Vicks Anti-Influenza Max Powder for oral solution lemon+vitamin C sachet, 10pcs

Composition

Clinical pharmacology

Pharmacological actionpharmacological action — anti-inflammatory, antipyretic, anticongestive. Pharmacodynamiccombinated drug, the action of which is determined by the composition of its components. Paracetamol has analgesic and antipyretic effects due to inhibition of PG synthesis in the central nervous system. Phenylephrine is a postsynaptic alpha-adrenergic agonist with low affinity for cardiac beta-adrenergic receptors. Decongestant, narrows blood vessels, eliminates swelling and hyperemia of the nasal mucosa. Pharmacokinetics Paracetamol is rapidly and completely absorbed in the small intestine. Cmax in the blood is observed 15-20 minutes after ingestion. Systemic bioavailability is determined by presystemic metabolism and, depending on the dose, ranges from 70 to 90%. Paracetamol spreads rapidly through all body tissues and has a T1 / 2 of approximately 2 hours. It is metabolized in the liver and excreted in the urine in the form of glucuronides and sulfate compounds (>80%). Phenylephrine is rapidly absorbed from the gastrointestinal tract. The level of primary metabolism is quite high (about 60%), so oral use of phenylephrine reduces its bioavailability (about 40%). Cmax in blood plasma is observed after 1-2 hours, and T1 / 2 varies from 2 to 3 hours. It is excreted in the urine in the form of sulfate compounds. Oral use of phenylephrine as a decongestant should be carried out at intervals of 4-6 hours.

Indications

Symptoms of “colds” and flu: headache, sore throat, other types of pain, nasal congestion, elevated body temperature.

Contraindications

• Hypersensitivity to paracetamol or other components of the drug;
• arterial hypertension;
• ischemic heart disease;
• the liver and a marked impairment of renal function;
• hyperthyroidism;
• diabetes mellitus;
• phenylketonuria (because the product contains aspartame);
• concomitant use of tricyclic antidepressants, MAO inhibitors or beta-blockers, or receiving during the last 2 weeks;
• hyperplasia of the prostate;
• glaucoma;
• a deficiency of sucrase/isomaltase;
• fructose intolerance;
• glucose-galactose malabsorption;
• pregnancy;
• the period of breastfeeding;
• the age of 18.

With caution: bronchial asthma; chronic obstructive pulmonary disease; glucose-6-phosphate dehydrogenase deficiency; blood diseases; congenital hyperbilirubinemia (Gilbert, Dubin-Johnson, Rotor syndrome); hyperoxaluria. Long-term use of the drug is not recommended. Concomitant use of other antipruritic and/or paracetamol-containing medications should be avoided. Do not take the drug at the same time as taking alcohol.

Side effects

Paracetamol-allergic reactions: rarely-skin rash, urticaria, anaphylaxis, bronchospasm, angioedema. From the central nervous system: rarely-dizziness. From the hematopoietic system: rarely-aplastic anemia, methemoglobinemia, increased blood pressure; very rarely-pathological changes in the blood, such as thrombocytopenia, agranulocytosis, hemolytic anemia, neutropenia, leukopenia, pancytopenia. From the digestive system: rarely-nausea, vomiting, dryness of the oral mucosa, hepatotoxic effect. From the urinary system: rarely-urinary retention, nephrotoxicity (papillary necrosis). Other: rarely-paresis of accommodation, increased intraocular pressure, mydriasis. Phenylephrine from the cardiovascular system: rarely-tachycardia, increased blood pressure. From the nervous system: rarely-insomnia, nervousness, tremor, anxiety, increased excitability, confusion, irritability and headache. From the digestive system: often — anorexia, nausea and vomiting. From the immune system and skin: rarely-allergic reactions, including skin rash, urticaria, anaphylaxis and bronchospasm.

Interaction

Paracetamol-stimulators of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, flumecinol, rifampicin, phenylbutazone, tricyclic antidepressants)increase the production of hydroxylated active metabolites, which causes the possibility of severe intoxication. Paracetamol enhances the effect of indirect anticoagulants and reduces the effectiveness of uricosuric drugs. The absorption rate of paracetamol increases under the action of metoclopramide or domperidone, and decreases under the action of colestyramine. Anticoagulant effect of warfarin, etc. coumarin derivatives are increased with prolonged use of paracetamol. The drug enhances the effects of MAO inhibitors, sedatives, and ethanol. Phenylephrinthe simultaneous use of phenylephrine with antidepressants, antiparkinsonian, antipsychotic agents, phenothiazine derivatives may cause urinary retention, dryness of the oral mucosa, constipation. When used with corticosteroids, the risk of glaucoma increases. Tricyclic antidepressants increase the adrenomimetic effect of phenylephrine, while concomitant use of halothane increases the risk of ventricular arrhythmia.

How to take, course of use and dosage

Dissolve the contents of one sachet in hot, but not boiling water (250 ml). Allow to cool to an acceptable temperature and drink. Adults and children over 18 years of age – one sachet. If necessary, repeat the dose every 4-6 hours, but no more than 4 doses (sachets) per day. It is not recommended to use the drug for more than 5 days as an analgesic and 3 days as an antipyretic without consulting a doctor. If symptoms persist, you should consult a doctor.

Overdose

Paracetamol Liver damage is possible in adults who have taken 10 g or more of paracetamol. Taking 5 g or more of paracetamol may cause liver damage if there are risk factors: prolonged treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin or other drugs that induce liver enzymes, alcohol abuse, lack of glutathione (for example, improper nutrition), cystic fibrosis, HIV infection, starvation, cachexia. Symptoms: if paracetamol is overdosed in the first 24 hours, paleness, nausea, vomiting, anorexia, and abdominal pain may occur. Liver damage may occur in the period from 12 to 48 hours after the use of the drug. In case of an overdose of paracetamol, despite the absence of primary symptoms of overdose, it is necessary to seek qualified help in medical institutions. To prevent the serious consequences of overdose, the necessary measures should be taken in a timely manner. Symptoms may only partially manifest as nausea or vomiting, and may not reflect the actual degree of overdose or risk of organ damage. 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. Phenylephrine symptoms: irritability, headache, increased blood pressure. If you experience these symptoms of overdose, you should consult a doctor. Treatment: use of SH-group donors and glutathione — methionine synthesis precursors within 8-9 hours after overdose and acetylcysteine-within 8 hours. The need for additional therapeutic measures (further use of methionine, intravenous use of acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as on the time elapsed after taking it.

Special instructions

The drug should not be combined with taking ethanol. During treatment, it is necessary to refrain from taking sleeping pills, anxiolytic drugs, as well as other drugs containing paracetamol. The drug distorts the results of laboratory tests that assess the concentration of glucose and uric acid in plasma. Contains sucrose. The drug is contraindicated in patients with rare congenital fructose intolerance, glucose-galactose malabsorption, or sucrose/isomaltase deficiency. Contains aspartame (E951), a source of phenylalanine. May be toxic to patients with phenylketonuria. Influence on the ability to drive a car or perform work that requires an increased rate of physical and mental reactions. When driving vehicles and engaging in other potentially dangerous activities, it is necessary to take into account that the drug can cause side effects such as dizziness and confusion.

Form of production

Powder for preparation of an oral solution

Storage conditions

At a temperature not exceeding 25 °C. Keep out of reach of children.

Shelf

life is 3 years.

Active ingredient

Paracetamol, Phenylephrine

Dosage form

oral solution