Андипал

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Андипал

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Treatment option: Migraine

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Андипал

Property Description
Active Ingredients Bendazol, Papaverine, Phenobarbital, Sodium Metamizole
Form Oral Tablet
Pharmacological Class Combined Antispasmodic-Analgesic and Sedative Agent
General Purpose Symptomatic relief of muscle spasm, pain, and nervous excitability
Origin Synthetic Fixed-Dose Combination Product

Андипал is a synthetic fixed-dose combination product commonly presented as an oral tablet, classified fundamentally as a Combined Antispasmodic-Analgesic and Sedative Agent. This unique structure dictates its general purpose: providing relief from discomfort caused by muscle spasms and associated pain, complemented by a calming effect on the nervous system. The drug's identity rests on its ability to target several sources of discomfort concurrently, distinguishing its profile from simpler analgesic preparations.

Composition and Classification of Андипал

The formulation of Андипал is built upon four distinct, synthetic active ingredients: Бендазол (Bendazol), Папаверин (Papaverine), Фенобарбитал (Phenobarbital), and Метамизол натрия (Sodium Metamizole). This unique assembly ensures a multifaceted approach to symptomatic relief.

Each component contributes specialized actions. Папаверин is a benzylisoquinoline alkaloid that acts as a direct-acting smooth muscle relaxant and vasodilator. This means Papaverine helps to ease discomfort by relaxing the constricted smooth muscles and promoting blood vessel widening. Similarly, the ingredient Метамизол натрия provides analgesic and antipyretic effects. This component serves to reduce pain and ease spasms. These components ensure the drug draws its overall classification from multiple pharmacological groups, including barbiturate and pyrazolone derivatives.

How Does Андипал Function as a Combination?

Андипал functions through pharmacodynamic synergy, a principle where the combined effects of its components are engineered to offer a broader spectrum of symptomatic relief than the individual ingredients might provide alone. The combination is designed to alleviate discomfort by integrating the principle of smooth muscle relaxation and dilation of blood vessels with effective pain relief. This systemic approach targets issues linked to smooth muscle tension, such as the discomfort associated with headaches, resulting in a reduction of pain signals and a calming of nervous excitability.

Regulatory References

  1. Muscle Relaxants (DrugBank)
  2. Chemistry and Synthesis Center (NIH)
  3. BENDAZOL Substance Information (NIH GSRS)
  4. Phenobarbital Drug Label (DailyMed/NIH)
  5. Smooth Muscle Relaxants (DrugBank)
  6. Analgesic Agents (NIH Bookshelf)

What side effects are possible with Андипал?

Possible Side Effects and Safety Information

The safety profile of Андипал is defined by the documented risks associated with its multi-component composition, specifically the analgesic (Sodium Metamizole) and sedative (Phenobarbital) components, as classified by government regulatory authorities.

Officially documented adverse reactions are categorized by frequency and the body system affected:

  • Common Reactions (Nervous and Vascular Systems): Side effects frequently reported in regulatory documentation include somnolence, drowsiness, dizziness, and hypotension (low blood pressure). These are primarily linked to the central nervous system depressant and vasodilatory properties of the medicine.

  • Rare, Serious Reactions (Blood and Immune Systems): Rare but clinically significant reactions documented include agranulocytosis (a severe reduction in white blood cells), anaphylactic shock, and severe skin reactions such as Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). These events are associated with the Sodium Metamizole component.

System-Organ Class Example Adverse Reaction Type
Blood and Lymphatic Agranulocytosis, Anemia
Nervous System Sedation, Ataxia
Psychiatric Disorders Drug dependence, Confusion

Safety statements in regulatory labeling also address specific constraints and patterns of use. The medication is contraindicated in individuals with a history of Metamizole-related agranulocytosis, acute porphyrias, or severe hepatic or renal impairment. Furthermore, official documents note that long-term therapy presents a risk of physical and psychological dependence and may be associated with decreased bone mineral density (osteoporosis), reflecting the Phenobarbital component’s safety characteristics. This framework defines the medicine's risk profile based on its complex composition.

Overdose and Emergency Response

Overdose: When to Seek Help

Overdose with Андипал, a combination product containing Phenobarbital, is primarily characterized by the severe effects of the barbiturate component on the central nervous system (CNS) and the cardiovascular system. Overdose information presented here is based on authoritative government regulatory sources.

Documented Overdose Presentations

System Manifestations
CNS Sedation, lethargy, stupor, confusion, progressing to deep coma. Loss of reflexes, nystagmus, and ataxia.
Cardiovascular Severe hypotension (low blood pressure), circulatory shock.
Respiratory Severe respiratory depression, slow/shallow breathing, potentially leading to respiratory arrest.

Emergency Response and Management

Urgent medical attention must be sought immediately upon any suspicion of overdose or the onset of significant CNS depression, stupor, or coma.

Official regulatory guidance emphasizes that the clinical management of an overdose is strictly supportive and symptomatic.

  • There is no specific antidote listed for barbiturate overdose.
  • Treatment focuses on maintaining vital functions, including establishing a clear airway and providing assisted ventilation if needed.
  • Measures may include gastrointestinal decontamination (e.g., activated charcoal) and methods to enhance drug elimination (e.g., hemodialysis), as determined by a healthcare professional.

Special consideration is required for vulnerable populations, including the elderly and those with pre-existing hepatic or renal impairment, who may experience enhanced or prolonged toxicity.

Therapeutic Uses of Андипал

Metamizole, the core analgesic component, is utilized for addressing symptoms related to pain and spasm. This combination medication is applied across domains where additional symptomatic support is needed, and is often used for conditions associated with acute episodes of discomfort.

The medication is commonly used to help with symptoms related to physical discomfort and pain linked to the tightening of smooth muscles around blood vessels and internal organs, often manifesting as tension-type headaches or in situations involving recurrent episodes of visceral or vascular spasms. It is applied to address symptom clusters that may become intense or disruptive, especially when pain is accompanied by symptoms of increased neurological activity or stress.

“This approach is utilized when symptoms cluster into patterns requiring supportive management of both physical pain and accompanying nervous tension.”

This therapeutic focus provides support that may help ease the overall symptom burden, may assist with maintaining functional stability, and contributes to support for comfort during periods of heightened symptoms.


Quick Fact: Relief for Combined Spasmodic Discomfort Андипал is commonly used when short-term symptomatic assistance is needed to address the symptoms of increased neurological or muscular activity combined with noticeable pain, and may help support general well-being during symptomatic phases.

Regulatory References

  1. NIH's LiverTox review on Metamizole (Dipyrone)

Eligibility and Restrictions for Use

Eligibility Map: Who can and cannot use Андипал — Official Regulatory Information

The eligibility status for Андипал is defined by official regulatory labeling, which establishes a strict profile of populations and conditions for which use is absolutely prohibited.

Category Official Regulatory Statement
Populations for whom use is allowed Individuals 8 years of age and older who do not have any of the absolute contraindications.
Age-related eligibility rules Use is contraindicated in children under 8 years of age.
Pregnancy and lactation status Contraindicated during pregnancy and the lactation period (breastfeeding).

Eligibility-Related Restrictions (Contraindications)

This medicine is contraindicated for patients with specific health conditions due to the risk profile of its components (Sodium Metamizole, Phenobarbital, Papaverine, and Bendazol). These conditions include:

  • Severe hepatic insufficiency or severe renal insufficiency.
  • Underlying blood disorders (e.g., bone marrow suppression) and Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency.
  • Specific cardiovascular conditions such as tachyarrhythmia, severe angina pectoris, and decompensated chronic heart failure.
  • Anatomical or ocular conditions, including closed-angle glaucoma, prostatic hyperplasia, intestinal obstruction, and megacolon.

Regulatory documents define who can and cannot use this medicine by classifying these conditions and statuses as absolute non-eligibility.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Андипал is a combination product whose interaction profile is dominated by its active components, Phenobarbital and Metamizole. These interactions are categorized based on their mechanism and clinical significance, as documented in authoritative regulatory sources.

Pharmacokinetic Interactions (Exposure Modification)

Mechanism Interacting Substances / Categories
Enzyme Induction (Phenobarbital/Metamizole) Reduces plasma concentration and therapeutic efficacy of many drugs, including Oral Contraceptives, Immunosuppressants (e.g., Cyclosporine), and certain Oral Anticoagulants (e.g., Acenocoumarol).

Pharmacodynamic Interactions

Mechanism Interacting Substances / Categories
Additive CNS Effects (Phenobarbital) Enhanced Central Nervous System (CNS) and respiratory depression when co-administered with Ethanol (alcohol) or other CNS Depressants (e.g., sedatives, tranquilizers).
Antiplatelet Interference (Metamizole) May diminish the irreversible antiplatelet effect of Acetylsalicylic Acid (ASA), potentially requiring a time-separation rule for administration.

Interaction Constraints

The strong enzyme-inducing activity necessitates the use of non-hormonal contraception when co-administering with hormonal birth control. Furthermore, use is constrained in patients with severe hepatic impairment, as reduced clearance of the Phenobarbital component increases the risk of clinically significant interactions.

Mechanism of Action

Андипал is a fixed-dose combination pharmaceutical formulated on the synergistic action of its four components across distinct molecular targets.

Papaverine modulates smooth muscle tone by inhibiting phosphodiesterase (PDE) enzymes. This action elevates the intracellular concentration of cyclic adenosine monophosphate (cAMP), triggering a cascade that results in the relaxation of smooth muscle cells and subsequent reduction in peripheral vascular resistance. Diphenhydramine acts as an H1-receptor antagonist, competitively binding to H1-receptor sites, which mitigates the effects of histamine-induced vasodilation. Metamizole sodium primarily inhibits cyclooxygenase (COX) enzymes, leading to a reduction in the synthesis of prostaglandins in the central and peripheral nervous systems. Phenobarbital allosterically modulates the GABAA receptor complex, enhancing the effect of GABA by increasing chloride ion influx, which promotes enhanced central inhibitory neurotransmission.

Dosage and Administration Information

The administration of Андипал follows established guidelines for the short-term use of this fixed-dose combination product. The product is administered via the oral route as a tablet and is taken according to a structured, divided daily regimen.


Standard Dosing and Administration

The procedural rules for taking the drug specify that the tablets are to be swallowed whole and not crushed or chewed, and should be taken with a sufficient amount of liquid. The general principle of use is that treatment begins with the lowest effective dose.

Dosing Parameter Official Instruction
Route Oral (tablet form).
Single Dose 1 tablet.
Frequency 2 to 3 times per day.
Maximum Daily Limit 3 tablets.

Regimen and Special Use Conditions

The medication is intended for short-term use, and the duration of administration does not exceed three days without medical reassessment. This time constraint characterizes the drug's use as an acute symptomatic measure.

The official instructions also include specific constraints based on patient demographics and health status. The use of the product is contraindicated for children under 8 years of age. For individuals 8 years and older, the administration follows the standard regimen of 1 tablet, 2–3 times per day. Furthermore, the instructions specify a dose reduction for patients with confirmed renal or hepatic impairment, a modification due to the potential for slower drug clearance.

Recent Clinical Evidence

Research evidence / Overview of studies for Андипал

Evidence for Symptomatic Relief of Tension-Type Headache

Research examining the use of this fixed combination, which includes analgesic and antispasmodic components, for managing acute tension-type headache primarily relies on studies exploring similar multimodal pain relief strategies. Researchers have used short-term randomized controlled trials (RCTs) and systematic reviews to study how symptoms change over time for acute pain episodes. These studies typically apply to adults experiencing conditions characterized by episodic manifestations.

The evidence so far indicates that research has focused on outcomes related to physical discomfort, specifically measuring acute changes in pain intensity using patient-reported outcomes describing perceived discomfort. Trials monitored responses over defined time intervals, reporting how symptoms evolved in the observed populations during periods of increased symptom activity. These findings describe patterns observed in the studies related to measurements of pain changes shortly after administration.


Evidence for Discomfort Related to Visceral or Vascular Spasm

The research landscape for this combination's use in conditions associated with acute or disruptive episodes, such as those involving visceral or vascular smooth muscle spasms, is composed of comparative pharmacological studies and observational data. Research examined temporary physiological imbalance, specifically focusing on the outcomes related to systemic or functional imbalance caused by the spasm.

The studies explored how combining an agent that relaxes smooth muscle with an analgesic agent was evaluated in the context of the two primary issues: the spasm itself and the associated pain. Findings described patterns observed in the studies related to both the muscle tension and the measured discomfort. Additionally, because the formula includes Phenobarbital, research describes observations related to the measured calming or sedative effects that occurred during the observed time intervals.


Key Limitations and Uncertainty in the Research Landscape

The overall evidence quality varies across studies, as much of the existing data draws from research on its individual active ingredients or from different, but related, fixed-dose combination principles. The available evidence base for the specific fixed-dose combination (Андипал) is characterized by limitations concerning sample sizes and comparative data in major peer-reviewed international literature.

Across both studied indications, the research exploring short-term symptom changes overwhelmingly focuses on the acute response. Follow-up durations were limited, resulting in limited information for long-term outcomes or durability of effect. Data for certain groups, such as older adults or those with multiple co-occurring health issues, remain insufficient.

Key Studies & References

  1. NIH's LiverTox review on Metamizole (Dipyrone)

Frequently Asked Questions (FAQ)

Common questions about Андипал (FAQ)

Q: Are there any specific safety warnings for people with liver issues using Андипал?

A: Regulatory documents state that severe hepatic insufficiency (serious liver issues) is an absolute reason to avoid the medicine (a contraindication).

If a patient has confirmed hepatic impairment (less severe liver issues), the official instructions require a dose reduction. This highlights the importance that patients share all existing health conditions with a healthcare provider.

Q: What should be known about Андипал's eligibility for people who are elderly?

A: Official regulatory sources do not list advanced age alone as an absolute reason to avoid the drug (a contraindication).

However, overviews of the official research indicate there is limited data specifically concerning its use in older adults.

Q: Is Андипал primarily intended for occasional use or for a long period?

A: The medicine is formally approved for short-term use only. Official instructions recommend that the administration duration not exceed three days without a medical reassessment.

Furthermore, regulatory documents note that long-term therapy carries a documented risk of physical and psychological dependence.

Q: Are there research papers looking at the long-term use of Андипал?

A: Official research reviews indicate that there is limited information available regarding long-term outcomes or the durability of the effect.

This is in line with the medicine’s purpose as a short-term symptomatic measure, and the regulatory safety profile notes that long-term use is associated with risks of dependence.

Q: Can people who have kidney problems use Андипал?

A: According to official documents, severe renal insufficiency (serious kidney issues) is listed as an absolute contraindication.

For individuals with confirmed renal impairment that is not severe, the instructions require a dose reduction. Due to the need for dose modification or contraindication, official guidelines require that kidney problems be communicated to a healthcare provider.

Q: Does the evidence suggest Андипал is suitable for managing chronic conditions?

A: Official guidelines approve the medicine for short-term use only, defining its role as an acute symptomatic measure.

Research evidence is limited concerning the long-term outcomes typically evaluated for the management of chronic conditions.

Q: Can Андипал cause drowsiness or affect driving ability?

A: Regulatory safety documents commonly report effects such as somnolence, drowsiness, and dizziness.

Individuals should exercise caution when driving or operating machinery due to these potential effects on the Central Nervous System (CNS).

Q: What are the key safety points about Андипал that patients should know?

A: Official product information highlights key safety points, including a list of conditions that are contraindications (such as severe organ or blood issues).

Other points include the risks of serious adverse reactions (like agranulocytosis) and potential interactions with other medicines, including oral contraceptives and alcohol.

Q: Is the term 'spasmolytic' or 'antispasmodic' officially used to describe part of Андипал's action?

A: Yes, the official Pharmacological Class for the medicine includes the term Antispasmodic.

This classification defines the drug as a Combined Antispasmodic-Analgesic and Sedative Agent.

Q: What are the findings from research regarding the safety profile of Андипал?

A: Research studies have focused on acute changes in pain intensity and observed the drug's calming or sedative effects.

The safety profile is further defined in regulatory documents, which list rare but serious risks such as agranulocytosis (a serious blood disorder).

Q: Does the drug's purpose involve treating the cause of pain or just the symptom?

A: Regulatory documents define the drug’s role as an acute symptomatic measure.

Its purpose is to provide symptomatic relief from discomfort and pain, meaning it addresses the symptoms but not the underlying condition causing them.

Q: Can you take Андипал if you also take vitamins or supplements?

A: General interaction constraints indicate that the drug has the potential to reduce the efficacy of many other drugs due to its composition.

Regulatory materials commonly state the importance of reporting all other products, including medicines, vitamins, and supplements, to a healthcare provider.

Q: Are there any widely known non-medicine interactions for Андипал?

A: The official interaction profile explicitly notes that co-administration with Ethanol (alcohol) can lead to enhanced Central Nervous System (CNS) effects.

Other common non-medicine substance interactions (like specific foods) are not specified in the regulatory documents.

Q: Do official sources discuss any potential interactions with caffeine intake?

A: Official drug interaction information for the combination product does not explicitly mention caffeine intake.

However, interactions with other CNS Depressants (medicines that slow down the brain and nervous activity) are specified.

Q: Are there known or published interactions between Андипал and common cold medications?

A: The official interaction profile warns of enhanced effects when taken with other CNS Depressants (drugs that slow down the nervous system).

Since some cold medications contain these types of ingredients, regulatory materials commonly highlight the importance of checking all ingredients for potential overlaps or contraindications.

Q: What should a patient know about using Андипал with other blood pressure medicines?

A: The medicine is contraindicated (should not be used) in patients with specific cardiovascular conditions, such as tachyarrhythmia.

Official documents also list hypotension (low blood pressure) as a common side effect.

Q: Does the official information include any warnings about stopping Андипал suddenly?

A: The medicine contains Phenobarbital, which is associated with a risk of dependence when used over a long period.

Although the drug is only approved for short-term use, it is appropriate for the possibility of withdrawal effects upon discontinuation to be discussed with a healthcare provider.

Q: Are there specific symptoms that indicate a user should stop taking Андипал and seek help?

A: Regulatory safety documents detail rare but serious reactions associated with the medication.

These include agranulocytosis (a severe drop in white blood cells) or anaphylactic shock (a severe allergic reaction), which would require immediate medical attention.

Q: Are there common questions about Андипал's potential effect on heart rate?

A: Official documents state the medicine is contraindicated for patients with certain cardiovascular issues, such as tachyarrhythmia (an irregular and rapid heart rate).

Furthermore, hypotension (low blood pressure) is listed as a common side effect in the regulatory safety profile.

How should Андипал be stored and disposed of?

How to Store and Dispose of Андипал

This information reflects the official storage and disposal requirements for Андипал (Andipal) as documented in regulatory labeling.

Storage Requirements

The medicine must be stored at a room temperature not exceeding 25 °C (77 °F) and protected from both moisture and direct light. It is essential to keep the tablets in the original container or packaging until the time of use and to ensure the product is kept out of the reach and sight of children to prevent accidental ingestion. Freezing the product is prohibited.

Disposal Instructions

Do not use the medicine after its expiration date. Unused or expired Андипал should not be disposed of in household trash or poured down a sink or toilet. Disposal must follow pharmaceutical waste protocols, typically requiring the return of the product to a pharmacy or an authorized government take-back program. This practice protects the environment from potential contamination.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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