Alka-Seltzer Plus Cold (Paracetamol_Phenylephrine hydrochloride)

Alka-Seltzer Plus Cold (Paracetamol_Phenylephrine hydrochloride)

Phenylephrine Hydrochloride, Acetaminophen

Inside.

Dissolve the contents of one sachet in hot, but not boiling water (250 ml). Allow to cool to an acceptable temperature and drink.

Adults and children over 18 years of age — one bag. If necessary, repeat the reception every 4-6 hours, but no more than 4 doses (bags) per day.

The drug is not recommended for use for more than 5 days as an analgesic and 3 days as an antipyretic without consulting a doctor.

If symptoms persist, you should consult a doctor.

hypersensitivity to paracetamol or other components of the drug,

arterial hypertension,

coronary heart disease,

impaired liver function and severe renal impairment,

hyperthyroidism,

diabetes mellitus,

phenylketonuria (because the drug contains aspartame),

simultaneous use of tricyclic antidepressants, MAO inhibitors or beta-blockers, or their use within the last 2 weeks,

prostatic hyperplasia,

glaucoma,

deficiency of sucrase/isomaltase,

fructose intolerance,

glucose-galactose malabsorption,

pregnancy,

breast-feeding period,

age up to 18 years.

With caution: bronchial asthma, chronic obstructive pulmonary disease, glucose-6-phosphate dehydrogenase deficiency, blood diseases, congenital hyperbilirubinemia (Gilbert, Dubin-Johnson, Rotor syndrome), hyperoxaluria.

Long-term use of the drug is not recommended. Concomitant administration of other antipruritic and / or paracetamol-containing drugs should be avoided. Do not take the drug at the same time as taking alcohol.

Paracetamol

Allergic reactions: rarely-skin rash, urticaria, anaphylaxis, bronchospasm, angioedema.

From the central nervous system: rarely-dizziness.

From the hematopoietic system: rarely-aplastic anemia, methemoglobinemia, increased blood pressure, very rarely-pathological changes in the blood, such as thrombocytopenia, agranulocytosis, hemolytic anemia, neutropenia, leukopenia, pancytopenia.

From the digestive system: rarely — nausea, vomiting, dryness of the oral mucosa, hepatotoxic effect.

From the urinary system: rarely-urinary retention, nephrotoxicity (papillary necrosis).

Other: rarely-paresis of accommodation, increased intraocular pressure, mydriasis.

Phenylephrine

From the CCC side: rarely-tachycardia, increased blood pressure.

From the nervous system: rarely-insomnia, nervousness, tremor, anxiety, increased excitability, confusion, irritability and headache.

From the digestive system: often — anorexia, nausea and vomiting.

On the part of the immune system and skin: rarely-allergic reactions, including skin rash, urticaria, anaphylaxis and bronchospasm.

Paracetamol

Liver damage is possible in adults who have taken 10 g or more of paracetamol. Taking 5 g or more of paracetamol can cause liver damage if there are risk factors: prolonged treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin or other drugs that induce liver enzymes, alcohol abuse, lack of glutathione (for example, poor nutrition), cystic fibrosis, HIV infection, starvation, cachexia.

Symptoms: if you overdose on paracetamol in the first 24 hours — paleness, nausea, vomiting, anorexia and abdominal pain.

Liver damage can occur in the period from 12 to 48 hours after the use of the drug.

In the case of an overdose of paracetamol, despite the absence of the primary symptoms of an overdose, it is necessary to seek qualified help from medical institutions. To prevent the serious consequences of overdose, the necessary measures should be taken in a timely manner.

The symptoms may appear only partially in the form of nausea or vomiting and may not reflect the actual degree of overdose or the risk of organ damage.

In severe overdose — liver failure with progressive encephalopathy, coma, death, acute renal failure with tubular necrosis (including in the absence of severe liver damage), arrhythmia, pancreatitis.

Phenylephrine

Symptoms: irritability, headache, increased blood pressure. If these symptoms of overdose occur, you should consult a doctor.

Treatment: administration of SH-group donors and precursors of glutathione synthesis-methionine for 8-9 hours after overdose and acetylcysteine - for 8 hours. The need for additional therapeutic measures (further administration of methionine, intravenous administration of acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as on the time elapsed after its administration.

A combined drug, the effect of which is due to the composition of its components.

Paracetamol has analgesic and antipyretic effects, due to the inhibition of the synthesis of PG in the central nervous system.

Phenylephrine is a postsynaptic alpha-adrenoceptor agonist with low affinity for cardiac beta-adrenoceptors. Decongestant constricts blood vessels, eliminates swelling and hyperemia of the mucous membrane of the nasal cavity.

Paracetamol is rapidly and completely absorbed in the small intestine. C_max in the blood, it is observed 15-20 minutes after ingestion. Systemic bioavailability is determined by presystemic metabolism and, depending on the dose, ranges from 70 to 90%. Paracetamol spreads rapidly through all body tissues and has a T_1/2 approximately 2 h. It is metabolized in the liver and excreted in the urine as glucuronides and sulfate compounds (>80%).

Phenylephrine is rapidly absorbed from the gastrointestinal tract. The level of primary metabolism is quite high (about 60%), so oral administration of phenylephrine reduces its bioavailability (about 40%). C_max in the blood plasma, it is observed after 1-2 hours, and T_1/2 it varies from 2 to 3 hours. It is excreted in the urine in the form of sulfate compounds. Oral administration of phenylephrine as a decongestant should be carried out at intervals of 4-6 hours.

• Remedy for the elimination of symptoms of acute respiratory infections and colds (analgesic non-narcotic drug alpha-adrenomimetic) [Anilides in combinations]

Paracetamol

Stimulators of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, flumecinol, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which leads to the possibility of severe intoxication.

Paracetamol increases the effect of indirect anticoagulants and reduces the effectiveness of uricosuric drugs.

The rate of absorption of paracetamol increases under the action of metoclopramide or domperidone, and decreases under the action of colestyramine.

Anticoagulant effect of warfarin, etc. coumarin derivatives are enhanced with prolonged use of paracetamol.

The drug enhances the effects of MAO inhibitors, sedatives, and ethanol.

Phenylephrine

With the simultaneous use of phenylephrine with antidepressants, antiparkinsonian, antipsychotic agents, phenothiazine derivatives, urinary retention, dryness of the oral mucosa, constipation is possible.

When used with corticosteroids, the risk of glaucoma increases.

Tricyclic antidepressants increase the adrenomimetic effect of phenylephrine, while the simultaneous administration of halothane increases the risk of ventricular arrhythmia.