramine in plasma is reached after approximately 1-2.5 hours. The half-life of pheniramine is 16-19 hours.

Excretion: 70-83% of the dose taken is excreted from the body in the urine in the form of metabolites or unchanged.

Phenylephrine Absorption Phenylephrine is unevenly absorbed from the gastrointestinal tract.

Metabolism: Subject to primary metabolism by monoamine oxidases in the intestine and liver. Phenylephrine when taken orally is characterized by reduced bioavailability.

Excretion: Excreted in urine almost entirely in the form of sulfate compounds. Maximum plasma concentrations are achieved in the range from 45 minutes to 2 hours. The half-life is 2-3 hours.

Ascorbic Acid Absorption

Ascorbic acid is quickly and completely absorbed from the gastrointestinal tract. Distribution

Plasma protein binding is 25%. Excretion In case of overdose, ascorbic acid is excreted in the form of metabolites in the urine.

Indications for use: Symptomatic treatment of infectious and inflammatory diseases (ARVI, including influenza), accompanied by high fever, chills, body aches, headache and muscle pain, runny nose, nasal congestion, sneezing.

Contraindications Hypersensitivity to individual components of the drug, simultaneous use of tricyclic antidepressants, beta-blockers or other sympathomimetic drugs, simultaneous or within the previous 2 weeks use of monoamine oxidase inhibitors (MAOIs), portal hypertension, alcoholism, diabetes mellitus, sucrase/isomaltase deficiency, fructose intolerance , glucose-galactose malabsorption, pregnancy, breastfeeding, children under 12 years of age, severe cardiovascular diseases, arterial hypertension, hyperthyroidism, angle-closure glaucoma, pheochromocytoma.

With caution In case of severe atherosclerosis of the coronary arteries, cardiovascular diseases, acute hepatitis, hemolytic anemia, bronchial asthma, severe liver or kidney diseases (concomitant liver disease increases the risk of paracetamol-related liver damage), hyperplasia and hypertrophy of the prostate gland, difficulty urinating due to hypertrophy prostate, blood diseases, glucose-6-phosphate dehydrogenase deficiency, congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes), vasospastic diseases (for example, Raynaud's disease), in patients suffering from malnutrition, dehydration, pyloroduodenal obstruction, stenosing gastric ulcer and /or duodenum, epilepsy, while taking drugs that can adversely affect the liver (for example, inducers of microsomal liver enzymes). Concomitant use with other drugs containing paracetamol may lead to an overdose. An overdose of paracetamol can cause liver failure, which can lead to liver transplantation or death. Cases of liver dysfunction/liver failure have been reported in patients with reduced glutathione levels, such as severely malnourished patients with anorexia, low body mass index, patients with severe chronic alcohol dependence or sepsis. In conditions accompanied by a decrease in glutathione levels, the use of paracetamol may increase the risk of metabolic acidosis. Concomitant use with other decongestants and antihistamines should be avoided. Caution should be exercised when treating patients with recurrent formation of urate kidney stones while using other antihypertensive drugs, digoxin and other cardiac glycosides, ergot alkaloids (ergotamine and methysergide). Should be used with caution in elderly patients who are more susceptible to developing undesirable effects. Avoid use in elderly patients with confusion.

Use during pregnancy and breastfeeding: It is not recommended to use the drug during pregnancy and breastfeeding.

Directions for use and dosage : Inside. The contents of one sachet are dissolved in 1 glass (250 ml) of hot but not boiling water. Take it hot. A repeat dose can be taken every 4-6 hours (no more than 3-4 doses within 24 hours). TheraFlu for colds and flu can be used at any time of the day, but the best effect comes from taking the drug before bed, at night. If there is no relief of symptoms within 3 days after starting to take the drug, you should consult a doctor. Patients should not take TheraFlu for colds and flu for more than 5 days. Do not exceed the indicated dose. The lowest dose necessary to achieve effect for the shortest possible duration of treatment should be used.

Special Populations: Hepatic Impairment: Patients with impaired liver function or Gilbert's syndrome should reduce the dose or increase the interval between doses of TheraFlu for colds and flu. Renal failure: in the presence of acute renal failure (creatinine clearance <10 ml/min), the interval between doses of TheraFlu for flu and colds should be at least 8 hours. Elderly patients: No dose adjustment is necessary in elderly patients.

Side effects Classification of the frequency of occurrence of adverse reactions: very often (≥1/10); often (≥1/100, <1/10); uncommon (≥1/1000, <1/100); rare (≥1/10000, <1/1000); very rare (<1/10000), including isolated reports and reactions with unknown frequency (frequency cannot be estimated from available data).

Blood and lymphatic system disorders: Very rare: thrombocytopenia, agranulocytosis, pancytopenia. Unknown: leukopenia, hemolytic anemia.

Immune system disorders: Rare: anaphylactic reaction, angioedema, hypersensitivity, urticaria, allergic dermatitis. Very rare: cutaneous hypersensitivity reactions including, but not limited to, toxic epidermal necrolysis, Stevens-Johnson syndrome, and skin rash.

Mental disorders: Rare: increased excitability, sleep disturbance. Unknown: hallucinations, confusion.

Nervous system disorders: Common: drowsiness. Rarely: dizziness, headache. Not known: anticholinergic symptoms, incoordination, tremor, loss of memory or concentration, balance problems, sedation.

Visual disorders: Rare: angle-closure glaucoma, mydriasis, increased intraocular pressure. Unknown: accommodation paresis.

Cardiac disorders: Common: increased blood pressure. Rarely: tachycardia, palpitations.

Vascular disorders: Rare: increased blood pressure. Unknown: orthostatic hypotension.

Respiratory, thoracic and mediastinal disorders: Very rare: bronchospasm in patients sensitive to aspirin and other NSAIDs.

Gastrointestinal disorders: Often: nausea, vomiting. Rarely: dry mouth, constipation, abdominal pain, diarrhea. Unknown: constipation.

Disorders of the liver and biliary tract: Rarely: increased activity of liver enzymes. Very rare: liver dysfunction

Skin and subcutaneous tissue disorders: Rare: rash, eczema, purpura, itching, erythema, urticaria.

Renal and urinary tract disorders: Rare: difficulty urinating.

General disorders and administration site disorders: Rare: malaise. Unknown: dry mucous membrane.

If any of the adverse reactions indicated in the instructions worsen, or you notice any other adverse reactions not listed in the instructions, tell your doctor.

Overdose of Paracetamol Symptoms and signsSymptoms (mainly caused by paracetamol, appear after taking more than 10-15 g): in severe cases of overdose, paracetamol has a hepatotoxic effect, including can cause liver necrosis. Also, an overdose can cause nephropathy and irreversible liver damage. The severity of an overdose depends on the dose, so patients should be warned against simultaneous use of paracetamol-containing drugs. The risk of poisoning is pronounced especially in elderly patients, in children, in patients with liver diseases, in cases of chronic alcoholism, in patients suffering from malnutrition and in patients taking inducers of microsomal liver enzymes. Overdose of paracetamol can lead to liver failure, encephalopathy, liver transplantation, coma and death. Symptoms of paracetamol overdose in the first 24 hours: pale skin, nausea, vomiting, anorexia, convulsions. Abdominal pain may be the first sign of liver damage and usually does not appear for 24-48 hours and can sometimes appear later, after 4-6 days. Liver damage occurs to its maximum extent on average 72-96 hours after taking the drug. Impaired glucose metabolism and metabolic acidosis may also occur. Even in the absence of liver damage, acute renal failure and acute tubular necrosis can develop. Cases of cardiac arrhythmia and acute pancreatitis have been reported, usually with liver dysfunction and liver toxicity.

Treatment In case of overdose, immediate medical intervention is required even in the absence of overdose symptoms. Administration of acetylcysteine ​​intravenously or orally as an antidote, gastric lavage, and oral methionine may have a beneficial effect for at least 48 hours after an overdose. It is recommended to take activated carbon and monitor breathing and circulation. If seizures develop, diazepam may be prescribed.

Pheniramine and phenylephrine (overdose symptoms for pheniramine and phenylephrine are combined due to the risk of mutual potentiation of the parasympatholytic effect of pheniramine and the sympathomimetic effect of phenylephrine in case of drug overdose).

Symptoms and signs Drowsiness, which is later joined by anxiety (especially in children), visual disturbances, irritability, rash, nausea, vomiting, headache, increased excitability, dizziness, insomnia, circulatory disorders, coma, convulsions, behavioral changes, disturbances of consciousness, hallucinations, increased or decreased blood pressure, arrhythmia and bradycardia. Cases of atropine-like “psychosis” have been reported in cases of pheniramine overdose.

Treatment There is no specific antidote. The usual measures of assistance are necessary, including the administration of activated charcoal, saline laxatives, and measures to support cardiac and respiratory functions. Psychostimulants (methylphenidate) should not be prescribed due to the risk of seizures. For hypotension, vasopressor drugs may be used. In case of increased blood pressure, intravenous administration of alpha-blockers (for example, phentolamine) is possible, because Phenylephrine is a selective alpha1-adrenergic receptor agonist; therefore, the hypertensive effect of phenylephrine overdose should be treated by blocking alpha1-adrenergic receptors. If seizures develop, use diazepam.

Ascorbic acidHigh doses of ascorbic acid (> 3000 mg) may cause transient osmotic diarrhea and gastrointestinal disturbances such as nausea and abdominal discomfort. The effects of ascorbic acid overdose can be attributed to the serious hepatotoxicity caused by paracetamol overdose.

Interaction with other drugs Effect of paracetamol Enhances the effects of MAO inhibitors, sedatives, ethanol. The risk of hepatotoxic action of paracetamol increases with simultaneous use of barbiturates, phenytoin, phenobarbital, carbamazepine, rifampicin, isoniazid, zidovudine and other inducers of microsomal liver enzymes. The anticoagulant properties of warfarin and other coumarins may be enhanced by long-term regular use of paracetamol, increasing the risk of bleeding. A single dose of paracetamol does not have this effect. When paracetamol is prescribed simultaneously with metoclopramide, the rate of absorption of paracetamol increases and, accordingly, its maximum concentration in plasma is reached faster. Likewise, domperidone may increase the rate of absorption of paracetamol. When chloramphenicol and paracetamol are used together, the half-life of chloramphenicol may increase. Paracetamol may reduce the bioavailability of lamotrigine, with a possible decrease in its effect due to induction of its hepatic metabolism. The absorption of paracetamol may be reduced when taken concomitantly with cholestyramine, but this can be avoided if cholestyramine is taken one hour after paracetamol. Regular use of paracetamol concomitantly with zidovudine may cause neutropenia and increase the risk of liver damage. Probenecid affects the metabolism of paracetamol. In patients taking probenecid concomitantly, the dose of paracetamol should be reduced. The hepatotoxicity of paracetamol may be increased by chronic or excessive alcohol consumption. Paracetamol may interfere with the results of the uric acid test using the phosphotungstate precipitating reagent.

Effect of pheniramine It is possible to enhance the effect of other substances on the central nervous system (for example, MAO inhibitors, tricyclic antidepressants, alcohol, antiparkinsonian drugs, barbiturates, benzodiazepines, tranquilizers and narcotics). Pheniramine may inhibit the action of anticoagulants. Pheniramine has anticholinergic activity and may enhance the anticholinergic effects of other drugs (eg, other antihistamines, drugs for Parkinson's disease and phenothiazine antipsychotics).

Effect of phenylephrineTheraFlu for colds and flu is contraindicated in patients who are taking or have taken MAO inhibitors within the past two weeks. Phenylephrine can enhance the effect of MAO inhibitors and cause a hypertensive crisis. Concomitant use of phenylephrine with other sympathomimetic drugs or tricyclic antidepressants (eg, amitriptyline) may increase the risk of cardiovascular side effects.

Phenylephrine may reduce the effectiveness of beta blockers and other antihypertensive drugs (eg, debrisoquine, guanethidine, reserpine, methyldopa). The risk of increased blood pressure and other cardiovascular side effects may be increased. Concomitant use of phenylephrine with digoxin and other cardiac glycosides may increase the risk of arrhythmia or myocardial infarction. Concomitant use of phenylephrine with ergot alkaloids (ergotamine and methysergide) may increase the risk of ergotism.

The effect of the medicinal product for medical use on the ability to drive vehicles and machinery TheraFlu for flu and colds may cause drowsiness, therefore, during treatment it is not recommended to drive a car or engage in other activities that require concentration and high speed of psychomotor reactions. In some patients, pheniramine may also cause dizziness, blurred vision, impaired cognitive function and motor coordination, which can significantly affect the ability to drive vehicles and operate machines. These undesirable effects may be further enhanced by the use of alcoholic beverages or other sedatives.

Special instructions To avoid toxic damage to the liver, the drug should not be combined with the use of alcoholic beverages. TheraFlu for colds and flu contains:

• sucrose 20 g per sachet. This should be taken into account in patients with diabetes mellitus. Patients with rare hereditary problems such as fructose intolerance, glucose-galactose malabsorption or sucrase/isomaltase deficiency should not take TheraFlu for colds and flu.
• Sunset yellow dye (E110). May cause allergic reactions.
• sodium 28.3 mg per sachet. This should be taken into account in patients on a sodium-low diet.

Do not use the drug from damaged sachets. Patients should consult a doctor if:

• Bronchial asthma, emphysema or chronic bronchitis is observed;
• Symptoms do not go away within 5 days or are accompanied by severe fever lasting 3 days, rash, or persistent headache.

These may be signs of more serious problems.

Release form: Powder for the preparation of a solution for oral administration (lemon). For the Delpharm Orleans plant, France: 22.1 g of powder in a 4-layer bag (polyethylene / low-density polyethylene / aluminum foil / low-density polyethylene) or 5-layer bag (paper / polyethylene / low-density polyethylene / aluminum foil / polyethylene low density). Sachets in quantities of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 , 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 or 50 pieces in a cardboard box, placed individually or in pairs, fastened through perforations, along with instructions for use. Secondary packaging is allowed to have a first-opening control. For GSK Consumer Health, Inc., USA: 22.1 g of powder in a 6-layer bag (paper / low-density polyethylene / polyethylene / low-density polyethylene / aluminum foil / low-density polyethylene). Sachets in quantities of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 , 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 or 50 pieces in a cardboard box, placed individually or in pairs, fastened through perforations, along with instructions for use. Secondary packaging is allowed to have a first-opening control.

Storage conditions: At a temperature not exceeding 25 °C. Keep out of the reach of children.

Shelf life: 2 years. The drug should not be used after the expiration date.

Conditions for dispensing from pharmacies: Without a prescription.

Manufacturer Delpharm Orleans, France / DELPHARM ORLEANS, 5 avenue de Concyr, ORLEANS CEDEX 2, 45071, France.

Or

GSK Consumer Health, Inc., USA/GSK Consumer Health, Inc., 10401 Highway 6, Lincoln, Nebraska, 68517, USA.

Legal entity in whose name the registration certificate was issued and the organization accepting claims on the territory of the Russian Federation: GlaxoSmithKline Healthcare JSC.

123112, Russian Federation, Moscow, Presnenskaya embankment, 10, premises III, room 9, floor 6. Tel.; Fax

Toll-free hotline number 8

Email

The trademark is owned or used by the GlaxoSmithKline Group of Companies. DN504906/RU-110

Side effects

Theraflu in certain situations can provoke the development of side effects. More often occur:

1. Dyspeptic disorders - vomiting, nausea, pain in the epigastric region, dry mouth.
2. Dizziness.
3. Insomnia, drowsiness.
4. Increased intraocular pressure.
5. Urinary dysfunction.
6. Decreased platelet levels in the blood.
7. Allergic manifestations - skin rashes, itching, hyperemia, swelling, urticaria.
8. Paresis.
9. Bronchospasm.

Side effects of the drug Theraflu extra

Most common: drowsiness, dizziness, dry mouth or throat, fatigue, headache, insomnia, irritability or nervousness, tachycardia and palpitations. Rarely (especially in children) - agitation and sleep disturbance. From the gastrointestinal tract: nausea, vomiting, constipation, diarrhea or flatulence. Adverse reactions associated with the action of paracetamol: rarely - urticaria and skin rashes, thrombocytopenia, leukopenia, hemolytic anemia, in isolated cases - agranulocytosis. Sometimes - hypersensitivity reactions in patients with intolerance to acetylsalicylic acid (with asthma). Adverse reactions associated with the sympathomimetic effect of phenylephrine: increased blood pressure (especially in patients with hypertension (arterial hypertension)), reflex bradycardia, mydriasis. Possible effects on the endocrine and other systems involved in metabolism, urinary retention and difficulty urinating. Adverse reactions associated with the peripheral anticholinergic effect of pheniramine: dry mouth, dry mucous membrane of the eyes, urinary retention, difficulty urinating in men. Adverse reactions associated with the central effect of pheniramine: drowsiness, in isolated cases - coma, epileptic seizures, dyskinesia, behavior changes. Unlike second-generation antihistamines, the use of pheniramine is not associated with prolongation of the QTc and cardiac arrhythmia.

Theraflu: how to take it

The product in powder form is intended for oral administration. The contents of the sachet are dissolved in 180 ml of hot water and drunk immediately. Sugar can be added if necessary. It is permissible to use no more than 3 sachets per day.

Taking the medicine does not depend on food or time. For the best pharmacological effect, it is advisable to take Theraflu before going to bed.

The duration of therapy is 3 days. If symptoms of the disease persist, it is important to consult a specialist.

The medicine in aerosol form is used for up to 5 days according to the traditional scheme: no more than 6 times a day, 4 sprays.

Drug interactions

When Theraflu interacts with MAO inhibitors, sedatives and ethyl alcohol, the effect of the latter is enhanced.

Combining medications with hormones can lead to the development of glaucoma.

The use of tricyclic antidepressants increases the symptomatic effect of Theraflu.

Phenothiazine group drugs, antipsychotics and antiparkinsonian drugs increase the risk of adverse reactions such as bowel problems, urinary problems and dry mouth.

Interactions of the drug Theraflu extra

Paracetamol may interact with anticoagulants (coumarin derivative - warfarin) and anticonvulsants. Concomitant use with NSAIDs may increase the risk of developing adverse reactions of the latter from the urinary system. Pharmacodynamic interactions with other analgesics (caffeine, opiates) have been noted. The half-life of chloramphenicol increases when used simultaneously with paracetamol. Probenecid affects the metabolism of paracetamol. The risk of developing hepatotoxic effects of the drug increases with the combined use of rifampicin and isoniazid. Antiepileptic drugs (phenobarbital, phenytoin, carbamazepine) do not increase the risk of hepatotoxicity of paracetamol. Phenobarbital reduces the antipyretic effect of paracetamol. Phenylephrine may cause undesirable reactions due to interaction with MAO inhibitors, α- and β-adrenergic receptor blockers, antihistamines, phenothiazine derivatives (promethazine), bronchodilator sympathomimetic drugs, tricyclic antidepressants (imipramine), guanethidine or atropine, digitalis preparations, rauwolfia alkaloids, indomethacin, methyldopa, other central nervous system stimulants, and theophylline. In isolated cases, an increase in the vasoconstrictor effect is noted when used simultaneously with stimulants of labor and arrhythmias - when used with anesthetics. A significant increase in blood pressure is possible with simultaneous intravenous administration of ergot alkaloids. Pheniramine potentiates the effect of drugs that depress the central nervous system (MAO inhibitors, tricyclic antidepressants, antiparkinsonian drugs, barbiturates, tranquilizers, narcotics), as well as alcohol. Pheniramine can inhibit the effect of anticoagulants and interact with progesterone, reserpine, and thiazide diuretics. Concomitant use of oral contraceptives may lead to a decrease in the effectiveness of the antihistamine component.