Powder from a cold teraflu. Teraflu in the treatment of cold and influenza: a powerful way to combat the disease

What types of "molecular impostors" are deceived by our receptors in the composition of drugs, why caffeine add to some of the powders from colds, whether the ascorbic is not useless in their composition and what's the series "in all the grave", we understand the heading "what we treat".

In August, the pharmaceutical market began to gain popularity drugs from ORVI symptoms. The teraflu-tested pharmacies torn on the rear shelves moved to the 14th line of the rating of the most purchased medicines, making a jump at 66 places up compared to July. Its sales in just a month increased by 123%. But is there a difference in efficiency between the theraflu and a simple paracetamol, which is included in its composition? Does the current pharmacy favorite of Pentalgin problems, is not very justified by combining numerous components? Let's figure it out.

What about what

Let's start with the composition of the teraflu. Immediately make a small reservation: we will not discuss the ointment, tablets and spray in this article, since they have a completely different set of components and a mechanism of action. In addition, these brand products are less popular.

Active substances The teraflu in the form of a powder is paracetamol, pheniramin, phenylephrine and ascorbic acid (vitamin C). In the theraflu of extra ascorbic acid, there is no paracetamol in the shock dosage of 650 mg (in one paracetamol tablet is usually from 200 to 500 mg). The number of the remaining ingredients in the theraflu of Extra is the same as in the usual: 20 mg of pheniramine and 10 mg of phenylephrine.

The structure of the phenylephrin molecule

JYNTO / WIKIMEDIA COMMONS

Initially, the theraflu was made with the addition of pseudoephedrine, one of the well-known means helping the nasal congestion, but a bluscle was launched with pseudoephedrine, the fans of the series "in all heavy" are quickly guessed: the craftsmen have adapted to do methamphetamine, so that this drug in 2005 2006 in the United States imposed strict legislative restrictions. In Russia, this substance entered the list of predecessors narcotic drugs, Therefore, its turnover is also strictly adjustable. After these events, many manufacturers preferred to replace the component on the phenylephrine so as not to reduce sales due to restrictions.

Fighting power over the receptor

Fenilephrin's terminology lovers will remind epinephrine - So in English-speaking medical literature is often called adrenaline. Names are similar due to structural similarity, and this similarity of phenylephrine uses in order to pretend to be a chemical "relative" in progressive meeting with adrenaline receptors of the alpha-1 type.

So the adrenaline molecule looks like. Looks like phenylephrine, isn't it?

Marinavladivostok / Wikimedia Commons

Safety molecules are several types: antagonists, agonists and inverse agonists. These types are easier to remember if you imagine the struggle for power in some kingdom.

The antagonist is the impoverished who, capturing the power, does not allow the receptor "throne" of this ruler and does not give it to spread the previous "decrees". Reverse agonist makes laws opposite to the will of the previous king. Phenylephrine acts otherwise. He is an agonist, so he launches the chain of events characteristic of sympathetic system: takes those laws that I would have published adrenaline, dancing on the balls, fascinates his bride (a similar story happens to Xylmetazoline, the active substance of the Nazivin, about which we have already talked about, only Phenylephrine is stronger than adrenaline. He completely steal the lives of our prince and now he does not refuse him.

An antagonist-impostor stops all adrenaline fun, while the agonist rushes into it with his head

Veronicago7 / Wikimedia Commons

We do not make sure about a sympathetic effect: adrenaline causes the excited state of "Bay or Run", in which the body obeys the action of sympathetic nervous system. As a result, the vessels are narrowed, with a smaller cross-sectional area increases blood pressure, breathing is rapidly, the heart begins to beat faster, and the digestion is suspended. In general, the body is preparing to reflect the attack or run away from danger. Phenylephrine works selectively with alpha-1 receptors and does not seek to act on other adrenaline receptors, so it should not make your heart score faster. However, its vasoconstrictor effect helps to eliminate the nasal congestion, and due to the ability to expand the pupil ophthalmologists use phenylephrine in the eye drops.

Another component of the theraflu, pheniramin, belongs to the group of antihistamine drugs and blocks the operation of the H1 receptor. This receptor is configured to take histamine - an important participant inflammatory processes. Instead, come antihistaminesthat this inflammation and tunes are removed. By the way, they were considered for a long time to be neutral antagonists who occupy a receptor and interfere with the histamine break through to him, but most of these drugs were in the inverse agonists.

I will consolidate the classification of impostors: the agonists are deceived forcing the receptor to work, even when there is no right-hand heir (the desired molecule), the antagonists do not give the ruler to return to the throne, preventing it from making decrees, but they themselves do not use the benefits of power, and inverse agonists occupy the throne and publish laws opposing the laws of the predecessor

D. Ilyin / Wikimedia Commons

And the pheniramine has a stereocenter. No, do not think, he does not carry musical columns with him. Stereocenter - point around which molecule can take two variants of spatial form, forming stereoisomers.

Two forms of pheniramine

DENWET / WIKIMEDIA COMMONS

Stereoisomers are the same by the formula and by structure, but in the space they could not be imposed on each other, like mirror images. Pheniramin in drugs is a mixture of equal amounts of two such isomers. This mixture is called a racemate, so do not be afraid if you see this word somewhere.

Paracetamol: in previous series

Paracetamol as an anesthetic and antipyretic we have already disassembled, but for those who missed, recall the plot of the previous series. Most likely, he interferes with the three sister-cycloxygenases, which in its "hairdresser" create prostaglandins from a non-sparkling arachidonic acid, which are "good" and "bad". "Bad" prostaglandins increase the sensitivity to pain, cause inflammation and fever.

Paracetamol molecule structure

Benjah-BMM27 / Wikimedia Commons

Therefore, non-steroidal anti-inflammatory drugs (NSAIDs), taking cyclooxygenases to his wife and interfering with them to work in a "hairdresser", save us from the anger of their dissatisfied customers. True, paracetamol is not entirely NSAID, and scientists still specify the plot of their "Santa Barbara". But already, thanks to Kohreinovsky review, we know that paracetamol can be effective against nasal congestion and a cold with a cold in adults.

The Kohreinov Library is the Database of the International Non-Profit Organization "Kohreinovsky Cooperation", participating in the development of the Governance of the World Health Organization. The name of the organization comes from the surname of its founder - the Scottish medical and physician of the XX century Archibald Kohrein, who defended the need for evidence-based medicine and conducting competent clinical trials and wrote the book "Efficiency and effectiveness: random reflections on health care." Medicine scientists and pharmacists consider the Kohrein database by one of the most authoritative sources of such information: the publications included in it were selected according to the standards of evidence-based medicine and talk about the results of randomized double-blind placebo-controlled clinical studies.

Vitamin C - Vitamin, which is better to take to prevent hypovitaminosis than colds, and reduces the duration of the ARVI, it is not strong. With complications bacterial infections (for example, at pneumonia) it helps better (read more about it in another of our material, and the body does not always receive it with food in sufficient quantity. In any case, because of 50 mg of vitamin C you do not get an overdose, so that Nothing terrible in the fact that he is in teraflu, no.

So, we have a mysterious, but domineering paracetamol, two impostors and ascorbica in addition. Phoenylephrine assigns adrenaline powers to help cope with the nasal mortgage, pheniramin with a stereocenter has its own orders, struggling with typical allergic symptoms (sneezing, tearing and also nose conjunction), and Paracetamol takes pain and fever. Theoretically, they look like a strong team, but what is the case with clinical studies and, most importantly, how good are they together?

Phenylephrine and pheniramin: similar name, different evidence

Data on two of our heroes on the letter "F" leaves much to be desired: about one conclusions of scientists are contradictory or disappointing, there is little more about the work (apparently, he rarely goes to the fight against the cold alone). In a double-blind randomized study, the results of which were released in the journal of the American College of Allergies, asthma and immunology, phenylephrine (in pills of 30 mg) with a deferred action were compared with placebo in patients (575 people) with allergic rhinitis and nasal congestion. No improvement in the group of phenylephrine did not find. Although perhaps this is a problem of such a form of release?

Double Blind Randomized Placebo-Controlled Method - Method clinical research Drugs in which the subjects are not dedicated to important details of the conducted research. "Double blind" means that there are neither the subject nor experimenters, "randomized" - that the distribution by groups is randomly, and placebo is used to show that the effect of the drug is not based on self-sustainment and that this medicine It helps better than a tablet without a valid substance. This method prevents subjective distortion of results. Sometimes the control group gives another drug with already proven effectiveness, not a placebo to show that the drug does not just treat better than anything, but also exceeds the analogues.

In another study, Phenylephrine was compared with pseudoephedrine and placebo and again did not find that it somehow helps against allergic running and nasal congestion, but pseudoephedrine was best. However, it should be noted that with the help of teraflu we treat allergic rhinitis, and usual. And against a cold with a cold, according to a review of eight very small studies, it still helps.

Contradictions and variation of opinions in the scientific community are explained in a letter to the editor of the same magazine of the American College of Allergies, Asthma and Immunology. The fact is that the liver enzymes quickly break down the phenylephrine, and only a small share of the substance falls into the bloodstream and reaches its destination. In large doses, it has not been studied, so to clarify the required amount of a substance (if it still helps) new research is needed.

What about Phoeniramine? A small scientific from Brazilian Journal of Anesthesiology confirms that he is successfully fighting with artificially caused by cough. The clinical test of the chemically similar, but effective in smaller doses of the "counterclaim" of Phoeniramin, Chloropheniramine, shows that it significantly reduces cold symptoms. The authors of the Kohreinovsky review dedicated to the struggle of antihistamine media conclude that they reduce the overall gravity of symptoms for a short time, but do not affect the runny nose, nasal congestion or sneezing frequency.

Universal formula and caffeine

In the case of drugs, the sum of two units can be equal not only to the deuce, but also a triple or even zero. Some preparations may interfere with the metabolism of others and in the end blocking or repeatedly enhanced some of each other effects, including side.

The formula "Analgesic + Decongestant + Antihistamine" Among the colds from the cold is very popular, the Koldrex, Ferwex, Rensasip, Antigrippin and still the darkness of these medicines are held. Sometimes there is also a vitamin C, which, as we remember, attribute the action against a cold, and caffeine (which is designed to fight drowsiness, including the antihistamine drug component). These drugs are very often produced in powders, which are dissolved in hot water. As analgesic, paracetamol is usually opposed.

In a randomized double-blind controlled study by 146 patients aged 18 to 60 years old, the magic combination showed its action against the SMI symptoms, reports in BMS infectious deseases. The authors of the study of one of the drugs in the same formula conducted on 1167 patients were compared the entire placebo drug, as well as its components in different combinations. As a result, scientists accounted for an efficiency hierarchy, where the drug is entirely on top, followed by a combination of paracetamol, caffeine and ascorbins, after them are chloropheniramine and ascorbic, which are already barely above placebo. Design Here you can call: I would like to learn more about the contribution of chloropheniramine and phenylephrine into action, because from vitamin C with caffeine powerful therapeutic effect No one would expect anyone.

Finally, Kohreinovsky review 2012, based on the analysis of 27 studies of drugs with such a universal formula (in the amount of the patients conducted at 5117), ends with the conclusion that such combined drugs helps with adults and adolescents. For young children, such evidence is absent.

Alas, all the geniuses of medicine are powerless before such a simple and even stupid to attack, as a cold. To cure her faster you will not help any drug - all hope for your body, so provide him with plenty of drink, warmth and rest and wait for five to seven days. However, ways to feel better, while immunity is engaged in the production of antibodies and is preparing to fight an ARVI or flu, there is. To bring down the temperature, defeat muscle pain and even, probably, to reduce the annoying runny nose will help paracetamol.

You can ask if it is easier to take it, the birth, and do not overpay for a beautiful box. Perhaps you are right, but if you want to additionally reduce the severity of symptoms, and even thanks to a drink with a pleasant taste, then soluble powders from a cold are your option. The temptation arises to offer a more pleasant alternative to small children, but with the evidence of the benefit of such a formula for them the situation is worse, so it is worth consulted with a doctor about each specific case.

Thus, if among the symptoms of your hands there is a runny nose and nasal congestion, you either choose a small arsenal (paracetamol, vaconishing drops etc.) separately, or buy one bag of combined means. From cough, however, such a bag of magic powder will not help, so it will have to fight separately. It may also be needed to rinse the nose with saline.

However, remember that local non-nasal stations (simply speaking, drops) are considered more effective. On the other hand, since the effectiveness of the decongestant as part of the Teraflu is in doubt, you are unlikely to receive medical rhinitis after it - when a runny nose has already passed, and it is still difficult to breathe due to the "addiction" of the body to the medicine.

And finally, again: of course, the teraflu contains not only paracetamol, but paracetamol is the most. Therefore, do not complement one powder with another or paracetamol in tablets - and before poisoning not far. In the treatment of paracetamol, it is important to comply with the dosage and not take it constantly (for example, in chronic diseases) in order not to suffer from hepatic or renal failure. The idea to combine paracetamol (and, accordingly, containing medicines) with alcohol or take it in a couple of hours after abundant libations, also clearly do not like your liver.

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One bag contains:
Active substances: Paracetamol 325 mg, phenylephrine hydrochloride 10 mg, pheniramine Maleate 20 mg, ascorbic acid 50 mg.
Excipients: Sodium citrate dihydrate, apple acid, dye Sunny sunset yellow, dye quinoline yellow, titanium dioxide, aromatizer lemon, calcium phosphate three-axle, citric acid, sucrose.

Description

Bulk white granulated powder with yellow splashes without outsided particles with citrus smell. Allowed by soft lumps.

Pharmacotherapeutic group

ARZ and "Cold" Symptoms Remedy (analgesic non-nancotic agent + alpha adrenomimetics + H1-histamine receptors Blocator + vitamin).

Pharmacological properties"Type \u003d" Checkbox "\u003e

Pharmacological properties

Combined drug, It has antipyretic, anti-essay, anesthetic and antiallergic effect.

Indications for use

Infectious inflammatory diseases (ARVI, flu) accompanied by high temperatures, chills, fragile in the body, head and muscular pain, runny nose, nose embezzlement, sneezing.

Contraindications

Increased sensitivity To individual components of the drug, simultaneous reception of tricyclic antidepressants, monoaminoxidase inhibitors, beta-adrenoblastors, portal hypertension, alcoholism, Sakharase / isomaltase deficiency, fructose intolerance, glucose-galactose maldoriety, pregnancy, period breastfeeding, childhood up to 12 years old.

For arterial hypertension, sugar diabetes, clotous glaucoma, severe liver diseases or kidney, lungs (including when bronchial asthma), difficulties of urination with the prostate gland adenoma, blood diseases, congenital hyperbilirubinemias (zhilbera syndromes, duby-johnson and rotor), hyperthyroidism, feuhromocytoma. If you have one of the listed diseases, you will definitely be consulted with your doctor before taking the drug.

Pregnancy and breastfeeding

Method of application and dosage

Inside.
The contents of one bag dissolve in 1 cup of boiled hot water. Use hot. You can add sugar to taste. Repeated dose can be taken every 4 hours (no more than 3 doses within 24 hours).
Teraflu® from influenza and colds can be used at any time of the day, but best Effect Brings the preparation before bedtime, overnight. If there are no facilitations of symptoms within 3 days after the start of receiving the drug, it is necessary to consult a doctor.

Side effect"Type \u003d" Checkbox "\u003e

Side effect

Possible allergic reactions (rash, itching, urticaria, angioedema), increased excitability, reducing the velocity of psychomotor reactions, feeling of fatigue, dry mouth, urine delay, nausea, vomiting, stomach pain, heartbeat, raising arterial pressure, dizziness, sleep disorder, mydriasis, accommodation paresis, an increase in intraocular pressure. Considering the presence of paracetamol: rarely - blood system disorders (anemia, thrombocytopenia, leukopenia, agranulocytosis), with long-term reception of high doses, hepatotoxic and nephrotoxic effect, hemolytic anemia, methemoglobinemia, pancytopenia are possible. If any of the side effects specified in the instructions are aggravated, or you noticed any other side effectsnot specified in the instructions

Report this to the doctor

Overdose

Nausea, vomiting, pain in the epigastric region, hepatotoxic and nephrotoxic effect, develops in severe cases liver failure, Encephalopathy I. coma.
Treatment: stomach wash, activated carbon In the first 6 hours, the introduction of Donders of SH-groups and precursors of glutathione synthesis -methionine after 8-9 h after overdose and N-acetylcysteine \u200b\u200bafter 12 hours

Interactions with other drugs

It is recommended to refrain from the reception of the drug when taking monoamoxidase inhibitors.
The risk of hepatotoxic action of paracetamol rises while simultaneously appointing barbiturates, phenytin, carbamazepine, rifampicin, zidovudine and other inductors of microsomal liver enzymes.
Enhances the action sedatives, ethanol. Ethanol enhances the sedative effect of pheniramine.
Antidepressants, anti-playing and antipsychotic drugs, phenothiazine derivatives increase the risk of urine delay, dry mouth, constipation.

special instructions"Type \u003d" Checkbox "\u003e

special instructions

In order to avoid toxic liver damage, the drug should not be combined using alcoholic beverages.
When taking the drug, it is not recommended to drive a car or other mechanisms. Do not use the drug from damaged bags.

Form release

Powder for preparing a solution for intake [lemon].
For plant Farman France. France:
22.1 g of powder in a 5-liter bag (low-density paper / polyethylene / polyethylene / aluminum foil / low-density polyethylene). 5, 6, 10 or 12 bags in a cardboard pack. Packets can be placed individually or bonded pairwise. The application instruction is applied to the bag.
For the factory Novartis Condumer Helsh Inc., USA:
22.1 g of powder in a 6-liter bag (low-density low-density polyethylene / polyethylene / low-density polyethylene / low-density polyethylene / polyethylene). 5, 6, 10 or 12 bags in a cardboard pack. Packets can be placed individually or bonded pairwise. The application instruction is applied to the bag.
Or 5, 6, 10 or 12 bags in a cardboard pack along with instructions for use. Packets can be placed individually or bonded pairwise.

Hello everyone!

It seems to me that quite recently the preparations like the Teraflu in the assortment of Pharmacies were only three. Now all new and new, hearing unknown brands regularly appear. The point is not that they are worse, they are simply not widely advertised, respectively, and do not launch the costs of advertising in the cost of the finished product. However, the pharmacy is not interested in to offer what cheaper.

PRODUCT INFORMATION

Price 129 rubles (in other pharmacies there are up to 100 rubles)

Where can I buy in pharmacies

Weight3 bags of 13 g

Producedin Russia

PACKAGING

The drug is sold by boxes of 3, 8 or 10 bags. I have the smallest box.

At the end of the box, there is the most important information.

My experience application

Packages with a standard format with a combined material itself. There were no instructions in the box. She is printed on bag. Very comfortably. Because we usually take a couple of bags with you on the road, I used to sometimes left in the table at work just in case. The box has thrown out. And so all the information is always at hand.

For autopsy you will need scissors. This is perhaps minus. Big bag, but is busy only half.

The drug is a major yellowish powder.

Perfectly dissolve in water. Pour costs hot water, but not boiling water. It turns out a pleasant solution. To taste, he grieves a little, as if the zest of lemon, but in general is pleasant. It seems to me that the theraflu is sweeter.

Such a solution should be taken at the beginning of the disease. Then it will be really effective, but it is worth understanding that he does not heal, but only removes the symptoms. The basis of all similar preparations is paracetamol, which only knocks down the temperature. I always have fun in the first-aid kit for an emergency to extinguish the starting cold and do not give a break. If you picked up the virus, it is unlikely to help you.

For comparison, represent the compositions of the teraflu and flupoflu in the calculation per bag. Both with lemon taste.

Paracetamol 325 mg; phenylephrine hydrochloride 10 mg; pheniramine Maleat 20 mg; Ascorbic acid 50 mg

Gripopoflu

Paracetamol 650 mg; phenylephrine hydrochloride 10 mg; pheniramine Maleat 20 mg; Ascorbic acid 50 mg

Those. active substances The same, but in the gripopulus, the dosage of paracetamol is twice as high. Accordingly, efficiency.

In this case, in one bag of traffle - 22.1 grams, and the gripopulu is 13 grams. Apparently in the first more auxiliary substances, it is likely that it is also tastier, only this does not affect the effectiveness.

The price, of course, above the Teraflu, is it an advertised and foreign, and the unknown Russian drug is unknown.

OUTPUT

Definitely the desired drug in each first-aid kit for an emergency.

Thank you for attention! Be healthy!

Preparation for symptomatic therapy of sharp respiratory diseases

Active substances

- (ASCORBIC ACID)
- Paracetamol (Paracetamol)
- Phenylefrin hydrochloride (Phenylephrine)
- Pheniramin Maleat (Pheniramine)

Release form, composition and packaging

◊ Powder for preparing a solution for intake (lemon) white color with yellow splashes, bulk, granulated, without outsided particles, with citrus smell; Allowed by soft lumps.

Auxiliary substances: sodium citrate dihydrate - 120.74 mg, malic acid - 50.31 mg, dye Sunny sunset yellow - 0.098 mg, chinoline yellow dye - 0.094 mg, Titanium Dioxide - 3.16 mg, lemon flavor - 208.42 mg, Calcium phosphate three-axis - 82 mg, Lemonic acid - 1221.79 mg, sucrose - 20 000 mg.

22.1 g - Multi-layered packets (4) - packs cardboard.
22.1 g - Multilayer Packages (10) - Cardboard packs.
22.1 g - Multilayer Packages (14) - Cardboard packs.

pharmachologic effect

The combined drug whose action is due to its composition components. It has an antipyretic, analgesic, vasoconductive effect, eliminates the symptoms of "colds". Supports vessels and eliminates the swelling of the mucous membrane of the nose and nasopharynx.

Paracetamol It has an anesthetic and antipyretic effect by suppressing prostaglandin synthesis in the CNS. Does not affect the platelet function and hemostasis.

Pheniramin- Tool, histamine Blocate H 1 -receptors. Eliminates allergic symptoms, a sedative effect has a moderate extent, and also shows antimuskarine activity.

Phenylephrin - Alpha 1 -adrenomimetic, causes the narrowing of the vessels, eliminates the swelling and hyperemia of the mucous membrane of the nose cavity.

Pharmacokinetics

Paracetamol

Paracetamol is quickly and almost completely absorbed from the gastrointestinal tract. C Max B is achieved in 10-60 minutes after intake. It is distributed in most body tissues. Penetrates the placental barrier, stands out from breast milk. In therapeutic concentrations, binding to plasma proteins is insignificant, but increases with increasing concentration. Subjected to primary metabolism in the liver. It is excreted mainly with urine in the form of glucuronides and sulfates. T 1/2 is from 1 to 3 hours.

Pheniramin

C max Feniramin in a plasma is achieved in approximately 1-2.5 h. T 1/2 of the pheniramine - 16-19 hours 70-83% dose is derived from the body with urine as metabolites or unchanged.

Phenylephrin

Phenylephrine is absorbed from the gastrointestinal tract. Metabolized with the "first passage" through the intestinal wall and in the liver, so when taking inside the phenylephrine, hydrochloride is characterized by limited bioavailability. C max in plasma is achieved in the range from 45 minutes to 2 hours. Excreted by the kidneys almost completely in the form of sulphate compounds. T 1/2 is 2-3 hours.

Vitamin C

Quickly and completely absorbed from the gastrointestinal tract. Binding of plasma proteins - 25%. Displays in the form of metabolites with urine. Ascorbic acid, adopted in excessive amounts, is rapidly excreted unchanged with urine.

Indications

• symptomatic treatment of infectious inflammatory diseases (ORVI, incl. influenza), accompanied by high temperature, chills, fragile in body, head and muscle pain, runny nose, nasal congestion, chichany.

Contraindications

• increased sensitivity to the components of the drug;
• severe cardiovascular diseases;
• arterial hypertension;
• portal hypertension;
• diabetes;
• hyperthyroidism;
• clotted glaucoma;
• feochromocytoma;
• alcoholism;
• sakaraz / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;
• simultaneous or during the preceding 2 weeks, the reception of Mao inhibitors;
• simultaneous reception of tricyclic antidepressants, other sympathomimetics;
• pregnancy;
• breastfeeding period;
• children's age up to 12 years.

Carefully:with pronounced atherosclerosis of coronary arteries, cardiovascular diseases, acute hepatitis, hemolytic anemia, bronchial asthma, severe liver or kidney diseases, prostate hyperplasia, difficulty urination due to prostate hypertrophy, blood diseases, shortage of glucose-6-phosphate dehydrogenase, congenital hyperbilirubinemia (zhilbera syndromes, dubb-johnson and rotor), during depletion, dehydration, saworoduodenal obstruction by stenosing ulcer stomach and / or duodenal gut, epilepsy, with simultaneous reception of drugs that can adversely affect the liver (for example, inductors of microsomal liver enzymes); Patients with the recurrent formation of uragual stones in the kidneys.

Dosage

Inside. The contents of one packet are dissolved in 1 cup of hot but not boiling water. Take hot. Repeated dose can be taken every 4-6 h (no more than 3-4 doses within 24 hours).

The theraflu from influenza and colds can be used at any time of the day, but the best effect brings the drug before bedtime, overnight. If there are no facilitations of symptoms within 3 days after the start of receiving the drug, it is necessary to consult a doctor.

Do not apply the theraflu from influenza and colds for more than 5 days.

W. patients with impaired liver function or housing syndrome It is necessary to reduce the dose or increase the interval between the receptions.

For renal failure of severe (QC<10 мл/мин) The interval between the techniques should be at least 8 hours.

W. elderly patients Dose correction is not required.

Side effects

Definition of side effects: Very often (≥1 / 10), often (≥1 / 100 and<1/10), нечасто (≥1/1000 и <1/100), редко (≥1/10 000 и <1/1000), очень редко (<1/10 000), включая отдельные сообщения, частота неизвестна (по имеющимся данным определить частоту невозможно).

From the hematopopitation system: Very rarely - thrombocytopenia, agranulocytosis, leukopenia, pancytopenia.

From the immune system: rarely - hypersensitivity (rash, shortness of breath, anaphylactic shock), angioedema swelling; The frequency is unknown - anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necroliz.

From the nervous system:often - drowsiness; Rarely - dizziness, headache.

Psyche violations:rarely - increased excitability, sleep disorder.

From the body of the vision: Rarely - mydriasis, accommodation paresis, an increase in intraocular pressure.

From the side of the cardiovascular system:rarely - tachycardia, a feeling of heartbeat, arterial hypertension.

From the digestive system:often - nausea, vomiting; Rarely - constipation, dryness of the oral mucosa, abdominal pain, diarrhea.

From the side of the liver and biliary tract:rarely - increasing the activity of hepatic enzymes.

From the side of the skin and subcutaneous fabrics:rarely - skin rash, itching, erythema, urticaria.

From the urinary system: Rarely - difficulty urination.

General reactions: Rarely - malaise.

If any of the above side effects are exacerbated and any other side effects appear, the patient must consult a doctor.

Overdose

Overdose symptoms are due to the main paracetamol.

Paracetamol

Symptoms: Basically manifest after receiving 10-15 g of paracetamol. In severe cases of overdose, paracetamol has a hepatotoxic effect, incl. May cause liver necrosis. Also an overdose may cause irreversible nephropathy and irreversible lesions of the liver. The expression of an overdose depends on the dose, so patients should be prevented on the ban on the simultaneous reception of paracetamol-containing drugs. The risk of poisoning is also expressed in elderly patients, in children, in patients with liver diseases, in cases of chronic alcoholism, in patients with exhaustion and in patients receiving inductors of microsomal liver enzymes.

Overdose paracetamol can lead to liver failure, encephalopathy, coma and death.

Symptoms of paracetamol overdose in the first 24 hours: the pallor of the skin, nausea, vomiting, anorexia, convulsions. Abdominal pain can be the first sign of liver damage and is usually not manifested for 24-48 hours and can sometimes manifest themselves later, after 4-6 days. Liver damage is manifested to the maximum extent after 72-96 hours after taking the drug. A violation of glucose metabolism and metabolic acidosis may also appear. Even in the absence of liver damage, acute renal failure and acute tubular necrosis can develop. It has been reported on the cases of cardiac arrhythmia and development of pancreatitis.

Treatment: The introduction of acetylcysteine \u200b\u200bin / in or orally as an antidote, washing the stomach, intake of methionine can have a positive effect, at least within 48 hours after an overdose. Recommended activated carbon, respiratory monitoring and blood circulation. In the event of the development of convulsion, it is possible to appoint diazepama.

Pheniramin and phenylephrine (symptoms of overdose are combined due to the risk of mutual potentiation of the parasimpatolytic effect of the pheniramine and the sympathomimetic effect of phenylephrine in the event of an overdose of the drug)

Symptoms: Sleepiness, to which concern in the future, anxiety (especially in children), visual disorders, rash, nausea, vomiting, headache, increased excitability, dizziness, insomnia, circulatory disorders, coma, convulsions, behavior changes, improving hell and bradycardia. Under the overdose of Pheniramin, cases of atropine-like "psychosis" were reported.

Treatment: Specific antidote is absent. Conventional assistance measures are needed, including the appointment of activated carbon, salt laxatives, cardiac and respiratory support measures. The psychostimulating agents (methylphenidate) should not be prescribed due to the danger of seizures. In the arterial hypotension, the use of vasopressar drugs is possible.

In the event of an increase in the blood pressure, possibly in / in the introduction of alpha-adrenoblockers, because Phenylephrine is a selective agonist α 1 -adrenoreceptors, therefore the hypotensive effect in overdose should be treated by blocking α 1 -adrenoreceptors. When developing seizures to enter diazepam.

Medicinal interaction

Paracetamol

Enhances the effects of Mao inhibitors, sedatives, ethanol.

The risk of hepatotoxic action of paracetamol rises with the simultaneous use of barbiturates, phenyotine, phenobarbital, carbamazepine, rifampicin, isoniazide, zidovudine and other inductors of microsomal liver enzymes.

With prolonged regular use of paracetamol, it is possible to strengthen the anticoagulant effect of warfarin and other kumarins, while the risk of bleeding increases. The unit use of paracetamol does not have significant influence.

Metoklopramide increases the absorption rate of paracetamol and reduces the time to achieve it C Max in the blood plasma. Similarly, domperidon can lead to an increase in paracetamol absorption speed.

Paracetamol can lead to an increase in T 1/2 of chloramphenicol.

Paracetamol is able to reduce the bioavailability of Lusotodzhina, while it is possible to reduce the effectiveness of Loudshotin due to the induction of its metabolism in the liver.

Paracetamol absorption can be reduced by simultaneously use with a skewer, but the reduction of suction is insignificant if the swiveramin is accepted at an hour later.

Regular use of paracetamol simultaneously with zidovudine can cause neutropenia and increase the risk of liver damage.

Probezide affects paracetamol metabolism. In patients simultaneously using a probe, the dose of paracetamol should be reduced.

The hepatotoxicity of paracetamol is enhanced with prolonged excessive use of ethanol (alcohol).

Paracetamol may affect the test results by determining uric acid using the flushing reagent of phosphorphramate.

Pheniramin

It is possible to strengthen the effect of other substances on the central nervous system (for example, Mao inhibitors, tricyclic antidepressants, alcohol, barbiturates, tranquilizers and narcotic drugs). Pheniramin can inhibit the effect of anticoagulants.

Phenylephrin

The theraflu from influenza and colds is contraindicated in patients who receive or obtained Mao inhibitors over the past 2 weeks. Phenylephrine can potentiate the action of Mao inhibitors and cause hypertensive crisis.

The simultaneous use of phenylephrine with other sympathomimetic drugs or tricyclic antidepressants (for example, amitriphylic) can lead to an increase in the risk of unwanted reactions from the cardiovascular system.

Phenylephrine can reduce the effectiveness of beta-adrenobloclars and others (for example, Debrizoshin, Guanethdine, reserpine, methyldopes). It is possible to increase the risk of arterial hypertension and other side effects from the cardiovascular system.

The simultaneous use of phenylephrine with digoxin and cardiac glycosides can increase the risk of heart rhythm or myocardial infarction.

The simultaneous use of phenylephrine with arcaloids of the ardines (ergotamine and methisrigid) can increase the risk of ergotism.

special instructions

In order to avoid toxic liver damage, the drug should not be combined with alcoholic beverages.

Patients should consult a doctor if:

• bronchial asthma, emphysema or chronic bronchitis is observed;
• symptoms do not pass within 5 days or accompanied by severe fever, which is ongoing for 3 days, rash or constant headache.

These may be signs of more serious violations.

The theraflu from influenza and colds contains:

• sugarozes 20 g per bag. This should be taken into account in patients with diabetes. Patients with such rare hereditary problems such as fructose intolerance, glucose-galactose malabsorption or insufficiency of sacrase-isomaltase should not be made by the teraflu from influenza and colds;
• dye sunny sunset yellow (E110). May cause allergic reactions;
• sodium 28.3 mg per bag. This should be taken into account in patients who comply with a diet with sodium limit.

Do not use the drug from damaged bags.

Impact on the ability to control vehicles and mechanisms

The theraflu from influenza and colds can cause drowsiness, so during treatment it is not recommended to manage vehicles or engage in other activities that require the concentration of attention and high velocity of psychomotor reactions.

With coldic diseases and influenza, in particular, the patient shows the bedding, as well as the moisturizing of the nose so that the undercurred mucoster does not allow the virus to fall lower and lead to the development of complications. ORVI can proceed quite easily, but lead to severe complications. In addition to these activities, symptomatic means can be used at this stage. Usually they include

• antipyretic means;
• cough agents;
• nasal drops.

The composition of the drug

The most effective, safe antipyretic preparation is paracetamol. It is this means recommends WHO with influenza in children and adults.

Based on it, there are various analogues and combined drugs. One of these means is a teraflu. It includes

1. Paracetamol;
2. Phenylephrine hydrochloride;
3. Pheniramin Maleat;
4. Vitamin C.

Paracetamol, which is a non-steroidal anti-inflammatory agent, in this combination drug has antipyretic, analgesic, and to a lesser extent, anti-inflammatory effect. Phenylephrine hydrochloride belongs to a group of vasoconstrictor means that have a local effect on the nasal mucosa, which contributes to a decrease in swelling, reducing the discharge from the nose. Pheniramin Maleat is an antihistamine, the action of which is also manifested by a decrease in the edema of the mucous membrane, reduce the stations, itching in the nose, tears.

The presence of ascorbic acid in the composition of the drug is due to the active participation of vitamin in the regulation of redox processes, which means that the imminent lifting.

Since such symptoms are as a runny nose, nasal congestion, the tearing with influenza is little expressed, and the increase in body temperature is a protective mechanism that provides more active production of interferon, then the teraflu is used in infrequently.

A much greater distribution of the drug was obtained with other ORVI, where the catarrhal phenomena is more pronounced.

Reviews

The presence of several components in the composition of the theraflu, according to part of the specialists, is a negative point that allows you to obtain allergic reactions in more cases, narrowing the age framework of drug intake. Paracetamol in the form of a monopreparation is used in the form of candles or syrup from the very early age, while the theraflu has a restriction of up to 12 years.

However, the other part of the specialists responds very positively about the theraflu, as a drug from influenza and colds, since the action of it begins quickly, and it is very effective in the fight against the symptoms of the disease.

According to the instructions, the following manifestations may be by side effects:

• allergic reactions,
• tachycardia;
• sleep disturbance;
• nausea;
• vomiting;
• raising blood sugar.

As for the testimony for receiving this drug, it is necessary to take into account that the theraflu is only a symptomatic means for the treatment of flu and colds.

Using it as an antipyretic drug, it is necessary to remember the positive role of hyperthermia in the fight against the virus. Consequently, it is desirable to use it with an increase in the temperature above 38.5 degrees.

The general principles of using symptomatic treatment with ORVI are that they are used when symptoms are so pronounced that the patient's condition takes place. At the same time, following the instructions for the drug, its use is limited in patients having

• intolerance to any of the components of the drug;
• severe vascular pathology;
• an increase in blood pressure;
• severe liver and kidney diseases;
• diabetes;
• pregnancy and breastfeeding.

The drug is also contraindicated to people in a state of intoxication, and caution should be used in patients with alcoholism in history. In case of overdose of the drug, a sharp progressive deterioration in a state requiring emergency assistance is possible. Despite the popularity of the drug, taking into account possible side effects, its use must be coordinated with a specialist.