Combined analgesics based on paracetamol and barbiturates

Quintalgin, Pentalgin Plus, ICN Pentalgin, Piralgin, Sedal-M, Sedalgin-Neo, Neo-Teofedrin, Teofedrin-N, Tempalgin.

Film-coated tablets.

Combined drugs have analgesic , antipyretic , vasodilating , anti-migraine and antitussive effects. Eliminates the symptoms of the common cold and flu .

• Caffeine stimulates the psychomotor centers of the brain , has an analeptic effect, enhances the effect of analgesics , eliminates drowsiness and a feeling of fatigue, and increases physical and mental performance.
• Codeine has a central antitussive effect (by suppressing the excitability of the cough center), as well as an analgesic effect due to the excitation of opiate receptors in various parts of the central nervous system , leading to stimulation of the antinociceptive system and a change in the emotional perception of pain. To a lesser extent than morphine , it depresses respiration, less often causes miosis , nausea , vomiting and constipation (activation of opioid receptors in the intestine causes relaxation of smooth muscles , decreased peristalsis and spasm of all sphincters ).
• Paracetamol is a non-narcotic analgesic ; blocks COX1 and COX2 mainly in the central nervous system, affecting the centers of pain and thermoregulation; It has an analgesic and antipyretic effect.
• Propiphenazone has an analgesic and antipyretic effect.
• Metamizole - NSAIDs , has an analgesic, antipyretic, antispasmodic effect on the smooth muscles of the urinary and biliary tract .
• Phenobarbital is an antiepileptic , has a sedative , hypnotic , antispasmodic and muscle relaxant effect. The duration of action is 4-6 hours.
• Ephedrine is a sympathomimetic, stimulates alpha and beta adrenoreceptors . It causes a vasoconstrictor , bronchodilator and psychostimulating effect.
• Belladonna leaf extract is used to treat diseases associated with convulsive pain.
• Theophylline - a bronchodilator , a derivative of purine ; inhibits phosphodiesterase , reduces contractile activity of smooth muscles. It relaxes the muscles of the bronchi , blood vessels (mainly the vessels of the brain, skin and kidneys); It has a peripheral vasodilating effect, increases renal blood flow, has a moderately pronounced diuretic effect.

Pain syndrome (mild to moderate intensity): arthralgia , myalgia , neuralgia , sciatica, migraine , toothache and headache , algomenorrhea ; pain with injuries, after tooth extraction , with burns ; febrile syndrome (including acute respiratory viral infections ).

Hypersensitivity , severe hepatic and / or renal failure , glucose-6-phosphate dehydrogenase deficiency ; anemia , leukopenia ; bronchial asthma , conditions accompanied by respiratory depression; intracranial hypertension , acute myocardial infarction ; arrhythmias , intoxication, glaucoma , pregnancy , lactation , children's age (up to 12 years).

Caution

Peptic ulcer of the stomach and 12 duodenal ulcer (in the acute stage), arterial hypertension, advanced age.

Inside, 1 tablet; if necessary - 1 tablet 4 times a day; the maximum single dose is 2 tablets, daily - 6 tablets. The course of treatment is up to 5 days.

Allergic reactions ( rash , itching , urticaria ), dizziness , drowsiness, decreased rate of psychomotor reactions, palpitations , tachycardia , nausea , vomiting, constipation; leukopenia , granulocytopenia, agranulocytosis . With prolonged uncontrolled intake in high doses - addiction (weakening of the analgesic effect), drug dependence (codeine); impaired liver and / or kidney function .

Overdose

Symptoms

Nausea, vomiting, gastralgia , tachycardia, arrhythmias, depression of the respiratory center.

Treatment

Gastric lavage , the appointment of intestinal adsorbents, symptomatic therapy.

With prolonged (more than 1 week) treatment, control of the peripheral blood picture and the functional state of the liver is necessary. May alter athletes' doping control test results. Diagnosis of “acute abdomen” is difficult. Patients suffering from atopic bronchial asthma , hay fever , have an increased risk of allergic reactions. During treatment, ethanol should be discontinued and caution should be exercised when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

With the simultaneous use of drugs that inhibit the central nervous system (including sedative drugs and anxiolytics ), an increase in the severity of the sedative effect and inhibitory effect on the respiratory center is likely. Enhances the effect of ethanol on the psychomotor reaction. Metoclopramide accelerates the absorption of paracetamol. Under the influence of paracetamol, the elimination time of chloramphenicol increases by 5 times. With repeated use, paracetamol may enhance the effect of anticoagulants ( dicumarin derivatives ). Caffeine accelerates the absorption of ergotamine . The simultaneous use of paracetamol and ethanol increases the risk of hepatotoxic effects. Metamizole reduces the concentration of cyclosporine . Displacing oral hypoglycemic drugs, indirect anticoagulants, corticosteroids and indomethacin from the association with protein , increases their activity. Tricyclic antidepressants , oral contraceptives and allopurinol disrupt the metabolism of metamizole in the liver and increase its toxicity. Barbiturates, phenylbutazone and other inducers of microsomal liver enzymes weaken the effect of metamizole. The simultaneous use of the drug with other non-narcotic analgesics can lead to increased toxic effects. Ephedrine weakens the effects of narcotic analgesics and sleeping pills.

• Paracetamol-based combined analgesics