Exedrin for headache and migraine, pills, 20pcs

Product description

Excedrin is an over-the-counter medication in tablet form that is designed to relieve migraines. Excedrin has a triple effect : acetylsalicylic acid and paracetamol relieve headaches, and caffeine enhances the effect of the combination. *, * * Excedrin also helps eliminate migraine-related symptoms, such as nausea and hypersensitivity to light and sound. * Excedrin helps relieve pain and other migraine symptoms within 30 minutes!** Richard B. Lipton, MD; Walter F. Stewart, PhD, MPH; Robert E. Ryan, Jr, MD; Joel Saper, MD; Stephen Silberstein, MD; Fred Sheftell, MD. ARCH NEUROL / VOL 55, FEB 1998* * Instructions for Medical use, RU N009980

Composition

1 tablet contains paracetamol 250 mg,

acetylsalicylic acid 250 mg,

caffeine 65 mg

Pharmacological action

Excedrin® is a combination drug containing paracetamol, acetylsalicylic acid and caffeine. Paracetamol has analgesic, antipyretic and extremely weak anti-inflammatory effect, which is associated with its effect on the center of thermoregulation in the hypothalamus and its weak ability to inhibit prostaglandin synthesis in peripheral tissues. Acetylsalicylic acid has analgesic, antipyretic and anti-inflammatory effects. It quickly relieves pain, especially caused by the inflammatory process, and also moderately inhibits platelet aggregation and slows down the process of thrombosis, improving microcirculation in the focus of inflammation. Caffeine increases the reflex excitability of the spinal cord, excites the respiratory and vasomotor centers, dilates the blood vessels of skeletal muscles, brain, heart, and kidneys, and reduces platelet aggregation. Reduces drowsiness, fatigue, increases mental and physical performance. In this combination, caffeine in a small dose has almost no stimulating effect on the central nervous system, but it helps to normalize the tone of blood vessels in the brain and accelerate blood flow in it.

Clinical pharmacology

Paracetamol is easily absorbed in the gastrointestinal tract, Cmax in blood plasma is detected in the interval from 30 minutes to 2 hours after use. Paracetamol is metabolized in the liver and excreted by the kidneys, mainly in the form of glucuronides and sulfate conjugates. Less than 5% of paracetamol is excreted unchanged. The duration of T1 / 2 varies from 1 to 4 hours. The association with plasma proteins is insignificant at normal therapeutic doses, however, it increases with increasing dose. The hydroxylated metabolite, which is formed in small amounts in the liver under the influence of mixed oxidases and is usually neutralized by binding to glutathione, can accumulate with an overdose of paracetamol and cause liver damage. Acetylsalicylic acid is rapidly and completely absorbed, undergoes rapid hydrolysis in the gastrointestinal tract, liver and blood to form salicylates, which are further metabolized, mainly in the liver. Caffeine is completely and quickly absorbed. Maximum concentrations are observed in the period from 5 to 90 minutes after ingestion on an empty stomach. In adults, excretion occurs almost entirely through hepatic metabolism. There is a pronounced variability in individual elimination values in adults. The average T1 / 2 from blood plasma is 4.9 h in the range of 1.9-12.2 h. Caffeine is distributed in all body fluids. The binding of caffeine to plasma proteins is 35%. Caffeine is almost completely metabolized by oxidation, demethylation, and acetylation and is eliminated by the kidneys. Main metabolites: 1-methylxanthine,7-methylxanthine,1.7-dimethylxanthine.

Indications

Pain syndrome of moderate and mild intensity of various origins: headache; migraine; toothache; neuralgia; arthralgia and myalgia (pain in muscles and joints); algodismenorrhea (pain during menstruation).

Use during pregnancy and lactation

Despite the fact that acetylsalicylic acid can be used in the second trimester of pregnancy, the safety of this combination in pregnant and breast-feeding women has not been studied, so the drug is contraindicated in pregnant women (in all trimesters) and breast-feeding women.

Contraindications

Hypersensitivity to any of the components of the drug; erosive and ulcerative lesions of the gastrointestinal tract in the acute phase; gastrointestinal bleeding; complete or incomplete combination of bronchial asthma, recurrent nasal and paranasal sinus polypnosis and intolerance to acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs (including in the anamnesis); surgical interventions accompanied by bleeding; hemophilia; hemorrhagic diathesis; hypoprothrombinemia; severe arterial hypertension; portal hypertension; severe CHD; glaucoma; avitaminosis K; renal failure; concomitant use of other medications containing paracetamol, acetylsalicylic acid or other nonsteroidal anti-inflammatory drug; glucose-6-phosphate dehydrogenase deficiency; pregnancy; lactation; increased excitability; sleep disorders; children under 15 years of age (risk of developing Reye’s syndrome in children with diabetes). hyperthermia on the background of viral diseases). Use the drug with caution for gout, liver diseases, headaches associated with head trauma, taking anticoagulants, hypoglycemic agents, gout or arthritis, as well as while taking medications containing acetylsalicylic acid or other analgesic and antipyretic components.

Side effects

Gastralgia, nausea, vomiting, hepatotoxicity, nephrotoxicity, erosive ulcerative lesions of the gastrointestinal tract, allergic reactions, tachycardia, increased blood pressure, bronchospasm. With prolonged use – dizziness, headache, visual disturbances, tinnitus, decreased platelet aggregation, hypocoagulation, hemorrhagic syndrome (nosebleeds, bleeding gums, purpura, etc. ), kidney damage with papillary necrosis, deafness, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), Reye’s syndrome in children (hyperpyrexia, metabolic acidosis, nervous system and mental disorders, vomiting, liver function disorders).

Interaction

The drug may enhance the effect of heparin, indirect coagulants, reserpine, steroid hormones and hypoglycemic drugs. Concomitant use with other NSAIDs, methotrexate increases the risk of side effects. Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, as well as anti-gouty drugs that promote the elimination of uric acid. Barbiturates, rifampicin, salicylamide, antiepileptic drugs, and other inducers of microsomal liver enzymes contribute to the formation of toxic metabolites of paracetamol that affect liver function. Metoclopramide accelerates the absorption of paracetamol. Under the influence of paracetamol, the half-life of chloramphenicol increases by 5 times. Repeated use of paracetamol may increase the effect of anticoagulants (coumarin derivatives). Concomitant use of paracetamol, acetylsalicylic acid, and alcoholic beverages increases the risk of hepatotoxic effects. Caffeine accelerates the absorption of ergotamine.

How to take, course of use and dosage

The drug is taken orally during or after a meal. Adults and adolescents from 15 years of age: 1 tablet every 4-6 hours. At the first sign of migraines, take 2 tablets. The average daily dose is 3-4 tablets per day, the maximum daily dose is 6 tablets per day. After taking 2 tablets, relief of headaches and other types of pain usually occurs quickly – in 15 minutes, with migraines, relief usually occurs in 30 minutes. In case of pain, the drug should not be taken for more than 5 days without consulting a doctor. For migraines, the drug should not be taken for more than 3 days without consulting a doctor.

Overdose

Symptoms due to the presence of paracetamol (when taken in doses of more than 10-15 g / day): during the first 24 hours, pallor of the skin, nausea, vomiting, anorexia, abdominal pain, impaired glucose metabolism, metabolic acidosis. Symptoms of impaired liver function may appear 12-48 hours after an overdose. In severe overdose -liver failure with progressive encephalopathy, coma, death; acute renal failure with tubular necrosis (including in the absence of severe liver damage); arrhythmia, pancreatitis. Hepatotoxic effect in adults is manifested when taking 10 g or more. Symptoms due to the presence of acetylsalicylic acid (when taken in doses of more than 150 mg / kg): with mild intoxication-nausea, vomiting, tinnitus, visual impairment, dizziness, severe headache. In severe poisoning-hyperventilation of the lungs of central origin (shortness of breath, suffocation, cyanosis, cold sticky sweat, respiratory paralysis), respiratory acidosis. The greatest risk of developing chronic intoxication is observed in children and the elderly when taking more than 100 mg / kg / day for several days. In case of moderate and severe poisoning, hospitalization is necessary. Symptoms due to the presence of caffeine (when taken in doses of more than 300 mg/day): gastralgia, agitation, anxiety, agitation, motor restlessness, confusion, delirium, dehydration, tachycardia, arrhythmia, hyperthermia, rapid urination, headache, increased tactile or pain sensitivity, tremor or muscle twitching; nausea and vomiting, sometimes with blood; ringing in the ears, epileptic seizures (in case of acute overdose – tonic-clonic). Treatment: monitoring of the acid-base state and electrolyte balance. Depending on the state of metabolism – the introduction of sodium bicarbonate, sodium citrate or sodium lactate.Increasing alkalinity increases the excretion of acetylsalicylic acid by alkalizing the urine. Gastric lavage in the first 4 hours, provocation of vomiting, taking activated charcoal, laxatives, use of SH-group donors and precursors of glutathione methionine synthesis within 8-9 hours after overdose, and acetylcysteine – within 8 hours.

Description

Tablets covered with a film-coated white color, oblong, with the inscription “E” on one side; cross – section view-the core is white or almost white.

Special instructions

If symptoms persist, worsen, or develop new symptoms after taking the drug, you should immediately consult a doctor. When taking the drug at the recommended dose, the body receives the same amount of caffeine as contained in one cup of coffee, so you should reduce the consumption of caffeinated products during treatment with this drug in order to avoid the development of nervous excitement, irritability, insomnia and rapid heartbeat against the background of an overdose of caffeine. If an overdose is suspected, seek immediate medical attention, even if there are no symptoms. You should refrain from drinking alcohol while taking the drug due to the increased risk of liver damage and gastrointestinal bleeding. Since acetylsalicylic acid slows down blood clotting, the patient who is going to undergo surgery should warn the doctor in advance about taking the drug. Acetylsalicylic acid in low doses reduces the excretion of uric acid, and therefore in patients with a predisposition, the drug can provoke an attack of gout. With prolonged use of the drug, monitoring of peripheral blood and the functional state of the liver is necessary. Effects on the ability to drive vehicles and work with mechanicsmi Ne effects of the drug on the ability to drive a car and work with mechanisms have been reported.

Form of production

Pills.

Storage conditions

At a temperature not exceeding 25°C.

Keep out of reach of children.

Shelf

life is 3 years. Do not use after the expiration date indicated on the package.

Active ingredients

: Acetylsalicylic acid, Caffeine, Paracetamol

Dosage form

Tablets

Purpose

For adults and Children over 15 years of age

Indications

Sciatica, Sciatica, Neuritis, Lumbago, Cold, Flu, Arthritis, Osteoarthritis, Myositis, Migraine