Citramon P tablets 20

Country

Russia

INN

Acetylsalicylic Acid+Caffeine+Paracetamol

Composition

1 tablet contains.

Active substances: acetylsalicylic acid - 0,24 g; paracetamol - 0,18 g; caffeine (in terms of caffeine monohydrate) - 0.03 g.

Excipients: cocoa bean powder - 0.0225 g; citric acid monohydrate - 0.0050 g; potato starch - 0,0615 g; talc - 0,0055 g; calcium stearate - 0,0055 g.

Pharmacological properties

Combined drug.

Acetylsalicylic acid has an antipyretic and anti-inflammatory effect, weakens pain, especially caused by the inflammatory process, and also moderately inhibits platelet aggregation and thrombosis, improves microcirculation in the focus of inflammation.

Caffeine increases the reflex excitability of the spinal cord, excites the respiratory and vasomotor centers, dilates blood vessels skeletal muscles, brain, heart, kidneys, reduces platelet aggregation; reduces drowsiness, feeling tired, increases mental and physical performance. In this combination, caffeine in a small dose has practically no stimulating effect on the central nervous system, but helps to normalize the tone of the vessels of the brain and accelerate blood flow.

Paracetamol has an analgesic, antipyretic and extremely weak anti-inflammatory effect, which is due to its effect on the center of thermoregulation in the hypothalamus and a mild ability to inhibit the synthesis of prostaglandins in peripheral tissues.

Indications for use

Pain syndrome of mild and moderate severity (of various genesis): headache; migraine; toothache; neuralgia; myalgia; arthralgia; algodismenorrhea.

Febrile syndrome: in acute respiratory infections; with the flu.

Contraindications

Hypersensitivity to the components of the drug; erosive- ulcerative lesions of the gastrointestinal tract (in the acute phase); gastrointestinal bleeding; "aspirin" asthma; hemophilia; hemorrhagic diathesis; hypoprothrombinemia; portal hypertension; avitaminosis K; renal failure; I and III trimesters of pregnancy; lactation (breastfeeding); deficiency of glucose-6-phosphate dehydrogenase; severe arterial hypertension; severe coronary artery disease; glaucoma; increased excitability; sleep disorders; surgical interventions accompanied by bleeding; children's age (up to 15 years - the risk of developing Reye's syndrome in children with hyperthermia on the background of viral diseases).

With caution: gout, liver disease.

Use in pregnancy and lactation

Contraindicated use in the I and III trimesters of pregnancy and during lactation (breastfeeding).

Acetylsalicylic acid has a teratogenic effect; when used in the first trimester of pregnancy leads to malformation - cleavage of the upper palen; in the III trimester - to inhibition of labor (inhibition of the synthesis of prostaglandins), to the closure of the arterial duct in the fetus, which causes pulmonary hyperplasia and hypertension in the vessels of the pulmonary circulation.

It is excreted in breast milk, which increases the risk of bleeding in a child due to impaired platelet function.

Use in case of impaired liver function

With caution: liver disease.

Use in renal dysfunction

Contraindicated in renal failure.

Use in children

Children under 15 years of age should not be prescribed drugs containing acetylsalicylic acid, because in the case of a viral infection, they can increase the risk of Reye's syndrome. Symptoms of Reye's syndrome are prolonged vomiting, acute encephalopathy, and enlarged liver.

Special instructions

Children should not prescribe drugs containing acetylsalicylic acid, since in the case of a viral infection they can increase the risk of Reye's syndrome. Symptoms of Reye's syndrome are prolonged vomiting, acute encephalopathy, and enlarged liver.

With prolonged use of the drug, control of peripheral blood and the functional state of the liver is necessary.

Since acetylsalicylic acid slows down blood clotting, the patient, if he has to undergo surgery, should warn the doctor in advance about taking the drug.

Patients with hypersensitivity or with asthmatic reactions to salicylates or their derivatives acetylsalicylic acid can be prescribed only with special precautions (in an emergency room).

Acetylsalicylic acid in low doses reduces the excretion of uric acid. In patients with a corresponding predisposition, this can be in a number of cases to provoke an attack of gout.

During treatment, you should abandon the use of ethanol (increased risk of gastrointestinal bleeding).

Drug Interactions

Enhances the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs.

Simultaneous administration with other NSAIDs, methotrexate increases the risk of side effects.

Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, as well as antigout drugs that promote the excretion of uric acid.

Barbiturates, rifampicin, salicylamide, antiepileptic drugs and other stimulants of microsomal oxidation contribute to the formation of toxic paracetamol metabolites that affect liver function.

Metoclopramide accelerates the absorption of paracetamol.

Under the influence of paracetamol T _1/2 chloramphenicole increases by 5 times. When taken again, paracetamol can enhance the effect of anticoagulants (dicumarin derivatives).

Simultaneous administration of paracetamol and ethanol increases the risk of hepatotoxic effects.

Caffeine accelerates the absorption of ergotamine.

Dosage and Administration

Inside (during or after meals) take every 4 hours. on average, take 3-4 times / day. Maximum frequency of reception - 8 times / day. The course of treatment is no more than 7-10 days.

In case of impaired kidney or liver function, the break between doses is at least 6 hours.

The drug should not be taken for more than 5 days when prescribed as an anesthetic and more than 3 days as an antipyretic. Other doses and regimens are established by the doctor.

Side effects

From the digestive system: gastralgia, nausea, vomiting, hepatotoxicity, erosive- ulcerative lesions of the gastrointestinal tract.

From the urinary system: nephrotoxicity,

Allergic reactions: skin manifestations, Stevens-Johnson syndrome, Lyell's syndrome, bronchospasm.

From the cardiovascular system: tachycardia, increased blood pressure,

With prolonged use: dizziness, headache, visual impairment, tinnitus, decreased platelet aggregation, hypocoagulation, hemorrhagic syndrome (including nosebleeds, bleeding gums, purpura), kidney damage with papillary necrosis; deafness; Reye's syndrome in children (hyperpyrexia, metabolic acidosis, disorders of the nervous system and psyche, vomiting, impaired liver function).

Storage conditions

Shelf life 4 years.