Coldact® Flu Plus
Paracetamol
Enhances the effects of MAO inhibitors, sedatives, ethanol.
The risk of hepatotoxic action of paracetamol increases with simultaneous use of barbiturates and 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.
Metoclopramide increases the rate of absorption of paracetamol and increases the level of paracetamol concentration in the blood plasma to the maximum.
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 the 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.
Phenylephrine
Contraindicated in patients who are taking or have taken MAOIs 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.
Chlorphenamine
Antihistamines, such as chlorphenamine, may enhance the effects of opioid analgesics, anticonvulsants, antidepressants (tricyclics and monoamine oxidase inhibitors), other antihistamines, antiemetics and antipsychotics, anxiolytics, hypnotics, ethanol (alcohol) and other central nervous system depressants.
Because chlorphenamine has some anticholinergic activity, the effects of anticholinergic drugs (eg, some psychotropic drugs, atropine, and urinary incontinence drugs) may be increased by this drug. This can lead to tachycardia and dryness of the oral mucosa. disorders of the gastrointestinal tract (for example, colic), urinary retention and headache.
The metabolism of phenytoin may be inhibited by chlorphenamine, and phenytoin toxicity may develop.
Coldact Flu + extended-release capsules No. 10
A country
India
Country of manufacture may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Active substance
Paracetamol + Chlorpheniramine + Phenylephrine
pharmachologic effect
Combined drug with prolonged action. Chlorphenamine has an antiallergic effect, eliminates lacrimation, itching in the eyes and nose. Paracetamol has an antipyretic and analgesic effect: reduces the pain syndrome observed during colds - sore throat, headache, muscle and joint pain, reduces high temperature. Phenylephrine has a vasoconstrictor effect - reduces swelling and hyperemia of the mucous membranes of the upper respiratory tract and paranasal sinuses .
Indications for use
- symptomatic treatment of colds, flu, acute respiratory viral infections (fever, pain, rhinorrhea).
Mode of application
Adults and children over 12 years old - 1 capsule every 12 hours for 3-5 days. Duration of use as an antipyretic - no more than 3 days; as a pain reliever - no more than 5 days. Coldact Flu Plus capsules are not recommended for use during pregnancy and lactation. Contraindicated in children under 12 years of age.
Interaction
The risk of developing hematotoxic effects of paracetamol increases with simultaneous use of barbiturates, diphenine, carbamazepine, rifampicin, zidovudine and other inducers of microsomal liver enzymes. Enhances the effects of sedative drugs, ethanol, MAO inhibitors. Antidepressants, phenothiazine derivatives, antiparkinsonian and antipsychotic drugs increase the risk of developing urinary retention, dry mouth, and constipation. GCS increase the risk of developing glaucoma. Paracetamol reduces the effectiveness of uricosuric drugs. Chlorphenamine combined with furazolidone can lead to hypertensive crisis, agitation, and hyperrexia. Tricyclic antidepressants enhance the adrenomimetic effect of phenylephrine; simultaneous administration of halothane increases the risk of developing ventricular arrhythmia. Reduces the hypotensive effect of guanethidine, which in turn enhances the alpha-adrenergic stimulating activity of phenylephrine.
Side effect
Increased blood pressure, tachycardia, drowsiness, difficulty falling asleep, dizziness, increased excitability, dry mucous membranes, mydriasis, accommodation paresis, increased intraocular pressure, loss of appetite, nausea, epigastric pain, anemia. Very rare: urinary retention, allergic reactions (skin rash, itching, urticaria, angioedema). Rarely: anemia, thrombocytopenia, leukemia, agranulocytosis. With long-term use in high doses, hepatotoxic and nephrotic effects are possible.
Contraindications
- hypersensitivity to any of the components included in the composition; - severe atherosclerosis of the coronary arteries; - arterial hypertension; - diabetes mellitus; - thyrotoxicosis; - angle-closure glaucoma; - severe diseases of the liver, kidneys, heart, bladder; - peptic ulcer of the stomach and duodenum intestines; - diseases of the pancreas; - difficulty urinating with prostate adenoma; - diseases of the blood system; - deficiency of glucose-6-phosphate dehydrogenase; - children under 12 years of age. With caution: congenital hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndromes) , bronchial asthma and chronic obstructive pulmonary disease.
Overdose
Symptoms caused by paracetamol appear after taking more than 10-15 g: pallor of the skin, decreased appetite, nausea, vomiting, hepatonecrosis, increased activity of liver transaminases, increased prothrombin time. Treatment: gastric lavage in the first 6 hours, administration of SH-group donors and precursors for the synthesis of glutathione-methionine 8-9 hours after an overdose and N-acetylcysteine after 12 hours. In case of accidental overdose, you should immediately consult a doctor, regardless of whether any symptoms of overdose are noted or not.
special instructions
Without a doctor's instructions, the drug should not be used by patients undergoing treatment with other medications, in particular MAO inhibitors. If, despite taking the drug, the disease is accompanied by ongoing fever or repeated increases in temperature are observed, you should consult a doctor. Do not take with alcohol or combine with other drugs containing paracetamol. When using Coldact Flu Plus, it is undesirable to use sleeping pills, tranquilizers and other psychotropic drugs. It distorts laboratory test results in the quantitative determination of glucose and uric acid in plasma. In case of long-term treatment, peripheral blood parameters and the functional state of the liver are monitored. Impact on the ability to drive vehicles and operate machinery During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Codelac Broncho tablets: instructions for use
Where can I buy
Registration number: LSR-008115/08
Trade name: Codelac® Broncho
Dosage form : Tablets
Description
Flat-cylindrical tablets from light cream to creamy yellowish in color with darker and lighter inclusions, with a score and a chamfer.
Composition per tablet
Active ingredients: ambroxol hydrochloride (ambroxol) - 20.0 mg, trisodium salt of glycyrrhizic acid (sodium glycyrrhizinate) - 30.0 mg, dry thermopsis extract - 10.0 mg, sodium bicarbonate - 200.0 mg.
Excipients: potato starch - 84.30 mg, microcrystalline cellulose - 150.10 mg, povidone (polyvinylpyrrolidone, povidone K25) -26.40 mg, talc - 13.00 mg, stearic acid - 5.20 mg, sodium carboxymethyl starch ( sodium starch glycolate) - 11.00 mg.
Pharmacotherapeutic group
Combination expectorant
ATX Code: [R05CA10]
Pharmacological properties
Pharmacodynamics
A combined drug for the treatment of cough, it has a mucolytic and expectorant effect, and also has anti-inflammatory activity.
The action of Codelac® Broncho is due to the pharmacological properties of its components:
Ambroxol has a secretomotor, secretolytic and expectorant effect, normalizes the disturbed ratio of serous and mucous components of sputum, and increases the secretion of surfactant in the alveoli. Reduces the viscosity of sputum and promotes its removal.
Glycyrrhat (glycyrrhizic acid and its salts) has anti-inflammatory and antiviral effects. It has a cytoprotective effect due to its antioxidant and membrane-stabilizing activity. Potentiates the effect of endogenous glucocorticosteroids, providing anti-inflammatory and antiallergic effects. Due to its pronounced anti-inflammatory activity, it helps reduce the inflammatory process in the respiratory tract.
Thermopsis extract has an expectorant effect, having a moderate irritant effect on the receptors of the gastric mucosa, and reflexively increases the secretion of the bronchial glands.
Sodium bicarbonate shifts the pH of bronchial mucus to the alkaline side, reduces the viscosity of sputum, and stimulates the motor function of the ciliated epithelium and bronchioles.
Pharmacokinetics
Ambroxol.
Suction. Ambroxol is characterized by rapid and almost complete absorption from the gastrointestinal tract. Bioavailability is 70-80%. The maximum concentration in blood plasma after oral administration is achieved within 1-3 hours. Plasma protein binding is 80-90%.
Distribution. The transition of ambroxol from the blood to tissues when taken orally occurs quickly. The highest concentrations of the active component of the drug are observed in the lungs. Penetrates the blood-brain barrier, placental barrier, and is excreted in breast milk.
Metabolism. Approximately 30% of an ingested dose undergoes a first pass effect through the liver. Studies on human liver microsomes have shown that CYP3A4 is the predominant isoenzyme responsible for the metabolism of ambroxol. The remainder of ambroxol is metabolized in the liver to inactive metabolites.
Excretion. The half-life (T ½) of ambroxol is about 10 hours. Excreted by the kidneys: 90% in the form of metabolites, 10% unchanged.
Pharmacokinetics in special groups of patients.
No clinically significant effect of age and gender on the pharmacokinetics of ambroxol was found, so there is no basis for dose adjustment based on these characteristics. The clearance of ambroxol in patients with severe liver failure is reduced by 20-40%.
In severe renal failure, T ½ of ambroxol metabolites increases.
Trisodium salt of glycyrrhizic acid (sodium glycyrrhizinate).
After oral administration, in the intestine, under the influence of the enzyme β-glucuronidase, produced by bacteria of normal microflora, an active metabolite is formed from glycyrrhizic acid - β-glycyrrhetic acid, which is absorbed into the systemic circulation. In the blood, β-glycyrrhetic acid binds to albumin and is almost completely transported to the liver. The excretion of β-glycyrrhetic acid occurs predominantly in bile, with residual amounts in urine.
Thermopsis dry extract.
The components of the extract are well absorbed in the gastrointestinal tract. The maximum effect occurs 30-60 minutes after oral administration and lasts for 2-6 hours. They are excreted from the body by the kidneys, mucous membrane of the respiratory tract and bronchial glands.
Sodium bicarbonate.
Well absorbed from the gastrointestinal tract. The maximum effect occurs 30-60 minutes after oral administration and lasts for 2-6 hours. They are excreted from the body by the kidneys, mucous membrane of the respiratory tract and bronchial glands.
Indications for use
Diseases of the respiratory tract with difficulty in sputum discharge: acute and chronic bronchitis, pneumonia, chronic obstructive pulmonary disease (COPD), bronchiectasis.
Contraindications
Hypersensitivity to the components of the drug, pregnancy, lactation, children under 12 years of age.
With caution: liver and/or kidney failure, gastric and duodenal ulcers, bronchial asthma.
Use during pregnancy and breastfeeding
The use of the drug during pregnancy is contraindicated. If it is necessary to use the drug during lactation, breastfeeding should be discontinued.
Directions for use and doses
Inside, during meals. Adults and children over 12 years old: 1 tablet 3 times a day. It is not recommended to use without medical prescription for more than 4-5 days.
Side effect
Allergic reactions. Rarely - weakness, headache, diarrhea, dry mouth and respiratory tract, exanthema, rhinorrhea, constipation, dysuria. With long-term use in high doses - gastralgia, nausea, vomiting.
Overdose
Symptoms: nausea, vomiting, diarrhea, dyspepsia.
Treatment is symptomatic; gastric lavage is advisable in the first 1-2 hours after taking the drug.
Interaction with other drugs
Combined use with antitussive drugs leads to difficulty in sputum discharge while reducing cough.
The drug increases the penetration of antibiotics into the bronchial secretions.
special instructions
Do not combine with antitussives.
Impact on the ability to drive vehicles and machinery
There are no known cases of the drug affecting the ability to drive a car or use machinery. No relevant studies have been conducted.
Release form
Pills.
10 tablets in a blister pack. 1 or 2 blister packs with instructions for use in a cardboard pack.
Storage conditions
Store at a temperature not exceeding 25 °C. Keep out of the reach of children.
Best before date
2 years. After the expiration date, do not use the drug.
Vacation conditions
Over the counter.
Marketing authorization holder/organization receiving consumer complaints
PJSC OTCPharm, Russia, 123317, Moscow, st. Testovskaya, 10
Tel.:+7, Fax
otcpharm.ru
, 305022, Russia, Kursk, st. 2nd Aggregatnaya, 1a/18, tel./fax, www.pharmstd.ru
Cilostazol (Cilostazolum)
The following unwanted effects may sometimes occur when taking cilostazol.
From the circulatory and lymphatic system:
often - hematomas; infrequently - anemia; rarely - prolonged bleeding time, thrombocytosis; single - tendency to bleeding, thrombocytopenia, granulocytopenia, agranulocytosis, leukopenia, pancytopenia, aplastic anemia.
From the immune system:
infrequently - allergic reactions.
From the digestive system and metabolism:
often - edema (peripheral or facial edema); uncommon - hyperglycemia, diabetes mellitus; isolated cases - anorexia.
Mental disorders:
infrequently - anxiety.
From the nervous system:
very often - headache; often - dizziness; infrequently - insomnia, unusual dreams; isolated cases - paresis, hypoesthesia.
From the side of the organ of vision:
isolated cases - conjunctivitis.
On the part of the hearing organ:
isolated cases - tinnitus.
From the cardiovascular system:
often - palpitations, tachycardia, angina pectoris, arrhythmia, ventricular extrasystoles; uncommon - myocardial infarction, atrial fibrillation, congestive heart failure, supraventricular tachycardia, ventricular tachycardia, loss of consciousness, eye hemorrhage, nosebleeds, gastrointestinal bleeding, unspecified bleeding, orthostatic hypotension; isolated cases - hot flashes, hypertension, hypotension, cerebral hemorrhages, pulmonary hemorrhages, muscle hemorrhages, hemorrhages in the respiratory tract, subcutaneous hemorrhages.
From the respiratory tract:
often - rhinitis, pharyngitis; infrequently - shortness of breath, pneumonia, cough; isolated cases of interstitial pneumonia.
From the gastrointestinal tract:
very often - diarrhea, bowel dysfunction; often - nausea, vomiting, dyspepsia, flatulence, abdominal pain; infrequently - gastritis.
From the hepatobiliary system:
isolated cases - hepatitis, liver dysfunction, jaundice.
For the skin and subcutaneous tissues:
often - rash, itching; isolated cases - eczema, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria.
From the kidneys and urinary tract:
rarely - renal failure, impaired renal function; isolated cases - hematuria, pollakiuria.
General violations:
often - chest pain, asthenia; infrequently - myalgia, chills; isolated cases - hyperthermia, malaise, pain.
Laboratory research:
isolated cases - increased levels of uric acid, urea, creatinine.
An increased incidence of palpitations and peripheral edema was observed when cilostazol was used concomitantly with other vasodilators that can cause reflex tachycardia, such as dihydropyridine calcium channel blockers.
