Grippostad C, capsules 10pcs

Composition

Auxiliary substances:  

Lactose monohydrate,

Glyceryl tristearate,

Gelatin.

Capsule body composition:  

Gelatin,

Water,

Titanium dioxide.

Capsule cap composition:  

Gelatin,

Quinoline yellow,

Water,

Dye yellow “sunny sunset”,

Titanium dioxide.

Pharmacological action

Pharmacodynamiccombinated drug for the elimination of symptoms of colds. Ascorbic acid is involved in the regulation of redox processes, carbohydrate metabolism, blood clotting, tissue regeneration (restoration), in the synthesis of steroid hormones; increases the body’s resistance to infections, reduces vascular permeability, reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid. Improves the tolerance of paracetamol and prolongs its action (slowing its elimination). Caffeine has an antispasmodic (relaxing) effect, dilates the bronchi, tones the blood vessels of the brain, stimulates the heart, and has a general tonic effect. Caffeine is a derivative of xanthine, it enhances the analgesic effect of paracetamol. Paracetamol has analgesic (analgesic), antipyretic and weak anti-inflammatory effects, which is associated with its effect on the center of thermoregulation in the hypothalamus and a weakly expressed ability to inhibit prostaglandin synthesis in peripheral tissues. Chlorphenamine is an antihistamine that has an anti-allergic effect: it reduces nasal discharge and congestion, lacrimation, and sneezing. The combination of components of the drug provides better tolerability of symptoms of malaise and fever in acute respiratory viral infections and other colds. Pharmacokinetics Ascorbic acid is absorbed in the proximal small intestine. Binding to plasma proteins is 25%. Easily penetrates into white blood cells, platelets, and then – into all tissues; the highest concentration is achieved in glandular organs, white blood cells, liver and lens of the eye; penetrates through the placenta. It is mainly metabolized in the liver to deoxyascorbic acid and then to oxaloacetic acid and ascorbate-2-sulfate. It is excreted by the kidneys, through the intestines, with sweat, breast milk in unchanged form and in the form of metabolites. Caffeine is fully 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 half-life (T 1/2/) from blood plasma is 4.9 hours in the range of 1.9-12.2 hours. 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. Paracetamol is fully and rapidly absorbed in the gastrointestinal tract, with maximum plasma concentrations detected after 30-60 minutes. Paracetamol is rapidly distributed in most body tissues, passes through the placenta, and is present in breast milk. At therapeutic concentrations, binding to plasma proteins is insignificant, increasing with increasing concentration. It undergoes primary metabolism in the liver, is mainly excreted in the urine in the form of glucuronide and sulfate compounds. The elimination half-life is 1-3 hours. The hydroxylated metabolite, formed in small amounts in the liver under the influence of mixed oxidases and usually neutralized by binding to glutathione, can accumulate with an overdose of paracetamol, and cause liver damage. The maximum plasma concentration of chlorphenamine is reached 1-2 hours after use. The duration of action is 3-6 hours. Metabolism is mainly carried out in the liver by hydroxylation and conjugation, as well as demethylation and the formation of N-and S-oxides. Oral bioavailability is 25-50% due to the pronounced first-pass effect, which decreases with insufficient liver function. Binding to plasma proteins is 69-72%. The apparent volume of distribution of the drug is relatively high, and amounts to 3-7 liters per kilogram of body weight. The plasma elimination half-life of chlorphenamine in adult patients is 15-36 hours, and in children-10-13 hours. For patients with renal insufficiency, it is necessary to take into account the prolongation of the half-life of metabolites. Depending on the pH level (acidic or alkaline medium),0-34% of the dose taken is excreted in the urine as unchanged chlorphenamine. With prolonged use, accumulation is possible.

Indications

• Febrile syndrome in infectious and inflammatory diseases
• pain syndrome of moderate or mild severity (headache, toothache, migraine, neuralgia, myalgia, arthralgia, painful menstruation).

Contraindications

• Individual intolerance to the components of the drug;
• gastrointestinal bleeding;
• portal hypertension;
• alcoholism;
• pronounced hepatic and/or renal failure;
• pregnancy (I and III trimester)and lactation;
• children up to age 15 years;
• deficiency of glucose-6-phosphate dehydrogenase;
• angle-closure glaucoma;
• prostatic hypertrophy c formation of residual urine;
• severe arrhythmia (abnormal heart rhythm);
• uncontrolled hypertension.

With caution, the drug is prescribed for:

• erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase),
• hepatic and/or renal failure,
• congenital hyperbilirubinemia (diseases in which the level of bilirubin in the blood is increased – Gilbert’s, Dubin-Johnson and Rotor syndromes).

Side effects

In therapeutic doses, the drug is usually well tolerated.

Sometimes allergic skin reactions are possible (skin rash, itching, urticaria, angioedema); gastrointestinal disorders (nausea, epigastric pain, dry mouth); difficulty urinating.

Rarely-disorders of the blood system (anemia, leukopenia — low white blood cell count, thrombocytopenia — low platelet count in the blood).

For long-term use in large doses (more than 12 capsules daily for more than 5 days) – hepatotoxic effect, disorders of the blood system; erosive and ulcerative lesions of the gastrointestinal tract; nephrotoxicity (papillary necrosis).

Interaction

Ethanol contributes to the development of acute pancreatitis. Microsomal oxidation inhibitors (cimetidine) reduce the risk of hepatotoxic effects.

The drug reduces the effectiveness of uricosuric drugs.

Enhances the effect of drugs that depress the central nervous system, ethanol.

When gastric emptying slows down (propanthelin), there may be a delayed onset of action of paracetamol.

When gastric emptying is accelerated (metoclopramide), the drug begins to act faster. The toxicity of chloramphenicol increases.

Caution should be exercised with prolonged use of paracetamol and concomitant therapy with oral medications that inhibit blood clotting.

Stimulators of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which causes the possibility of severe intoxication with small overdoses.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

How to take it, course of use and dosage

Inside, with a small amount of liquid,2 capsules at a time.

If necessary, repeat the same dose in 4-6 hours 3-4 times a day.

The maximum daily dose should not exceed 12 capsules.

Overdose

Symptoms (due to paracetamol): pallor of the skin, decreased appetite, nausea, vomiting; hepatonecrosis (the severity of necrosis due to intoxication directly depends on the degree of overdose).

Toxic effect in adults is possible after taking more than 10-15 g of paracetamol: increased activity of hepatic transaminases, increased prothrombin time (12-48 hours after use); a detailed clinical picture of liver damage is manifested in 1-6 days.

Rarely, liver failure develops rapidly and can be complicated by renal failure (tubular necrosis).

Treatment: use of SH-group donors and glutathione – methionine synthesis precursors 8-9 hours after overdose and N-acetylcysteine – 12 hours after overdose.

The need for additional therapeutic measures (further use of methionine, intravenous use of N-acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as on the time elapsed after taking it.

Special instructions

It is not recommended to use Grippostad C for more than 3 days as an antipyretic and more than 5 days as an analgesic without medical supervision.

If hyperthermia (high body temperature) continues for more than 3 days and pain syndrome lasts for more than 5 days, a doctor’s consultation is required.

Ascorbic acid, which is part of Grippostad C, distorts the results of laboratory tests that assess the concentration of glucose and uric acid in plasma.

You should not simultaneously use other medications containing paracetamol, as well as other non-narcotic analgesics and NSAIDs (metamizole, acetylsalicylic acid, ibuprofen, etc. ), as well as barbiturates, antiepileptic drugs, rifampicin, chloramphenicol.

Concomitant use of other medications should be agreed with your doctor. When using the drug for more than 5 days, it is necessary to monitor the picture of peripheral blood and the functional state of the liver.

People who are prone to using ethanol should consult a doctor before starting treatment with the drug, since paracetamol can have a damaging effect on the liver.

Form of production

Grippostad S. Capsules.

Storage conditions

At a temperature not exceeding 25 °C

Shelf

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

Active ingredient

Caffeine, Paracetamol, Chlorphenamine, Ascorbic Acid

Dosage form

Capsules

Purpose

Pregnant women only in the second trimester as prescribed by a doctor, Children over 15 years of age, For adults

Indications

Runny Nose, Cold, Flu