Analgin solution 500mg/ml 2ml ampoules, 10pcs

Composition

Active ingredient: metamizole sodium-250 mg or 500 mg; auxiliary substance: water for injection-up to 1 ml

Pharmacological action

Analgesic non-narcotic drug.

ATX code [N02BB02]

Pharmacological properties

Pharmacodynamics

It has analgesic, antipyretic and weak anti-inflammatory effects, the mechanism of which is associated with inhibition of prostaglandin synthesis. It is a pyrazolone derivative.

Pharmacokinetics

With intravenous use: the onset of action – in 5-10 minutes, the maximum effect – in 5-30 minutes, the duration of action-up to 2 hours. It is metabolized in the liver, a small concentration of unchanged metamizole sodium is detected in plasma, and is excreted by the kidneys. In therapeutic doses, it penetrates into the mother’s milk.

Indications

Severe acute or chronic pain syndrome for injuries and postoperative pain syndrome, colic, cancer, and other conditions where other therapeutic measures are contraindicated. Fever that is resistant to other treatments.

Contraindications

Hypersensitivity to pyrazolone derivatives (phenylbutazone, tribuzone), tendency to bronchospasm. Severe liver and/or kidney dysfunction, glucose-6 – phosphate dehydrogenase deficiency, blood diseases, hematopoietic depression (agranulopitosis, cytostatic or infectious neutropenia), as well as anemia and leukopenia. Bronchial obstruction, rhinitis, urticaria caused by taking acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs (including in the anamnesis), active liver disease, condition after coronary artery bypass grafting; confirmed hyperkalemia, erosive and ulcerative changes in the gastric and duodenal mucosa, active gastrointestinal bleeding, inflammatory bowel diseases. children age up to 3 months. Use during pregnancy and lactation. Do not use during pregnancy (especially in the first 3 months and last 6 weeks) and during lactation. With caution Ischemic heart disease, chronic heart failure, cerebrovascular diseases, dyslipidemia/hyperlipidemia, diabetes mellitus, peripheral artery disease, smoking, creatinine clearance less than 60 ml/min. anamnestic data on the development of ulcerative lesions of the gastrointestinal tract, the presence of H. pylori infection, elderly age, long-term use of nonsteroidal anti-inflammatory drugs, severe somatic diseases, simultaneous use of oral glucocorticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including serotonin reuptake inhibitors). c. citalopram, fluoxetine, paroxetine, sertraline). Special care is required when prescribing to patients with systolic blood pressure below 100 mm Hg or with circulatory instability (for example, with myocardial infarction, multiple trauma, incipient shock), with a history of kidney disease (pyelonephritis, glomerulonephritis) and with a long history of alcohol.

Side effects

In therapeutic doses, the drug is well tolerated. When using the drug in some patients, side effects may occur: allergic reactions (skin rash, angioedema; rarely anaphylactic shock, Stevens-Johnson and Lyell syndromes, bronchospasm); with prolonged use, agranulocytosis, leukopenia, thrombocytopenia, arterial hypotension, interstitial nephritis may occur. Impaired renal function, oliguria, anuria, proteinuria, red urine staining. With a tendency to bronchospasm, it is possible to provoke an attack. With intravenous use, infiltrates at the injection site are possible.

Interaction

Due to the high probability of pharmaceutical incompatibility, do not mix with other drugs in the same syringe. Increases the effects of ethanol; concomitant use with chlorpromazine or other phenothiazine derivatives may lead to severe hyperthermia. Radiopaque agents, colloidal blood substitutes and penicillin should not be used during treatment with metamizole sodium. With simultaneous use of cyclosporine, the concentration of the latter in the blood decreases. Metamizole sodium, replacing oral hypoglycemic drugs, indirect anticoagulants, glucocorticosteroids and Indometacin from protein binding, increases their activity. Phenylbutazone, barbiturates, and other hepatoinducers, when administered concomitantly, reduce the effectiveness of metamizole sodium. Concomitant use with other non-narcotic analgesics, tricyclic antidepressants, contraceptive hormones and allopurinol may lead to increased toxicity, Sedatives and tranquilizers enhance the analgesic effect of metamizole sodium. Thiamazole and sarcolysin increase the risk of leukopenia. The effect is enhanced by codeine, histamine H2 blockers and propranolol (slows down inactivation). Myelotoxic drugs increase the manifestation of hematotoxicity of metamizole sodium.

How to take, course of use and dosage

Parenteral use is indicated only if it is impossible to take it orally.

Before use, it is recommended to heat up to body temperature.

Adults and adolescents 15 years and older: as a single dose,1-2 ml of 50% (500 mg/ml) metamizole sodium is recommended (intramuscularly or intravenously), the maximum daily dose can be up to 4 ml of 50% injectable solution (no more than 2 g), divided into 2-3 doses. The maximum single dose can be 1 g (2 ml of 50% solution).

Children: Metamizole sodium is contraindicated under 3 months of age or if the body weight is less than 5 kg.

For children, metamizole sodium is prescribed at a dose of 50-100 mg per 10 kg of body weight (0.1-0.2 ml of 50% solution).

A single dose can be prescribed up to 2-3 times a day.

For children aged 3-12 months (child body weight 5-9 kg), use is carried out only intramuscularly.

Intravenous use should be carried out slowly (the rate of use should not exceed 1 ml (500 mg of metamizole sodium per minute)) in the supine position, when monitoring blood pressure, pulse and respiratory rate to minimize the risk of lowering blood pressure.

Discontinue the drug at the first sign of anaphylactic/anaphylactoid reactions.

Since there is a concern that the drop in blood pressure of non-allergic origin is dose-dependent, an amount of metamizole sodium solution greater than 2 ml (1 g) should be administered with extreme caution.

If the drug is administered too quickly, a critical drop in blood pressure and shock may occur.

Elderly patients should use lower dosages due to the possible decrease in the excretion of metamizole sodium metabolites from the body.

Patients in serious condition and with impaired creatinine clearance should use lower doses due to a decrease in the rate of elimination of metamizole sodium metabolites.

In patients with impaired liver or kidney function, the rate of elimination of the drug is slowed, so it is necessary to avoid repeated use of the drug, there is no experience of long-term use.

No dose adjustment is required for short-term therapy.

Duration of treatment

When used as an analgesic, the duration is 1-5 days. When used as an antipyretic-1-3 days.

Overdose

Symptoms: nausea, vomiting, gastralgia, oliguria, hypothermia, low blood pressure, tachycardia, shortness of breath, tinnitus, drowsiness, delirium, impaired consciousness, acute agranulocytosis, hemorrhagic syndrome, acute renal and/or liver failure, convulsions, paralysis of the respiratory muscles. Treatment: induction of vomiting, trans-probe gastric lavage, saline laxatives, activated charcoal; forced diuresis, hemodialysis, with the development of convulsive syndrome – intravenous use of diazepam and fast-acting barbiturates.

Special instructions

When treating children under 5 years of age and patients receiving cytostatic agents, analgin should be taken only under the supervision of a doctor. Patients with atopic bronchial asthma and hay fever have an increased risk of developing hypersensitivity reactions. With prolonged (more than a week) use, it is necessary to monitor the picture of peripheral blood and the functional state of the liver. While taking analgin, agranulocytosis may develop, and therefore, if an unmotivated fever, chills, sore throat, difficulty swallowing, stomatitis is detected, as well as with the development of vaginitis or proctitis, the drug should be immediately discontinued. Intolerance is very rare, but the risk of shock after intravenous use of the drug is relatively higher than after oral use of the drug. It is not allowed to use it to relieve acute abdominal pain (until the cause is clarified). For intravenous use, a long needle should be used.

Storage conditions

List B. Store in a dry place protected from light, 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 ingredient

Metamizole sodium

Conditions of release from pharmacies

By prescription

Dosage form

solution for injection and infusion