Panadol acting. Drug Description Panadol

Panadol is a means of medicinal, which affects the body, like antipyretic effect and analgesic.

Release form of this medicine: Panadol tablets. Depending on the features, these tablets are divided into: soluble tablets (they are dispersed) are flat ellipse structures with a bevelled edge; Covered with film shell tablets in the form of a capsule with a flat edge.

Panadol: instructions for use

Indications for Panadol:

• As symptomatic therapy of feverish syndrome (with cold and flupes) as an antipyretic agent.
• As symptomatic therapy with pain syndrome (also with pain during menstruation, muscle pain, pain pain and lumbar pain) as an anesthetics.

Contraindications for the use of Pandola. They are divided into absolute and relative.

Among the list absolute are such conditions as:

• Junior age, excluded the use of the drug to children under the age of 6 years.
• Reception of this drug is excluded and with an increased sensitivity in the body to any component that is part of the drug.

Among the list of relative contraindications, these are conditions such as:

1. Hepatitis viral.
2. Hyperbilirubeimia benign.
3. Laptop glucose-6-phosphate dehydrogenase.
4. Failure renal and liver.
5. Alcohol and liver lesion is alcoholic.
6. Feeding period of chest or.
7. Elderly age.

Pandola use methods

Take this medicinal tool is required inside. Moreover, if it is dispersible pills, then pour water before use so that they dissolve in it. The volume of water for dissolving one pandol tablet is 100 ml.

Also, the drug provides a special treatment scheme. Given the fact that the break between doses of one-time drug can not be less than 4 hours.

For adults, the dosage is calculated in such a way that on the day they should not drink more than 4 grams (this is the total daily dose). It is more often assigned to 1 gram about 4 times a day. In compliance with the main order of reception this medicineNo earlier than 4 hours to take the next dose of the drug.

Children B. age group From 9 to 12 years have a slightly reduced testimony of the Pria. Their maximum dosage per day will be already equal to only 2 grams. These 2 grams are divided into 4 receptions during the day. And one turn is equal to a dose of 0.5 grams of medication.

Children in the age group from 6 to 9 years old have an even lower mass of the drug for reception. And the maximum daily dosage of Panadol they already have 1 gram per day. And for one reception - this is 0.25 grams.

If Panadol is accepted without medical control, then the course of treatment cannot be more than five days to control the anesthesia. And no more than three days for treatment as an antipyretic agent. It is important to know that the slightest changes in the scheme that the doctor recommended should be discussed in the doctor's office.

Pandola composition

The composition of Panadol as well as the types of its dosage forms are divided into two types.

The first. This is the composition for the tablet dispersible. The active substance is such a tablet contains 0.5 grams. This active ingredient is paracetamol. But this is not one of the components of Panadol. Also, the drug also contains additional components, such as: sodium bicarbonate, citric acid, sorbitol, sodium saccharinate, povidone, sodium carbonate, sodium lauryl sulfate, dimethicone.

Second. This is the composition for a tablet covered with a film shell. Such one tablet contains 0.5 grams of paracetamol, active substance drug. And plus additional components: hypimloose, talc, corn starch, pre-mentioned starch, calcium sorbate, triacenetin, stearic acid.

Suppresses the synthesis of PG into the CNS, reduces the excitability of the hypothalamic center of heat regulation, increases the heat transfer. Quickly and almost completely absorbed from the gastrointestinal tract. Plasma concentration reaches a peak after 30-60 minutes, T1 / 2 plasma - 1-4 hours. Metabolized in the liver. It is allocated with urine, mainly in the form of esters with glucuronic and sulfuric acids; less than 5% is excreted in unchanged form. The analgesic and antipyretic properties; The latter are manifested in the conditions of feverish syndrome of any genesis.

Indications for the use of drug Panadol adult

Pain and moderate intensity (headache, migraine, back pain, arthralgia, Malgy, neuralgia, toothache, Menalgia). Fevering syndrome with colds.

Contraindications for the use of drug Panadol adult

Hypersensitivity.

Application of drug Panadol adult

Inside the adult Panadol is prescribed in a single dose of 500 mg (the maximum one-time dose is 1 g). Purpose of destination - up to 4 times a day. Maximum daily dose - 4 g. The maximum duration of treatment is 5-7 days.
One-time doses for children aged 6-12 years - 240-480 mg; 6-12 years - 240 mg; 1-6 years - 120-240 mg; From 3 months to 1 year - 24-120 mg. Panadol destination is 4 times a day; The interval between each reception is at least 4 hours. The maximum duration of treatment is 3 days.
When taking inside the tablet, the capsules of the Panadol are watered with water.

Side effects of drug Panadol adult

Allergic reactions in the form of skin rashes.

Overdose drug Panadol adult, symptoms and treatment

Overdose symptoms in the first 24 h - pallor, nausea, vomiting and pain in the abdominal area. After 12-48 hours, after admission, kidney and liver may be observed with the development of hepatic insufficiency (encephalopathy, coma, lethal outcome). Liver damage is possible when taking for 10 g and more (in adults). Acute renal failure Channel necrosis can develop in the absence of severe liver damage. Other manifestations of overdose are heart arrhythmias and pancreatitis.

Special instructions for the use of drug Panadol adult

Caution is used in patients with impaired liver or kidney function. The risk of hepatotoxic action increases with the simultaneous purpose of the barbiturates, diphenin, carbamazepine, rifampicin, zidovudine and other inductors of microsomal liver enzymes, as well as at the same time receiving methoclopramide, domperidone and cholestiramine. It is recommended to avoid long and regular reception of paracetamol as an anesthetic .

List of pharmacies where you can buy Panadol adult:

• St. Petersburg

Registration number: N014375 / 01-050214
Trade proprietary title: Panadol®
International unpatient name: Paracetamol.
Dosage form: soluble tablets

Composition (on a tablet)
Active substance: Paracetamol 500 mg.
Excipients: Sorbitol 50 mg, sodium saccharinate 10 mg, sodium hydrocarbonate 1342 mg, povidone 1 mg, sodium Lauril sulfate 0.1 mg, dimethicone 1 mg, citric acid 925 mg, sodium carbonate 134.2 mg.

Description.
Flat white tablets with beveled around the edge of the edge, with risky on one side. The surface on both sides of the tablet may be slightly rough.

Pharmacotherapeutic Group: Analgesic nonarcotic agent.
ATH code: N02BE01

Pharmacological properties

The drug has painkillers and antipyretic properties. Blocks COF1 and COG2 mainly in the CNS, affecting the centers of pain and thermoregulation. Anti-inflammatory effect is practically absent. Does not cause irritation of the gastric and intestine mucosa. It does not affect water-salt exchange, because it does not affect the synthesis of prostaglandins in peripheral tissues.

Pharmacokinetics.

Absorption is high, TCmax is achieved through 0.5-2 hours; Cmax - 5-20 μg / ml. Communication with plasma proteins - 15%. Penetrates through the BC. Less than 1% of the adopted dose of paracetamol adopted by the dose breast milk. The therapeutically effective concentration of paracetamol in plasma is achieved when it is prescribed at a dose of 10-15 mg / kg. Metabolized in the liver (90-95%): 80% enters the reaction of conjugation with glucuronic acid and sulfates to form inactive metabolites; 17% is subjected to hydroxylation with the formation of 8 active metabolites, which are conjugated with glutathione with the formation of already inactive metabolites. With a lack of glutathione, these metabolites can block enzyme hepatocyte enzyme systems and cause them necrosis. In the metabolism of the drug also involved the CYP2E1 isoenzyme. Half-life (T1 / 2) - 1-4 h. Is excreted by the kidneys in the form of metabolites, mainly conjugates, only 3% unchanged. The elderly patients decrease the clearance of the drug and the half-life increases.

Indications for use

Panadol® is used to facilitate headaches, migraine, dental pain, throat pain, back pain, pain in muscles, painful menstruation. Panadol® also applies to symptomatic treatment feverish syndrome (as an antipyretic means); for increased temperature Body background "cold" diseases and influenza. The drug is intended to reduce pain at the time of use and the progression of the disease does not affect.

Contraindications

Hypersensitivity;
- childhood up to 6 years

Carefully

Apply with caution in renal and liver failure, benign hyperbilirubinemias (including Zhilbera syndrome), viral hepatitis, deficiency of glucose-6-phosphatehydrogenase, alcohol lesion of the liver, alcoholism, in old age.

Application during pregnancy and in breastfeeding period

According to epidemiological studies among pregnant women, paracetamol has no adverse effects when applied in the recommended doses during pregnancy. However, use during pregnancy is possible only after consulting with the doctor.
Paracetamol penetrates breast milk in minor quantities. According to the published data, use during breastfeeding Not contraindicated.

Method of use and dose:

Inside.
PANADOL®, soluble tablets, should be dissolved before receiving by no less than 100 ml (half a compound) of water.
Adults (including the elderly):
1-2 tablets (0.5 - 1 g) up to 4 times a day, as needed. Maximum single dose - 2 tablets (1 g). Maximum daily dose - 8 tablets (4 g). The interval between receptions is at least 4 hours.
Children
The dose is calculated, based on the body's mass of the child: the maximum one-time dose is 15 mg / kg of body weight, the maximum daily dose is 60 mg / kg body weight.
Children (6-9 years old): 1/2 tablets (250 mg) up to 4 times a day, as needed. Maximum one-time dose - 1/2 tablet (250 mg). Maximum daily - 2 tablets (1 g). The interval between receptions is at least 4 hours.
Children (9-12 years old): 1 tablet (500 mg) up to 4 times a day, as needed. Maximum single dose - 1 tablet (500 mg). Maximum daily dose - 4 tablets (2 g). The interval between receptions is at least 4 hours.
In adults, the drug is not recommended to use more than 5 days as an anesthetic and more than 3 days as an antipyretic means without appointing and observing the doctor. In children, the drug is not recommended to apply more than 3 days without appointing and observing the doctor.
Do not exceed the specified dose. If the recommended dose is exceeded, consult a doctor immediately, even if you feel good, as there is a risk of delayed serious liver damage.
The increase in the daily dose of the drug or the duration of treatment is possible only under the supervision of the doctor.

Side effect

In the recommended doses, the drug is usually well tolerated. Substituted side effects Revealed spontaneously in the course of the preparation use of the drug.
Side effects are classified by organs and frequency systems. The frequency of side effects is defined as follows: Very often (greater than or equal to 1/10), often (greater than or equal to 1/100 and less than 1/10), infrequently (greater than or equal to 1/1000 and less than 1/100), rarely ( More than or equal to 1/10,000 and less than 1/1000) and very rarely (more than or equal to 1/100 000 and less than 1/10,000).
Allergic reactions:
Very rare - in the form of rashes on, skin, itching, angioedema edema, Stevens-Johnson syndrome, anaphylaxis;
From the hematopopitation system:
Very rarely thrombocytopenia, methemoglobinemia, hemolytic anemia;
From the respiratory system:
Very rarely - bronchospasm (in patients with hypersensitivity to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs);
From the hepatobiliary system:
Very rarely - violation of the liver function.
For long use In high doses, the likelihood of violation of the liver and kidney function increases ( renal colic, nonspecific bacteriuria, interstitial nephritis, papillarous necrosis), is necessary to control the blood picture.
If any of the listed side effects occur, stop taking the drug and immediately consult a doctor.

Overdose

Symptoms: During the first 24 hours after overdose of nausea, vomiting, stomach pain, sweating, pallor skin Pokrov, anorexia. After 1-2 days, signs of liver damage are determined (soreness in the field of liver, increasing the activity of "liver" enzymes). It is possible to develop a violation of carbohydrate metabolicism and metabolic acidosis. In adult patients, liver damage is developing after receiving more than 10 g of paracetamol. In the presence of factors affecting the toxicity of paracetamol for the liver, (see section "Interaction with other drugs", " special instructions») Liver damage is possible after receiving 5 or more grams of paracetamol. In severe cases of overdose as a result of hepatic failure, encephalopathy (violation of the brain function), bleeding, hypoglycemia, brain swelling, up to death, can develop. It is possible to develop acute renal failure with acute tubular necrosis, characteristic features which is pain in the lumbar region, hematuria (blood cell or erythrocytes in the urine), proteinuria ( increased content Protein in the urine), while severe liver damage may be absent. There were cases of violation of heart rhythm, pancreatitis.
Treatment: With suspected overdose, even in the absence of pronounced first symptoms, it is necessary to stop the use of the drug and immediately apply for medical help. Within 1 hour after an overdose, it is recommended to wash the stomach and reception of enterosorbents ( activated carbon, Polyfepan). The level of paracetamol in the blood plasma should be determined, but not earlier than 4 hours after overdose (earlier results are unreliable). The introduction of acetylcysteine \u200b\u200bwithin 24 hours after overdose. The maximum protective effect is ensured during the first 8 hours after an overdose, with time the efficiency of the antidote drops sharply. If necessary, an acetylcysteine \u200b\u200bintravenously is introduced. In the absence of vomiting before the patient's admission to the hospital, the use of methionine is possible. The need to carry out additional therapeutic measures (the further administration of methionine, B / in the administration of acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as from the time after its reception. Treatment of patients with a serious violation of the liver function 24 hours after receiving paracetamol must be carried out in conjunction with the specialists of the toxicological center or specialized branch Liver diseases.

Interaction with other medicines

The long-term joint use of paracetamol and the NSAID increases the risk of developing "analgesic" nephropathy and renal papillary necrosis, the occurrence of the terminal stage of renal failure.
The simultaneous prolonged use of paracetamol in high doses and salicylate increases the risk of developing kidney cancer or bladder.
With regular reception for a long time, the drug enhances the action indirect anticoagulantov (Warfarin and other kumarins), which increases the risk of bleeding. An episodic reception of a single dose of the drug does not significantly affect the effect of indirect anticoagulants.
Difluunisal increases the plasma concentration of paracetamol by 50%, which increases the risk of hepatotoxicity.
Barbiturates, carbamazepine, phenytoine, prison, ethanol, rifampicin, zidovudine, fluemicinol, phenylbutazone, pendant tricyclic, tricyclic antidepressants and other microsomal oxidizers increase the products of hydroxylated active metabolites, causes the possibility of developing severe liver damage with small overdoses of paracetamol (5 g and more ). Inhibitors of liver microsomal enzymes (cimetidine) reduce the risk of hepatotoxic action. Under the influence of paracetamol, the elimination time of chloramphenicol increases 5 times. Simultaneous reception of paracetamol and alcoholic beverages increases the risk of liver damage and acute pancreatitis.
Metoklopramide and Domperidon are increased, and the koligarine reduces the absorption rate of paracetamol.
The drug can reduce the effectiveness of uricosuric drugs.

special instructions

Before taking the drug "Panadol®", you must consult with your doctor if you take any of the drugs specified in the section "Interaction with others drugs».
If, when taking the drug, the improvement of the state is not observed or headache It becomes constant, you need to consult a doctor.
Glutathione deficiency due to disorder food Behavior, cystic fibrosis, HIV infection, starvation, exhaustion causes the possibility of developing severe liver damage in paracetamol overdoses (5 g or more).
The drug should not be taken simultaneously with other paracetamol-containing drugs.
Patients observing an inadequate or low-grade diet, when calculating the daily consumption of salts, the sodium content in the tablet (427 mg) should be taken into account.
When analyzing the determination of uric acid and the content of glucose in the blood, you should inform the doctor about the reception of the drug.
The preparation with caution should be used in fructose intolerance, since the drug contains sorbitol.
In order to avoid toxic lesion of the liver, paracetamol should not be combined with the admission of alcoholic beverages, as well as to take to persons prone to chronic, alcohol consumption
In the consumption of sodium bicarbonate in high doses, the development of disorders from the gastrointestinal tract is possible, including belching, nausea; It is also possible to develop hypernatremia, in this case it is necessary to control the water and electrolyte balance and apply the appropriate patient tactics.

Structure

N.and Tablet

Active substance: paracetamol 500 mg;

Excipients: Starch premaritalized, corn starch, povidone (K25), Talc, potassium sorbate, stearin acid, hypimosellos, triacenetin.

Description

White tablets coated with film shell, capsule shape with flat edges, with marking in the form of a triangular logo on one side and risk on the other side.

Pharmacotherapeutic group

Other analgesics and antipilers. Anilides. Paracetamol.

ATH code:N02B E01.

Indications for use

As a painlier and antipyretic agent for short-term use with:

Headache

Skeletal muscular pain

Menstrual pain

Dental pain

Symptoms of cold and influenza.

It can also be used for symptomatic relief of pain of light or moderate intensity in osteoarthritis diagnosed by a doctor.

Method of application and dosage

The drug is intended only for oral administration.

Adults, faces of old age and children aged 12 years and older: 1-2 tablets every 4-6 hours if necessary. The minimum interval between the receptions is 4 hours. Not more than 8 tablets (4000 mg) for 24 hours.

Children (6-11 years): On ½-1 tablet every 4-6 hours, if necessary, with an interval between receptions at least 4 hours. No more than 4 doses for 24 hours.

The maximum duration of application without the recommendation of the doctor - 3 days.

Patients with renal / hepatic insufficiency

Patients with severe hepatic or severe renal failure is not recommended to apply the drug. Patients who were diagnosed renal / liver failure should be consulted with a doctor before applying this drug.

The lowest dose should be used to achieve the therapeutic effect.

Contraindications

Increased sensitivity To paracetamol or any other component of the drug in history, children's age up to 6 years.

Precautionary measures

Contains paracetamol. Do not apply simultaneously with other paracetamol-containing means. Simultaneous use with other preparations containing paracetamol can lead to overdose.

Paracetamol overdose may cause irreversible liver damage, which can lead to liver transplant or lethal outcome.

Related liver diseases increase the risk of liver damage when receiving paracetamol. Before applying the drug, it is necessary to consult with the doctor regarding the possibility of using the drug in patients who were diagnosed with renal or hepatic failure.

There have been reported on cases of disorders of the liver / liver failure in patients with reduced glutathione levels (for example, in exhaustion, anorexia, a reduced body mass index, chronic alcohol abuse).

In patients with states that are accompanied by a decrease in glutathione levels (for example, with severe infections, such as sepsis), an increase in the risk of metabolic acidosis is possible.

When saving symptoms, you need to contact your doctor.

Keep out of the reach of children.

Interaction with other medicines

The drug with a long-term regular daily reception enhances the effect of anticoagulants (warfarin and other kumarins), which increases the risk of bleeding; One-time doses do not have a significant effect. Paracetamol absorption velocity may increase when used with metoclopramide and domperidone. Paracetamol absorption can decrease when applying with cholestiram.

Application during pregnancy and breastfeeding

Pregnancy. Clinical and up data clinical studies did not reveal the risk for pregnancy or intrauterine development. However, as with the use of any drug, it is necessary to follow the instructions of the doctor and exercise caution when used during the first trimester.

Chestveverman. These clinical studies have not revealed risk against breastfeeding or child to be breastfeeding.

Paracetamol penetrates through the placental barrier and stands out in breast milk.

Impact on the ability to drive a car and working with mechanisms

It is unlikely that paracetamol affects the ability to drive a car or working with mechanisms.

Side effect"Type \u003d" Checkbox "\u003e

Side effect

Very rarely (

From blood and lymphatic system: thrombocytopenia.

From side immune system: Anaphylaxis, hypersensitivity skin reactions, including skin rash, angioedema edema, Stevens-Johnson syndrome and toxic epidermal necroliz.

From the respiratory system: Bronchospasm in patients sensitive to aspirin and other NSAIDs.

From the side of the liver and biliary tract: Violations of the liver function.

Message about unwanted reactions

If you have any unwanted reactions, consult your doctor. This recommendation applies to any possible unwanted reactions, including those not listed in the liner. You can also report unwanted reactions to the information database for unwanted reactions (actions) for drugs, including messages about inefficiency. medicinal preparations. Reporting about unwanted reactions, you help to get more information about the safety of the drug.

Overdose

Exceeding the recommended dose of paracetamol can lead to hepatic failure, which in turn can cause liver transpotation or death. Acute pancreatitis was observed, most often with impaired liver function and hepatotoxicity. The risk of intoxicating paracetamol is higher in the elderly, young children, patients with liver diseases, chronic malnutrition, individuals with chronic alcoholism. In these cases, an overdose may be fatal. After one-time intake, the high dose of paracetamol in adults and children can develop full and irreversible liver necrosis, leading to hepatocellular insufficiency, metabolic acidosis, encephalopathy, coma and death.

The lesion of the liver in adults is possible when receiving 10 or more grams of paracetamol. Reception 5 or more grams of paracetamol can lead to a liver damage in patients with risk factors that include:

Long-term use of carbamazepine, phenobarbiton, phenytoin, prison, rifampicin, hunter or other drugs that induce liver enzymes;

Regular alcohol abuse;

Probable glutathionic deficiency (for example, in violation of nutrition, fibergation, HIV infection, starvation, cachexia).

Overdose symptoms usually appear during the first 24 hours and may include: nausea, vomiting, anorexia, skin pallor, abdominal pain.

Within 12-48 hours after an overdose, it is possible to raise the level of hepatic transaminase (ACT, ALT), lactate dehydrogenase and bilirubin.

Treatment:

It is necessary to immediately deliver the patient to the hospital. In the case of acute overdose, the concentration of paracetamol in the blood plasma should be measured no earlier than 4 hours after intake. The use of activated carbon is advisable if no more than 1 hour passed from the moment of receiving the excess dose. As soon as possible, impose antidot N-acetylcysteine \u200b\u200bor methionine in accordance with national recommendations.

If necessary, symptomatic treatment is carried out.

Pharmacological properties

Pharmacodynamics

The drug contains paracetamol - analgesic and antipictic (analgesic and antipyretic agent). The mechanism of action of paracetamol includes inhibition of prostaglandin synthesis, mainly in the central nervous system.

Pharmacokinetics

Absorption

Paracetamol is quickly and almost completely absorbed from the gastrointestinal tract. After receiving therapeutic doses, the maximum plasma concentration is achieved for 30-60 minutes, and the half-life is 1-4 hours.

Distribution

Binding with plasma proteins is minimal in therapeutic concentrations. Paracetamol is relatively uniformly distributed in most organism fluids. The degree of binding with plasma proteins is low and can vary.

Metabolism

Paracetamol is metabolized in the liver and is excreted in the urine mainly in the form of glucuronide and sulphate conjugates.

Election

Less than 5% paracetamol is output unchanged.

Shelf life

5 years. Do not use after the expiration date indicated on the package.

Storage conditions

Store at a temperature not higher than 25 ° C in an inaccessible place for children.

Form release

12 tablets in a blister from PVC / ALU. 1 blister along with instructions for use in a cardboard box.

Conditions of vacation from pharmacies

Without recipe.

Registration certificate holder:

Glasosmitklein Condumer Helker (Yuk) Treding Limited, 980 Great West Road, Brentford, Middlesex, TW8 9GS, United Kingdom / Glaxosmithkline Consumer Healthcare (UK) Trading Limited, 980 Great West Road, Brentford, Middlesex, Tw8 9GS, UK.

Manufacturer:

Glasosmitklein Dangang Limited, Nokbrak, Dangang, County Waterford, Ireland / GlaxosmithKline Dungarvan Limited, KnockBrack, Dungarvan, Co. Waterford, Ireland.

Packager and responsible for the release of the series:

Smithklein Bech S.A., ul. de Akhalvir, km. 2,500, Alcala de Enaren, 28806 Madrid, Spain / Smithkline Beecham S.A., Ctra. de ajalvir, km. 2,500, Alcala de Henares, 28806 Madrid, Spain.

If unwanted phenomena occurs when taking the drug, please inform you by email: (for Azerbaijan, Georgia, Uzbekistan, Tajikistan, Turkmenistan) and (for Armenia, Belarus, Kyrgyzstan and Mongolia). Messages about the complaints of the quality of the drug are accepted by email.

Trading stamps belong or used under license by GSK Group of Companies.

© 2018 GSK group of companies or their licensor.

N014409 / 01

Trade proprietary title: Panadol

International UnPatented Name:

paracetamol

Dosage form:

Tablets covered with film shell

Composition of the drug (1 tablet)

Active substance: Paracetamol 500 mg. Excipients: Starch corn, starch premaritalized, potassium sorbate, povedium, talc, stearin acid, triacenetin, hypimosellos.

Description
White tablets capsule shape with flat edge.

On one side of the tablet in the form of embossed Panadol was applied on the other side - risk.

Pharmacotherapeutic Group:

Analgesic nonarcotic agent.

ATX code: N02BE01

Pharmacological properties
The drug has painkillers and antipyretic properties. Blocks COF1 and COG2 mainly in the CNS, affecting the centers of pain and thermoregulation. Anti-inflammatory effect is practically absent. Does not cause irritation of the gastric and intestine mucosa. It does not affect water-salt exchange, because it does not affect the synthesis of prostaglandins in peripheral tissues.

Pharmacokinetics
Absorption is high, TCmax is achieved through 0.5-2 hours; CMS - 5-20 μg / ml. Communication with plasma proteins -15%. Penetrates through the BC. Less than 1% of the adopted nursing mother of the Paracetamol dose penetrates into breast milk. The therapeutically effective concentration of paracetamol in plasma is achieved when it is prescribed at a dose of 10-15 mg / kg. Metabolized in the liver (90-95%): 80% enters the reaction of conjugation with glucuronic acid and sulfates to form inactive metabolites; 17% is hydroxylation with the formation of active metabolites, which are conjugated with glutathione with the formation of already inactive metabolites. With a lack of glutathione, these metabolites can block enzyme hepatocyte enzyme systems and cause them necrosis. In the metabolism of the drug also involved the CYP2E1 isoenzyme. The half-life (T1 / 2) -1-4 h. Is excreted by the kidneys in the form of metabolites, mainly conjugates, only 3% unchanged. The elderly patients decrease the clearance of the drug and the half-life increases.

Indications
Symptomatic therapy:

1. painful syndrome: with headaches, migraine, dental pain, throat pain, back pain, pain in muscles, painful menstruation
2. fevering syndrome (as an antipyretic means). With elevated body temperature on the background of "cold" diseases and influenza. The drug is intended to reduce pain at the time of use and the progression of the disease does not affect.

Contraindications

• hypersensitivity;
• children's age up to 6 years.

Carefully
Use with caution in renal and liver failure, benign hyperbilirubinemias (including zhilber syndrome), viral hepatitis, shortage of glucose-6-phosphate dehydrogenase, alcohol lesion of the liver, alcoholism, in old age, during pregnancy and lactation.

Method of use and dose:

Adults (including the elderly): 0.5 -1 g (1-2 tablets) up to 4 times a day, if necessary. The interval between receptions is at least 4 hours, a one-time dose (2 tablets) can be taken no more than 4 times (8 tablets) within 24 hours.

Children (6-9 years old): 1/2 Tablets 3-4 times a day, if necessary. The interval between receptions is at least 4 hours. Maximum one-time dose for children 6-9 years old - 1/2 tablets (250 mg), maximum daily daily - 2 tablets (1 g).

Children (9-12 years old): 1 tablet up to 4 times a day, if necessary. The interval between the techniques is at least 4 hours, a one-time dose (1 tablet) can be taken no more than 4 times (4 tablets) within 24 hours.

The drug is not recommended to apply more than 5 days as an anesthetic and more than 3 days of the antipyretic means without appointing and observing the doctor. The increase in the daily dose of the drug or the duration of treatment is possible only under the supervision of the doctor.

Side effect
In the recommended doses, the drug is usually well tolerated. Paracetamol rarely causes side effects. Sometimes it can be observed allergic reaction In the form of rashes on the skin, itching, swelling. Rarely - blood system disorders (anemia, thrombocytopenia, methemoglobinemia).

With long-term use in high doses, the likelihood of violation of the function of the liver and kidney function increases (renal colic, nonspecific bacteriuria, interstitial nephritis, papillarous necrosis) and monitoring blood pattern.

Overdose
The drug should be taken only in recommended doses. In case of exceeding the recommended dose, immediately refer to medical helpEven if you feel good, as there is a risk of delayed serious liver damage.

The lesion of the liver in adults is possible when receiving 10 or more grams of paracetamol. Reception 5 or more grams of paracetamol can lead to a liver damage in patients with the following risk factors:

• long-term treatment of carbamazepine, phenobarbital, phenytio, prison, rifampicin, pendant, or other drugs in stimulating liver enzymes, or other drugs;
• regular use of alcohol in excess amounts;
• perhaps having glutathione deficiency (having a nutritional disorder, fibrosis, HIV infection, hungry, exhausted)

Signs acute poisoning Paracetamol are nausea, vomiting, stomach pain, sweating, pallor of skin. After 1-2 days, signs of liver damage are determined (soreness in the field of liver, increasing the activity of "liver" enzymes). In severe cases, overdose is developing liver failuremay develop acute renal failure with tubular necrosis (incl. in the absence of severe liver damage), arrhythmia, pancreatitis, encephalopathy and coma. The hepatotoxic effect in adults is manifested when taking 10 g and more.

Treatment: Terminate the use of the drug and immediately consult a doctor. It is recommended to wash the stomach and reception of enterosorbents (activated carbon, polyfepan); The introduction of Donders of SH-groups and precursors of glutathione synthesis - methionine after 8-9 h after an overdose and N-acetylcysteine \u200b\u200b- after 12 hours. The need to carry out additional therapeutic measures (the further administration of methionine, in / in the introduction of N-acetylcysteine) is determined depending on The concentrations of paracetamol in the blood, as well as from the time passed after its reception. Treatment of patients with a serious impaired liver function 24 hours after receiving paracetamol must be carried out together with specialists of the toxicological center or specialized branch of liver disease.

Interaction with other medicines
Long-term sharing of paracetamol and other NSAIDs increases the risk of developing "analgesic" nephropathy and renal papillary necrosis, the occurrence of the terminal stage of renal failure.

The simultaneous long-term purpose of paracetamol in high doses and salicylate increases the risk of developing kidney cancer or bladder.

Difluunisal increases the plasma concentration of paracetamol by 50%, which increases the risk of hepatotoxicity.

Myelotoxic drugs enhance the manifestations of the hematotoxicity of the drug.

The drug during reception for a long time enhances the effect of indirect anticoagulants (warfarin and other kumarins), which increases the risk of bleeding. Inductors of microsomal oxidation enzymes in the liver (barbiturates, phenytoin, carbamazepine, rifampicin, zidovudine, phenytoin, ethanol, fluecinol, phenylbutazone and tricyclic antidepressants) increase the risk of hepatotoxic effects in overdoses. Microsomal oxidation inhibitors (cimetidine) reduce the risk of hepatotoxic action.

Metoklopramide and Domperidon are increased, and the koligarine reduces the absorption rate of paracetamol. Ethanol contributes to the development of acute pancreatitis. The drug can reduce the activity of uricosuric drugs.

special instructions
Before taking the drug, you must consult with your doctor if:

• You have a liver or kidney disease;
• You are taking drugs against nausea and vomiting (metoclopramide, domperidone), as well as drugs that reduce blood cholesterol (swiveramin);
• You are taking anticoagulants and you daily for a long time, painkillers are needed. Paracetamol in this case can occasionally be taken;
• You are pregnant or breastfeed;

When analyzing the determination of uric acid and blood sugar levels, you should inform the doctor about the reception of the drug.

To avoid toxic lesion of the liver, paracetamol should not be combined with the reception of alcoholic beverages, as well as to take to persons prone to chronic alcohol consumption.

Form release
Tablets covered with film shell of 500 mg.

PVC / aluminum blister containing 6 or 12 tablets.

1 or 2 blisters (6 or 12 tablets each) are packed in a cardboard pack along with instructions for use.

Shelf life
5 years.
Do not use after the expiration date indicated on the package.

Storage conditions
Store at a temperature not higher than 25 ° C.
Keep out of the reach of children.

Conditions of vacation from pharmacies
Without recipe.

Made GlaxoSmithKline Dungarvan Ltd.., Ireland, Nokbrak, Dungarvan, County Waterford / GlaxoSmithKline Dungarvan Ltd, Ireland, Knockbrack, Dungarvan, County Waterford for GlaxoSmithKline Consumer Helsker, United Kingdom, 980 Great West Road, Brentford, Middlesex, TW8 9GS / GlaxoSmithKline Consumer Healthcare , United Kingdom, 980 Great West Road, Brentford, Middlesex, TW8 9GS
Representative in the Russian Federation / Importer: JSC "Glaksmithklein Helker", Russia, 109180, Moscow, Yakimanskaya Nab., \u200b\u200bD.2.