Efferalgan with Vitamin C: instructions for using the medicine, structure, Contraindications

Active material: vitamin C, paracetamol
When ATH: N02BE51
CCF: Analgesics, antipyretics combined structure
ICD-10 codes (testimony): J06.9, J10, K08.8, M79.1, M79.2, N94.4, N94.5, R50, R51, R52.0, R52.2
Manufacturer: BRISTOL-MYERS SQUIBB (France)

Efferalgan with Vitamin C: dosage form, composition and packaging

◊ Effervescent tablets white, flat, with beveled edges and a notch; when dissolved in water is observed effervescence.

Excipients: potassium bicarbonate, natriya carbonate, sorbitol, Citric acid anhydrous, Sodium benzoate, docusate sodium, povidone.

10 PC. – polypropylene tubes (1) – cardboard boxes.
10 PC. – polypropylene tubes (2) – cardboard boxes.

Efferalgan with Vitamin C: pharmachologic effect

Analgesics, antipyretics combined structure.

Paracetamol okazыvaet analygeziruyushtee and zharoponizhayushtee action. Inhibits COX-1 and COX-2 mainly in the central nervous system, acting on pain centers and thermoregulation.

Vitamin C (vitamin C) involved in the regulation of redox processes, It reduces the permeability of blood vessels and increases the body's resistance to infections.

Efferalgan with Vitamin C: pharmacokinetics

Data on the pharmacokinetics Efferalgan with vitamin C is not provided.

Efferalgan with Vitamin C: testimony

• colds (incl. ARI, flu) and other infectious and inflammatory diseases, accompanied by fever;
• pain syndrome of mild or moderate intensity: headache, toothache, neuralgia, myalgia, pain in trauma and burns, algomenorrhea.

Efferalgan with Vitamin C: dosing regimen

Adults and children over 15 years (body weight 50 kg or more) appoint 2-3 tab. 2-3 times / day. The maximum single dose is 3 tab. (990 mg paracetamol). The maximum daily dose – 12 tab. (3960 mg of paracetamol.).

Duration of treatment – no more 3 days of the appointment as antipyretic, no more 5 days – as analgesic

For children 8 and older depending on the body weight of the drug administered is based 10-15 mg of paracetamol on the 1 kg body weight 3-4 once a day. The maximum daily dose based on paracetamol – 60 mg / kg.

The ratio of the age and weight of the child are given approximately. The maximum duration of treatment for children is 3 day. If necessary, a more long-term therapy is required physician supervision.

The interval between doses of the drug is not less than 4 no.

In patients with impaired liver or kidney function, Gilbert's syndrome, in elderly patients the daily dose should be reduced, the interval between doses of the drug is not less than 8 no .

A tablet dissolved in a glass of water (200 ml) and drink.

Efferalgan with Vitamin C: side effects

Allergic reactions: itching, rashes on the skin and mucous membranes (usually erythematous or urticaria), angioedema, erythema multiforme exudative (incl. Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

From the central and peripheral nervous system: usually when taken in high doses – dizziness, psychomotor agitation, disorientation.

From the digestive system: nausea, epigastric pain, increase in liver transaminases, usually, without the development of jaundice, gepatonekroz (dose-dependent effect).

On the part of the endocrine system: gipoglikemiâ, up to hypoglycemic coma.

From the hematopoietic system: anemia (cyanosis), sulʹfogemoglobinemiâ, metgemoglobinemiâ (breathlessness, precordialgia), gemoliticheskaya anemia (especially for patients with deficiency of glucose-6-phosphate dehydrogenase); long-term use in high doses – aplasticheskaya anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia.

From the urinary system: when taken in high doses – nephrotoxicity (počečnaâ how, nonspecific bacteriuria, interstitial nephritis, papillary necrosis).

Efferalgan with Vitamin C: Contraindications

• Children up to age 8 years;
• hypersensitivity to the drug.

FROM caution use in patients with renal and / or hepatic insufficiency, benign hyperbilirubinemia (Gilbert's syndrome), viral gepatite, alcoholic liver disease, chronic alcoholism, in the definition, glucose-6-fosfatdegidrogenazы, Pregnancy, lactation, in elderly patients.

Efferalgan with Vitamin C: Pregnancy and lactation

Precautions should use the drug during pregnancy and lactation (breast-feeding)

Efferalgan with Vitamin C: Special instructions

With continued feverish syndrome, during treatment with paracetamol more 3 days, and pain syndrome – more 5 days, requires medical consultation.

The risk of liver damage increases with the use of the drug in patients with alcoholic hepatosis.

The drug distorts the performance of laboratory research for the quantitative determination of glucose and uric acid in plasma.

During long-term treatment is necessary to monitor patterns of peripheral blood and functional state of the liver.

In connection with the stimulating effect of ascorbic acid on the formation of corticosteroid hormones, You need to monitor renal function and blood pressure.

With prolonged use of ascorbic acid in high doses may oppression of the insular apparatus of the pancreas.

Patients with high content of iron in the body, ascorbic acid, should be used in minimum doses.

Appointment drugs, containing ascorbic acid, Patients with rapidly proliferating and rapidly metastasizing tumors may increase during the process.

Vitamin C, as a reducing agent, may distort the results of the various laboratory tests (blood levels of glucose, bilirubin, transaminases, LDH).

The appointment of the drug to patients, We are on a salt-restricted diet, should be considered, what in 1 tab. contains 330 mg of sodium.

The product contains sorbitol, so it should not be used when fructose intolerance, low absorption of glucose and galactose, isomaltase deficiency.

Efferalgan with Vitamin C: overdose

The clinical picture of acute overdose develops over 6-14 h adopted after paracetamol. Symptoms of chronic overdose manifested through 2-4 days after increasing the dose.

Symptoms: in acute overdose observed violations of the digestive system – diarrhea, decreased appetite, nausea and vomiting, abdominal discomfort and / or abdominal pain; increased sweating.

In chronic overdose develops hepatotoxic effects, characterized by common symptoms (pain, weakness, adinamija, increased perspiration) and specific, characterized by lesions of the liver. As a result, it may develop gepatonekroz. Hepatotoxic effect of paracetamol may be complicated by the development of hepatic encephalopathy (thought disorders, oppression of the higher nervous activity, agitation and stupor), convulsions, respiratory depression, coma, swelling of the brain, coagulation failure, the development of DIC, gipoglikemiâ, metabolic acidosis, arrhythmia, collapse. Rarely – fulminant hepatic failure, which may be complicated by renal failure (tubular necrosis).

Treatment: introduction of donators SH-groups and precursors of glutathione synthesis – through methionine 8-9 hours after the overdose and N-acetylcysteine – through 12 no. The need for additional therapeutic interventions (further introduction of methionine, a / introduction of N-acetylcysteine) It is determined depending on the concentration of acetaminophen in the blood, and the time, elapsed since his admission.

Efferalgan with Vitamin C: drug interaction

The drug reduces the effectiveness of drugs urikozuricheskih.

Concomitant use of paracetamol enhances the effect of high doses of anticoagulant agents (decreased synthesis of procoagulant factors in the liver).

Inductors of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, which makes the possibility of severe intoxication, even at low overdose.

With prolonged use of barbiturates is reduced effectiveness of paracetamol.

Inhibitors of microsomal oxidation (incl. cimetidine) reduce the risk of hepatotoxicity of paracetamol.

Long-term concomitant use of paracetamol and other NSAIDs increases the risk of analgesic nephropathy and renal papillary necrosis, onset ESRD.

At the same time long-term use in high acetaminophen doses of salicylates and increases the risk of cancer of the kidney or bladder.

Diflunisal increases plasma concentration of paracetamol 50%, thus there is a risk of hepatotoxicity.

Ascorbic acid enhances the absorption of penicillin, gland, reduces the effects of heparin and indirect anticoagulants, increases the risk of crystalluria in the treatment of salicylates.

The absorption of ascorbic acid decreased while the use of oral contraceptives.

Ascorbic acid slows down kidney acids, reduces the reabsorption of drugs, having an alkaline reaction (incl. alkaloidov).

Ascorbic acid in combination with deferoxamine increases the toxic effect of the iron on the fabric (especially on the heart, causing the development of heart failure), prescriptions, containing ascorbic acid is carried out after determining the concentration and determination of deferoxamine iron excretion, no earlier than 1-2 h after infusion of deferoxamine.

Ethanol contributes to the development of acute pancreatitis.

Efferalgan with Vitamin C: terms of dispensing from pharmacies

The drug is resolved to application as an agent Valium holidays.

Efferalgan with Vitamin C: terms and conditions of storage

The drug should be stored out of reach of children, dry place at temperatures no higher than 30 ° C. Shelf life – 3 year.