2010/06/08

Paracetamol+Dextromethorphan

Trade name:
Grippostad Good Night

International name:
Paracetamol + Dextromethorphan (Paracetamol + Dextromethorphan)

Group Affiliation:
Analgetic tool

Description of the active substance (INN):
Paracetamol + Dextromethorphan

Dosage Form:
solution for oral administration, tablets effervescent

Mode of action:
Combined medication. Dextromethorphan has antitussive effect. Paracetamol has analgesic, antipyretic and weakly anti-inflammatory action.

Indications:
Symptomatic treatment of influenza, "cold" diseases.

Contraindications:
Hypersensitivity, severe renal / hepatic failure, lack of glucose-6-phosphate dehydrogenase, blood diseases, bronchial asthma, COPD (emphysema, chronic obstructive bronchitis), pneumonia, respiratory failure or respiratory depression, pregnancy and lactation, epilepsy, children's age (up to 16 years). C care. Simultaneous reception of MAO inhibitors, renal failure, congenital hyperbilirubinemia (Gilbert syndrome, Dubin-Johnson and Rotor), cough with abundant expectoration.

Side effects:
Excessive fatigue, dizziness, nausea, vomiting (disappear after discontinuation). Drug dependency (dextromethorphan), flushing of the skin, very rare - allergic reactions (skin rash), violations of blood (thrombocytopenia, leukopenia, agranulocytosis, pancytopenia). In some cases, in predisposed patients - bronchospasm ("Aspirin" Asthma), hypersensitivity reactions (angioedema, dyspnea, increased sweating, nausea, blood pressure reduction, until the shock). Overdosage. Symptoms (dextromethorphan): agitation, dizziness, respiratory depression, impaired consciousness, reduced blood pressure, tachycardia, muscle hypertonicity, ataxia. Treatment: intubation, artificial respiration (may need to take measures to protect against excessive heat loss). Symptoms (paracetamol) : receiving high doses of paracetamol may lead to toxic symptoms (duration of the latent period of 24 to 48 h). At the same time due to necrosis of liver cells can develop in violation of its functions, up to hepatic coma, including and fatal. Chance of necrosis of renal tubules with the development of renal failure. Symptoms: 1 day - nausea, vomiting, increased sweating, drowsiness, malaise, in the 2-day - a subjective improvement in well-being, mild abdominal pain, hepatomegaly, increased activity of "liver" of transaminases and bilirubin, prolongation of thromboplastin time, oliguria and in the third day - high "liver" enzymes, jaundice, blood coagulation disorders, hypoglycemia, hepatic coma. Treatment: within 6 hours - gastric lavage, in the first 8 h - i / in the introduction of donators SH-groups ( acetylcysteine), dialysis is effective (recommended determination of the concentration of paracetamol in plasma), symptomatic therapy.

Dosage and administration:
Inside, teenagers under age 16 and adults - 30 ml of 1 time per day (the evening, before bedtime). In renal / hepatic failure, hyperbilirubinemia reduce the dose. The duration of admission should not exceed 3-4 days.

Cautions:
The product contains 18 vol.% Ethanol. 30 ml containing 1.18 XU or 391 kj, respectively. In the period of treatment should refrain from the use of ethanol and use caution when driving vehicles, and occupation of other potentially hazardous activities that require high concentration and quickness of psychomotor reactions .

Interactions:
Enhances the effect on the CNS and the toxicity of MAO inhibitors and other drugs which depress the central nervous system. Stimulators of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, fenilbutazon, tricyclic antidepressants) increase the production of hydroxylated active metabolites, leading to the possibility of severe intoxication with small overdoses paracetamol; increase the concentration of dextromethorphan in the blood. With simultaneous use of paracetamol and zidovudine increases the risk of developing neutropenia. Metoclopramide accelerates the absorption and the onset of action. myelotoxic drugs increase the expression gematotoksichnosti drug. Paracetamol slows the excretion of chloramphenicol. Simultaneous reception of indirect anticoagulants must be used under medical supervision.