Antigrippin Express powder for injection solution for internal use 13.1g lemon N 9

Description of the dosage form

Powder from white to white with a yellowish tint with a characteristic odor (lemon); from white with a pinkish tint to pink with a characteristic odor (raspberry); from white to white with a pinkish tint with a characteristic odor (black currant). The presence of loosely packed lumps is allowed.

An aqueous solution of the drug, obtained by dissolving the contents of the sachet in 200 ml of warm water: opalescent, colorless to yellowish in color with a characteristic lemon odor (lemon); from light pink to red-pink color with a characteristic raspberry (raspberry) smell; lilac-red to violet in color with a characteristic smell of black currant (black currant).

Pharmacological action - anti-cold, antihistamine, antipyretic, analgesic.

Contraindications

• hypersensitivity to paracetamol, ascorbic acid, pheniramine or any other component of the drug;
• erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
• liver failure;
• angle-closure glaucoma;
• urinary retention associated with prostatic hyperplasia;
• blood diseases (sideroblastic anemia, thalassemia, leukopenia, thrombocytopenia);
• portal hypertension;
• diabetes;
• deficiency of glucose-6-phosphate dehydrogenase;
• hyperoxaluria;
• kidney stone disease;
• sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption (the dosage form contains sucrose);
• pregnancy;
• breastfeeding period;
• children under 18 years of age (since the content of ascorbic acid in the daily dose of the drug (400 and 600 mg) exceeds the permitted maximum daily dose for children - 300 mg).

With caution: renal failure; congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes); viral hepatitis; alcoholic hepatitis; hemochromatosis; elderly age. If the patient has one of the listed diseases, be sure to consult a doctor before taking the drug.

Antigrippin-Express Powder, sachet, 12 pcs., for preparing solution, raspberry

Interaction with other drugs

Ethanol enhances the sedative effect, promotes the development of acute pancreatitis Antidepressants, antiparkinsonian drugs, antipsychotic drugs (phenothiazine derivatives) increase the risk of side effects (urinary retention, dry mouth, constipation) Glucocorticosteroids increase the risk of developing glaucoma; with long-term use they deplete ascorbic acid reserves Inducers of microsomal liver enzymes (barbiturates, phenytoin, phenylbutazone, rifampicin, zidovudine, carbamazepine, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication with small overdoses Barbiturates and primidone increase the excretion of ascorbic acid in the urine Inhibitors of microsomal oxidation ( including cimetidine) reduce the risk of hepatotoxicity. With long-term combined use with other non-steroidal anti-inflammatory drugs, the risk of developing “analgesic” nephropathy and renal papillary necrosis, and the onset of end-stage renal failure increases. Diflunisal increases plasma concentrations of paracetamol by 50%, increasing hepatotoxicity. Long-term use in high doses concomitantly with salicylates increases the risk of developing kidney or bladder cancer. When used simultaneously with acetylsalicylic acid (ASA), the absorption of ascorbic acid is reduced (by approximately 30%) and its excretion in the urine is increased, the excretion of ASA is reduced. Myelotoxic drugs increase the manifestations of hematotoxicity of the drug. contraceptives, fresh juices and alkaline drinks reduce its absorption and absorption. Paracetamol, which is part of the drug, reduces the effectiveness of uricosuric drugs; when taken in high doses, it increases the effect of anticoagulant drugs. Ascorbic acid increases the concentration of benzylpenicillin and tetracyclines in the blood, at a dose of 5 sachets per day increases the bioavailability of ethinyl estradiol; improves the absorption of iron preparations in the intestine, can increase the excretion of iron when used simultaneously with deferoxamine; reduces the effectiveness of heparin and indirect anticoagulants; increases the risk of developing crystalluria during treatment with salicylates and short-acting sulfonamides, slows down the excretion of acids by the kidneys and increases the excretion of drugs that have an alkaline reaction (including alkaloids); reduces the blood concentration of oral contraceptives; increases the overall clearance of ethanol, which in turn reduces the concentration of ascorbic acid in the body; reduces the therapeutic effect of antipsychotic drugs - phenothiazine derivatives, tubular reabsorption of amphetamine and tricyclic antidepressants; when used simultaneously, it 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 increases the excretion of mexiletine by the kidneys

Antigrippin-Express

Alcohol enhances the sedative effect and contributes to the development of acute pancreatitis.

Antidepressants, antiparkinsonian drugs, antipsychotic drugs (phenothiazine derivatives) increase the risk of side effects (urinary retention, dry mouth, constipation).

GCS increase the risk of developing glaucoma; with long-term use, they deplete ascorbic acid reserves.

Inducers of microsomal liver enzymes (barbiturates, phenytoin, phenylbutazone, rifampicin, zidovudine, carbamazepine, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication with a minor overdose.

Barbiturates and primidone increase the excretion of ascorbic acid in the urine.

Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxicity.

With long-term combined use with other NSAIDs, the risk of developing analgesic nephropathy and renal papillary necrosis, and the onset of end-stage renal failure increases.

Diflunisal increases plasma concentrations of paracetamol by 50%, increasing hepatotoxicity.

Long-term use in high doses concomitantly with salicylates increases the risk of developing kidney or bladder cancer.

When used simultaneously with acetylsalicylic acid (ASA), the absorption of ascorbic acid is reduced by approximately 30% and its excretion in the urine increases, and the excretion of ASA is reduced.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

Quinoline drugs and calcium chloride, when used for a long time, deplete ascorbic acid reserves, and oral contraceptives, fresh juices and alkaline drinks reduce its absorption and assimilation.

Paracetamol, which is part of the drug, reduces the effectiveness of uricosuric drugs; when taken in high doses, it increases the effect of anticoagulant drugs.

Ascorbic acid increases the concentration of benzylpenicillin and tetracyclines in the blood.

At a dose of 5 sachets per day, ascorbic acid increases the bioavailability of ethinyl estradiol.

Ascorbic acid improves the absorption of iron preparations in the intestines. When used simultaneously with deferoxamine, it may increase iron excretion.

Ascorbic acid reduces the effectiveness of heparin and indirect anticoagulants.

When treated with salicylates and short-acting sulfonamides, ascorbic acid increases the risk of developing crystalluria, slows down the excretion of acids by the kidneys and increases the excretion of drugs that have an alkaline reaction (including alkaloids).

Ascorbic acid reduces the blood concentration of oral contraceptives.

With simultaneous use, ascorbic acid increases the overall clearance of ethanol, which in turn reduces the concentration of ascorbic acid in the body.

Ascorbic acid reduces the therapeutic effect of antipsychotic drugs - phenothiazine derivatives, tubular reabsorption of amphetamine and tricyclic antidepressants.

When used simultaneously, ascorbic acid reduces the chronotropic effect of isoprenaline.

With long-term use or when used in high doses, ascorbic acid may interfere with the interaction of disulfiram and ethanol.

When used in high doses, ascorbic acid increases the excretion of mexiletine by the kidneys.

Antigrippin powder for preparing a honey-lemon oral solution in bags No. 10

Name

Antigrippin with honey-lemon flavor.

Dosage

4.825 g.

Description

Honey-lemon powder: powder of varying degrees of granulation, consisting of particles from white to grayish-beige. Dark brown inclusions are allowed. Chamomile powder: powder of varying degrees of granulation, consisting of particles ranging from white to beige and light brown. Brown inclusions are allowed.

COMPOSITION FOR ONE PACKAGE

Active ingredients: paracetamol-325 mg chlorphenamine maleate-10 mg ascorbic acid-200 mg Excipients: Honey-lemon: sodium bicarbonate (E500), citric acid (E330), sorbitol (E420), povidone (E1201), sucrose, sodium cyclamate (E952) , aspartame (E951), acesulfame potassium (E950), lemon flavor (lemon flavor, malto dextrin, gum arabic (E414)), caramel coloring, honey flavor (honey, dextrose, silicon dioxide (E551)). Chamomile: sodium bicarbonate (E500), citric acid (EZZO), sorbitol (E420), povidone (E1201), sucrose, sodium cyclamate (E952), aspartame (E951), acesulfame potassium (E950), chamomile extract (chamomile extract dry, wheat maltodextrin).

Pharmacotherapeutic group

Other analgesics and antipyretics. ATX code:

N02BE51

.

Pharmacological properties

A combination drug consisting of three active substances. Paracetamol has an analgesic and antipyretic effect; eliminates headaches and other types of pain, reduces fever. Chlorphenamine maleate is an antihistamine, a blocker of H1-histamine receptors, a propylamine derivative, and has an anticholinergic effect. The sedative effect of chlorphenamine maleate is due to its penetration through the blood-brain barrier. The adrenolytic properties of chlorphenamine maleate may increase the risk of orthostatic hypotension. It has an antiallergic effect, helps restore nasal breathing, reducing swelling of the nasal mucosa and mucus production, lacrimation and runny nose. Ascorbic acid (vitamin C) is involved in the regulation of redox processes, carbohydrate metabolism, and increases the body's resistance.

Indications for use

In adults and children over 15 years of age, to relieve symptoms associated with colds and flu, such as clear nasal discharge, watery eyes, sneezing, headache, muscle pain, and/or fever (increased body temperature).

Contraindications

Hypersensitivity to paracetamol, ascorbic acid, chlorphenamine or any of the excipients, phenylketonuria, sugar intolerance; deficiency of glucose-6-phosphate dehydrogenase; erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase); severe liver or kidney failure; angle-closure glaucoma; risk of urinary retention associated with prostatic hypertrophy; combined use with monoamine oxidase inhibitors (MAO) and for 2 weeks after their discontinuation; chronic alcohol abuse; children's age (up to 15 years); pregnancy, lactation; Urolithiasis Use with caution in the presence of diseases or conditions such as: epilepsy, bleeding disorders, hyperoxaluria, thalassemia, hemochromatosis, sideroblastic anemia, progressive malignancies, congenital hyperbilirubinemia (Gilbert syndrome, etc.), diabetes mellitus, liver and kidney diseases, renal mild to moderate insufficiency, severe cardiovascular disease or arterial hypertension, chronic bronchitis, bronchiectasis or bronchial asthma, obstruction of the bladder neck, pyloroduodenal obstruction, polycythemia, leukemia, thrombophlebitis, a tendency to thrombosis, as well as in children and elderly patients ( see also section "Precautions").

Directions for use and doses

Inside. Adults and children over 15 years old: 1 packet 1-2 times a day. The contents of the package should be completely dissolved in a glass (200 ml) of warm water (50-60 °C) and the resulting solution should be drunk immediately. It is better to take Antigrippin between meals. The maximum daily dose is 2 packets. The interval between doses should be at least 4 hours. In patients with impaired liver and kidney function: the interval between doses of the drug should be at least 8 hours (see also “Contraindications”, “Precautions”). In elderly patients: the maximum daily dose is 1 packet (see "Precautions"). If the temperature does not decrease after 3 days of taking Antigrippin and/or the symptoms of the disease do not improve, you should consult a doctor. The maximum duration of use as an anesthetic is 5 days. The drug is not suitable for relieving pain not associated with colds, as it contains components that together eliminate the symptoms of a cold.

Side effect

Minimizing the risk of adverse reactions is facilitated by compliance with the recommended doses and duration of drug use. Side effects may occur with varying frequency: Associated with the presence of paracetamol. Isolated rare cases of immediate hypersensitivity reactions have been observed: anaphylactic shock, Quincke's edema, erythema, urticaria, skin rash. If these manifestations occur, you should immediately stop taking this medicine and other medicines containing paracetamol. In very rare cases, thrombocytopenia, leukopenia and neutropenia have been observed. Associated with the presence of chlorphenamine maleate, the pharmacological characteristics of chlorphenamine underlie side effects of varying degrees of intensity, which are associated or not associated with the dosage of Antigrippin. From the autonomic nervous system: drowsiness, more pronounced at the beginning of treatment; orthostatic hypotension; anticholinergic effect: dry mucous membranes, constipation, impaired accommodation, dilated pupils, increased intraocular pressure, rapid heartbeat (arrhythmia is also possible), urinary disorder (dysuria, urinary retention); imbalance, dizziness, decreased memory or concentration, more common in older people; loss of coordination of movements, tremors; confusion, hallucinations. Hypersensitivity reactions: erythema, eczema, severe itching, purpura; less commonly, Quincke's edema; anaphylactic shock. From the hematopoietic organs: leukopenia, neutropenia; thrombocytopenia; hemolytic anemia. Other (frequency unknown): hepatitis, jaundice, muscle twitching, muscle weakness, chest tightness, fatigue. Neurological anticholinergic effects and paradoxical arousal (eg, hyperactivity, restlessness, nervousness) are more common in children and elderly patients. Associated with the presence of ascorbic acid Allergic reactions and irritation of the gastrointestinal mucosa are possible. Daily doses of vitamin C greater than 600 mg have a diuretic effect. With long-term use of large doses of vitamin C, flushing or redness of the skin, nausea, vomiting, diarrhea, ulceration of the gastrointestinal mucosa, increased excitability, fatigue, sleep disturbance, headache, and damage to the insular apparatus of the pancreas may occur. When using large doses of vitamin C (usually a daily dose of more than 1 g), cases of hyperoxaluria and the appearance of oxalate stones, and hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency have been reported. The use of ascorbic acid in therapeutic doses may distort the results of tests to determine glycosuria, uric acid and creatinine levels, as well as the results of various laboratory tests (blood glucose, bilirubin, transaminase activity, lactate dehydrogenase). A dose of 1 g may produce false-negative results in stool occult blood tests. If any adverse reactions occur, including those not listed in these instructions, you should consult a doctor.

Overdose

Symptoms of an overdose of chlorphenamine maleate: dizziness, agitation, sleep disturbance, depression, convulsions, dilated pupils, dry mouth, constipation, abnormally high temperature, possible loss of consciousness, coma. The maximum permissible daily dose of chlorphenamine maleate for adults and children over 15 years of age is 24 mg, for elderly patients - 12 mg. Symptoms of paracetamol overdose: nausea, vomiting, loss of appetite, pallor, abdominal pain. These symptoms appear mainly in the first 24 hours. An overdose, starting with 10 g of paracetamol at one time for an adult and 150 mg per 1 kg of weight at one time for a child, leads to liver cytolysis, which can lead to complete and irreversible liver necrosis, expressed in liver failure, metabolic acidosis, encephalopathy up to coma and death. At the same time, there is an increase in the level of liver transaminases, lactate dehydrogenase, bilirubin and a decrease in the level of prothrombin, which can manifest itself 12-48 hours after administration. An overdose of ascorbic acid increases the risk of hemolysis and the formation of kidney stones. After a single dose of 3 g, diarrhea and gastrointestinal symptoms such as nausea or gastritis almost always develop after a single dose of 10 g. The literature describes isolated cases of acute and chronic overdose of ascorbic acid (taking more than 4 g/day) in patients with glucose-6-phosphate dehydrogenase deficiency. In DIC, an overdose of ascorbic acid can lead to a significant increase in oxalate levels in the blood serum and urine. Emergency care: Immediately transport the patient to the hospital; collecting a blood test in a test tube to determine the initial concentration of paracetamol in plasma; rapid elimination of the drug taken by gastric lavage; Treatment of paracetamol overdose usually involves administering the antidote N-acetylcysteine ​​intravenously or orally as early as possible, within the first ten hours of administration if possible; symptomatic treatment.

Interaction with other drugs

Paracetamol The interaction of paracetamol and inducers of microsomal oxidation in the liver (phenytoin, barbiturates, rifampicin, carbamazepine, ethanol) increases the production of hydroxylated active metabolites, which makes it possible to develop severe intoxications with small overdoses. Concomitant use of barbiturates reduces the effectiveness of paracetamol. The rate of absorption of paracetamol increases when used simultaneously with metoclopramide and domperidone, and decreases when taken together with drugs that slow down gastric emptying (propantheline, antidepressants with anticholinergic properties, narcotic analgesics) and cholestyramine. When taken simultaneously with paracetamol, the half-life of chloramphenicol increases by 5 times. Paracetamol may reduce the effectiveness of lamotrigine. Salicylamide prolongs the half-life of paracetamol and leads to the accumulation of hepatotoxic metabolites. The simultaneous use of zidovudine and paracetamol increases the risk of neutropenia. Probenecid inhibits the conjugation of paracetamol with glucuronic acid and thus leads to a decrease in the clearance of paracetamol. Paracetamol in high doses (4 g/day) for more than 4 days may potentiate the effect of oral anticoagulants and, therefore, increase the risk of bleeding. Constant monitoring of the INR (international normalized ratio) is necessary. It is necessary to consider the use of paracetamol when co-administered with oral anticoagulants and the discontinuation of paracetamol. Chlorphenamine maleate Chlorphenamine maleate can enhance the depressant effect on the central nervous system of many drugs and substances, slowing reaction speed and reducing concentration. These are morphine derivatives (analgesics, antitussives), neuroleptics, tranquilizers, barbiturates, benzodiazepines, hypnotics, sedative antidepressants (amitriptyline, mianserin, mirtazapine, timipramine), sedative H1-blockers, centrally acting antihypertensives, baclofen, thalidomide. Ethanol enhances the sedative effect of chlorphenamine maleate. Ascorbic acid Increases the concentration of benzylpenicillin and tetracyclines in the blood, improves the absorption of iron in the intestines (converts ferric iron to ferrous), and can increase the excretion of iron when used simultaneously with deferoxamine. Concomitant use of ascorbic acid with antacids containing aluminum may increase urinary excretion of aluminum. When treating with salicylates and short-acting sulfonamides, the joint administration of vitamin C slows down the excretion of acids by the kidneys, increases the excretion of drugs that have an alkaline reaction (including alkaloids), and increases the risk of developing crystalluria. Ascorbic acid, when used simultaneously, reduces the blood concentration of oral contraceptives and indirect anticoagulants, increases the overall clearance of ethanol, reduces the therapeutic effect of isoprenaline, vitamin B12, neuroleptics - phenothiazine derivatives (for example, fluphenazine), reduces the tubular reabsorption of tricyclic antidepressants. Concomitant use of barbiturates increases the excretion of ascorbic acid in the urine. Indomethacin may reduce the effectiveness of ascorbic acid.

Precautionary measures

If there is a high fever, signs of superinfection, or if symptoms do not resolve within five days, treatment should be reconsidered. To avoid the risk of overdose, you must make sure that there is no paracetamol, chlorphenamine maleate and ascorbic acid in other medicines (see also section “Interaction with other medicines”). With prolonged use of high doses or improper use of analgesics, headaches may occur that should not be relieved by taking even higher doses of painkillers. Frequent use of analgesics, especially when several of them are combined, leads to the risk of kidney damage and the occurrence of renal failure. If suddenly discontinued after long-term use of high doses of analgesics, headaches, fatigue, muscle pain, nervousness and autonomic symptoms may occur, which disappear within a few days after stopping the drug. Until they disappear, you should avoid taking painkillers; their subsequent use is recommended after consultation with your doctor. Do not exceed recommended doses! Currently, there are recommendations to reduce the daily dose of paracetamol from 4 g/day to 3 g/day. Cases of acute liver failure (in some cases resulting in liver transplantation or death) due to the use of paracetamol have been reported. Most cases of liver damage are associated with doses greater than 4 g per day, and are also common with taking more than one paracetamol-containing product. Excessive consumption of paracetamol may be intentional or unintentional, for example when trying to get maximum effect. Patients should consult a doctor immediately if more than 4 g of paracetamol has been taken at one time, even if they feel well. With long-term use in doses significantly higher than recommended, the likelihood of impaired liver and kidney function increases; monitoring of the peripheral blood picture is necessary. To avoid toxic liver damage, paracetamol should not be combined with alcoholic beverages, or taken by persons prone to chronic alcohol consumption. The risk of developing liver damage increases in patients with alcoholic hepatosis. Patients who consume three or more servings of alcohol per day (1 serving: 10-12 g of alcohol - 1 glass of vodka or cognac (25-30 ml) = 1 glass of wine (100-120 ml) = 1 small glass of beer (220- 260 ml)), should be informed of the need to consult with your doctor about when and how to take paracetamol. Chronic alcohol drinkers are at increased risk of liver damage when taking paracetamol, even at recommended doses. Chlorphenamine maleate should be used with caution, especially together with other drugs that have anticholinergic effects, in epilepsy, increased intraocular pressure, severe cardiovascular disease or hypertension, chronic bronchitis, bronchiectasis or bronchial asthma. Neurological anticholinergic effects and paradoxical arousal (eg, hyperactivity, restlessness, nervousness) are more common in children and the elderly. Monitoring of the use of chlorphenamine maleate should be enhanced in elderly patients (high likelihood of orthostatic hypotension, dizziness, sedation, chronic constipation and the risk of paralytic ileus, worsening prostatic hypertrophy), with impaired liver and/or kidney function due to possible accumulation . Prescribing ascorbic acid to patients with rapidly proliferating and intensively metastasizing tumors can aggravate the process. In patients with high iron levels in the body, ascorbic acid should be used in minimal doses. You should not take large doses of ascorbic acid (more than 500 mg) for diabetes mellitus, hyperoxaluria, thalassemia, hemochromatosis, sideroblastic anemia. Due to the content of ascorbic acid, special care should be taken when prescribing to patients with increased blood clotting, polycythemia, leukemia, thrombophlebitis or a tendency to thrombosis, hyperoxaluria, and kidney stones. In conditions that may be accompanied by hyperglycemia, ascorbic acid can be taken only on the recommendation of a doctor and in minimal dosages. Taking large doses of ascorbic acid is associated with the formation of calcium oxalate stones in the kidneys, so ascorbic acid should be used with caution in patients with hyperoxaluria. Since the simultaneous use of ascorbic acid with antacids containing aluminum may increase the excretion of aluminum in the urine, their combined use in patients with renal failure is not recommended. Effect on diagnostic tests Abnormally high concentrations of paracetamol may distort the results of blood glucose tests performed by the glucose oxidase-peroxidase method. The use of paracetamol may affect the results of determining blood urea by a method that uses phosphotungstic acid. Ascorbic acid can also distort the parameters of laboratory tests (quantitative determination of glucose and uric acid in the blood plasma, bilirubin, activity of “liver” transaminases - ALT, AST, LDH). This medicine contains sucrose and sorbitol, which should be taken into account in patients with sugar intolerance. Aspartame is a source of phenylalanine, do not use in patients with phenylketonuria! One dose of Antigrippin contains about 181 mg (8 mmol) Na+, which should be taken into account in patients on a low sodium diet.

Use during pregnancy and breastfeeding

The presence of chlorphenamine maleate, as well as ascorbic acid, determines restrictions on use in this category of patients. There are no sufficient data on the safety of use. Antigrippin is contraindicated during pregnancy and breastfeeding.

Impact on the ability to drive a car and operate machinery

The use of this medicine may cause drowsiness, especially at the beginning of treatment. This effect is enhanced by the consumption of alcoholic beverages or alcohol-containing medications. During the treatment period, you should not drive vehicles, work with potentially dangerous mechanisms and engage in other activities associated with increased concentration.

Package

Powder for preparing a solution for internal use, honey-lemon or chamomile. 4.825 g of powder in a bag made of 3-layer PET/Al/PE laminate. 10 packets in a cardboard box with instructions for use.

Storage conditions

At a temperature not exceeding 25 °C. Keep out of the reach of children!

Best before date

3 years. Do not use after the expiration date.

Conditions for dispensing from pharmacies

Over the counter.

Buy Antigrippin powder for preparing an oral solution, honey-lemon, in bags No. 10 at the pharmacy

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Instructions for use for Antigrippin powder for preparing honey-lemon oral solution in bags No. 10