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Обезболивающие

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Аквацитрамон гранулы д/р-ра внутр 3 г x5

 ,

Код ATX: (Ацетилсалициловая кислота в комбинации с другими препаратами (исключая психолептики))


Активные вещества





Лекарственная форма









АКВАЦИТРАМОН
гранулы д/пригот. р-ра д/приема внутрь 360 мг+270 мг+45 мг/3 г: уп. 5 шт.
рег. №: Р N003404/01 от 29.12.09 - Действующее


Форма выпуска, состав и упаковка

















Гранулы для приготовления раствора для приема внутрь3 г гранул
ацетилсалициловая кислота360 мг
парацетамол270 мг
кофеин45 мг

3 г гранул - упаковки безъячейковые контурные (5) - пачки картонные.


Клинико-фармакологическая группа:


Приведенная научная информация является обобщающей и не может быть использована для принятия решения о возможности применения конкретного лекарственного препарата.



Фармакологическое действие



Комбинированное лекарственное средство.


Ацетилсалициловая кислота обладает жаропонижающим и противовоспалительным действием, ослабляет боль, особенно вызванную воспалительным процессом, а также умеренно угнетает агрегацию тромбоцитов и тромбообразование, улучшает микроциркуляцию в очаге воспаления.


Кофеин повышает рефлекторную возбудимость спинного мозга, возбуждает дыхательный и сосудодвигательный центры, расширяет кровеносные сосуды скелетных мышц, головного мозга, сердца, почек, снижает агрегацию тромбоцитов, уменьшает сонливость, чувство усталости, повышает умственную и физическую работоспособность. В данной комбинации кофеин в малой дозе практически не оказывает стимулирующего действия на ЦНС, однако способствует нормализации тонуса сосудов мозга и ускорению кровотока.


Парацетамол обладает анальгетическим, жаропонижающим и крайне слабым противовоспалительным действием, что связано с его влиянием на центр терморегуляции в гипоталамусе и слабовыраженной способностью ингибировать синтез простагландинов в периферических тканях.



Показания



Болевой синдром слабой и умеренной выраженности (различного генеза): головная боль, мигрень, зубная боль, невралгия, миалгия, артралгия, альгодисменорея.


Лихорадочный синдром: при ОРЗ, при гриппе.




Режим дозирования



Внутрь (во время или после еды) принимают каждые 4 ч. В среднем принимают 3-4 раза/сут. Максимальная частота приема - 8 раз/сут. Курс лечения - не более 7-10 дней.


При нарушении функции почек или печени перерыв между приемами - не менее 6 часов.


Препарат не следует принимать более чем 5 дней при назначении в качестве обезболивающего средства и более 3 дней в качестве жаропонижающего. Другие дозы и схемы применения устанавливает врач.



Побочное действие



Со стороны пищеварительной системы: гастралгия, тошнота, рвота, гепатотоксичность, эрозивно-язвенные поражения ЖКТ.


Со стороны мочевыделительной системы: нефротоксичность,


Аллергические реакции: кожные проявления, синдром Стивенса-Джонсона, синдром Лайелла, бронхоспазм.


Со стороны сердечно-сосудистой системы: тахикардия, повышение АД,


При длительном применении: головокружение, головная боль, нарушения зрения, шум в ушах, снижение агрегации тромбоцитов, гипокоагуляция, геморрагический синдром (в т.ч. носовое кровотечение, кровоточивость десен, пурпура и ), поражение почек с папиллярным некрозом, глухота, синдром Рейе у детей (гиперпирексия, метаболический ацидоз, нарушения со стороны нервной системы и психики, рвота, нарушения функции печени).



Противопоказания к применению



Повышенная чувствительность к компонентам препарата, эрозивно-язвенные поражения ЖКТ (в фазе обострения), желудочно-кишечное кровотечение, "аспириновая" астма, гемофилия, геморрагический диатез, гипопротромбинемия, портальная гипертензия, авитаминоз K, почечная недостаточность, I и III триместры беременности, период лактации (грудное вскармливание), дефицит глюкозо-6-фосфатдегидрогеназы, выраженная артериальная гипертензия, тяжелое течение ИБС, глаукома, повышенная возбудимость, нарушения сна, хирургические вмешательства, сопровождающиеся кровотечением, детский возраст (до 15 лет - риск развития синдрома Рейе у детей с гипертермией на фоне вирусных заболеваний).


C осторожностью: подагра, заболевания печени.



Применение при беременности и кормлении грудью



Противопоказано применение в I и III триместрах беременности и в период лактации (грудного вскармливания).


Ацетилсалициловая кислота обладает тератогенным действием, при применении в I триместре беременности приводит к пороку развития - расщеплению верхнего неба, в III триместре - к торможению родовой деятельности (ингибирование синтеза простагландинов), к закрытию артериального протока у плода, что вызывает гиперплазию легочных сосудов и гипертензию в сосудах малого круга кровообращения.


Выделяется с грудным молоком, что повышает риск возникновения кровотечений у ребенка вследствие нарушения функции тромбоцитов.



Применение при нарушениях функции печени



C осторожностью: заболевания печени.



Применение при нарушениях функции почек



Противопоказан при почечной недостаточности.



Применение у детей


Детям до 15 лет нельзя назначать лекарственные средства, содержащие ацетилсалициловую кислоту, поскольку в случае вирусной инфекции они способны увеличить риск возникновения синдрома Рейе. Симптомами синдрома Рейе являются продолжительная рвота, острая энцефалопатия, увеличение печени.


Особые указания



Детям нельзя назначать лекарственные средства, содержащие ацетилсалициловую кислоту, поскольку в случае вирусной инфекции они способны увеличить риск возникновения синдрома Рейе. Симптомами синдрома Рейе являются продолжительная рвота, острая энцефалопатия, увеличение печени.


При продолжительном применении препарата необходим контроль периферической крови и функционального состояния печени.


Поскольку ацетилсалициловая кислота замедляет свертывание крови, то пациент, если ему предстоит хирургическое вмешательство, должен заранее предупредить врача о приеме препарата.


Пациентам с повышенной чувствительностью или с астматическими реакциями на салицилаты или их производные ацетилсалициловую кислоту можно назначать только с соблюдением специальных мер предосторожности (в условиях службы неотложной помощи).


Ацетилсалициловая кислота в низких дозах уменьшает выведение мочевой кислоты. У пациентов с соответствующей предрасположенностью это может в ряде случаев спровоцировать приступ подагры.


Во время лечения следует отказаться от употребления этанола (повышение риска желудочно-кишечного кровотечения).



Лекарственное взаимодействие



Усиливает действие гепарина, непрямых антикоагулянтов, резерпина, стероидных гормонов и гипогликемических лекарственных средств.


Одновременное назначение с другими НПВС, метотрексатом увеличивает риск развития побочных эффектов.


Уменьшает эффективность спиронолактона, фуросемида, гипотензивных лекарственных средств, а также противоподагрических лекарственных средств, способствующих выведению мочевой кислоты.


Барбитураты, рифампицин, салициламид, противоэпилептические лекарственные средства и другие стимуляторы микросомального окисления способствуют образованию токсичных метаболитов парацетамола, влияющих на функцию печени.


Метоклопрамид ускоряет всасывание парацетамола.


Под воздействием парацетамола T1/2 хлорамфеникола увеличивается в 5 раз. При повторном приеме парацетамол может усилить действие антикоагулянтов (производных дикумарина).


Одновременный прием парацетамола и этанола повышает риск развития гепатотоксических эффектов.


Кофеин ускоряет всасывание эрготамина.

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Алгезир Ультра Инструкция по применению: 1. Форма выпуска и состав 2. Показания к применению 3. Противопоказания 4. Способ применения и дозировка 5. Побочные действия 6. Особые указания 7. Лекарственное взаимодействие 8. Аналоги 9. Сроки и условия хранения 10. Условия отпуска из аптек Таблетки, покрытые пленочной оболочкой, Алгезир УльтраАлгезир Ультра – нестероидный противовоспалительный препарат (НПВП). Форма выпуска и состав Лекарственная форма – таблетки, покрытые пленочной оболочкой: круглые, двояковыпуклые (275 мг) или продолговатые, двояковыпуклые, со скругленными концами, с риской (550 мг), голубого цвета, на поперечном разрезе видны 2 слоя, внутренний – белого или бело-желтоватого цвета (по 5, 10, 12 или 15 шт. в контурных ячейковых упаковках, в пачке картонной 1, 2, 3, 5, 6 либо 10 упаковок). В 1 таблетке содержится: Действующее вещество: напроксен натрия – 275 или 550 мг, Дополнительные компоненты: кремния диоксид коллоидный (аэросил), коповидон, сахар молочный (лактоза), макрогол 6000, целлюлоза микрокристаллическая, гипромеллоза (гидроксипропилметилцеллюлоза), тальк, титана диоксид, кальция стеарат, краситель бриллиантовый голубой. Показания к применению Лихорадочный синдром при инфекционных и «простудных» заболеваниях, Болевой синдром слабой или умеренной степени выраженности: посттравматический болевой синдром с воспалением (растяжения и ушибы), послеоперационная боль (в челюстно-лицевой хирургии, ортопедии, травматологии, гинекологии), головная боль, зубная боль, мигрень, миалгия, оссалгия, люмбоишиалгия, невралгия, аднексит, альгодисменорея, Заболевания опорно-двигательного аппарата: псориатический, ревматоидный, подагрический и ювенильный хронический артрит, ревматическое поражение мягких тканей, болезнь Бехтерева (анкилозирующий спондилоартрит), бурсит, тендовагинит, остеоартроз периферических суставов и позвоночника, в том числе с корешковым синдромом, Инфекционно-воспалительные заболевания ЛОР-органов с выраженным болевым синдромом: отит, тонзиллит, фарингит (в составе комплексной терапии). Таблетки Алгезир Ультра применяют для симптоматической терапии (снижения повышенной температуры тела, уменьшения боли и воспаления) и на прогрессирование заболевания не влияет. Противопоказания Абсолютные: Угнетение костномозгового кроветворения, Нарушение гемостаза, цереброваскулярное или другие кровотечения, Выраженная почечная недостаточность (клиренс креатинина меньше 20 мл/минуту), Период после проведения аортокоронарного шунтирования, Обострение воспалительного заболевания кишечника (неспецифического язвенного колита, болезни Крона), Активное желудочно-кишечное кровотечение, эрозивно-язвенные изменения слизистой оболочки желудка или 12-перстной кишки, Анамнестические данные о приступе бронхообструкции, ринита, крапивницы после приема любого НПВП, в том числе ацетилсалициловой кислоты, Детский и подростковый возраст до 15 лет, Беременность и лактация, Гиперчувствительность к компонентам препарата. Относительные (Алгезир Ультра принимают с осторожностью): Клиренс креатинина от 20 до 60 мл/минуту, Сахарный диабет, Дислипидемия/гиперлипидемия, Цереброваскулярные заболевания, Ишемическая болезнь сердца, Тяжелые соматические заболевания, Заболевания периферических артерий, Хроническая сердечная недостаточность, Курение, Частое употребление алкоголя, Наличие инфекции Helicobacter pylori, Язвенные поражения желудочно-кишечного тракта в анамнезе, Пожилой возраст, Длительное лечение с применением НПВП, Одновременный прием селективных ингибиторов обратного захвата серотонина (в том числе циталопрама, пароксетина, флуоксетина, сертралина), антикоагулянтов (например, варфарина), пероральных глюкокортикостероидов (например, преднизолона), антиагрегантов (в том числе клопидогрела, ацетилсалициловой кислоты). Способ применения и дозировка Алгезир Ультра следует принимать внутрь во время еды: глотать таблетки целиком и запивать достаточным количеством жидкости. Рекомендуемые дозы: Болевой синдром: 550-1100 мг, при заболеваниях, сопровождающихся очень сильными болями, но при условии отсутствия анамнестических данных о болезнях желудочно-кишечного тракта, возможно увеличение суточной дозы до 1650 мг, однако продолжительность такого лечения не должна превышать 2 недели, Повышенная температура тела: первая доза – 550 мг, далее каждые 6-8 часов – по 275 мг, Мигрень: при болевом синдроме – по 550 мг 2 раза в сутки, если в течение 4-6 недель интенсивность, длительность и частота приступов мигрени не уменьшаются, препарат следует отменить, при первых признаках мигренозного приступа рекомендуется принять 825 мг, при необходимости через 30 минут – еще 275-550 мг, Гинекологические боли (альгодисменорея, аднексит, боль после введения внутриматочной спирали и др.): начальная доза – 550 мг, далее каждые 6-8 часов – по 275 мг, Острый приступ подагры: начальная доза – 825 мг, через 8 часов – 550 мг, далее каждые 8 часов – по 275 мг до прекращения приступа, Ревматические заболевания: по 550-1100 мг 2 раза в сутки (утром и вечером) в зависимости от клинической ситуации. Обычная суточная доза составляет 550-1100 мг в 2 приема. Пациентам, у которых боль является основным симптомом, больным, переводимым на Алгезир Ультра с высоких доз другого НПВП, а также при выраженной ночной боли и/или утренней скованности рекомендуемая начальная суточная доза составляет 825-1650 мг. Побочные действия Со стороны пищеварительной системы: язвенные стоматиты, диарея/запор, мелена, дискомфорт в эпигастрии, тошнота, боль в животе, рвота, рвота с кровью, кровотечения и перфорации желудочно-кишечного тракта, нарушение функции печени, повышение активности печеночных ферментов, гастропатии, связанные с приемом НПВП (поражение антрального отдела желудка в виде язв, эрозий, кровоизлияний, эритемы слизистой оболочки), желтуха, гепатит, Со стороны сердечно-сосудистой системы: одышка, отеки, сердцебиение, васкулит, застойная сердечная недостаточность, Со стороны мочеполовой системы: нефротический синдром, гематурия, почечный папиллярный некроз, почечная недостаточность, интерстициальный нефрит, гломерулонефрит, нарушения менструального цикла, Со стороны центральной нервной системы: затруднение концентрации внимания, нарушение сна, сонливость, головная боль, головокружение, бессонница, мышечная слабость, замедление скорости реакции, миалгия, асептический менингит, недомогание, когнитивная дисфункция, депрессия, Со стороны кроветворных органов: гемолитическая анемия, тромбоцитопения, лейкопения, апластическая анемия, гранулоцитопения, эозинофилия, Со стороны дыхательной системы: эозинофильная пневмония, Со стороны органов чувств: нарушение зрения, снижение слуха, шум в ушах, Со стороны кожных покровов: экхимозы, зуд, повышенная потливость, фотодерматозы, алопеция, тромбоцитопеническая пурпура, Аллергические реакции: крапивница, кожная сыпь, синдром Стивенса-Джонсона, мультиформная экссудативная эритема, эпидермальный токсический некролиз (синдром Лайелла), ангионевротический отек, Прочие реакции: гипогликемия, гипергликемия, гипертермия, жажда. Особые указания Во избежание развития нежелательных реакций со стороны желудочно-кишечного тракта рекомендуется принимать Алгезир Ультра в минимальной эффективной дозе минимально возможным коротким курсом. Если лихорадка и/или боль сохраняются либо усиливаются, следует обратиться к врачу. У пациентов с почечной недостаточностью во время лечения напроксеном необходимо контролировать клиренс креатинина. Если этот уровень ниже 20 мл/минуту, принимать препарат не рекомендуется. Пациентам с повышенной чувствительностью к другим анальгетикам, нарушением свертываемости крови и бронхиальной астмой перед применением Алгезира Ультра нужно проконсультироваться с врачом. Пациентам, которые проходят терапию антикоагулянтами, необходимо учитывать, что напроксен может увеличивать время кровотечения. Концентрация несвязанного напроксена повышается при циррозе печени (в том числе хроническом алкогольном), поэтому таким пациентам рекомендуется принимать более низкие дозы. Снижение дозы необходимо и людям пожилого возраста. Без назначения врача Алгезир Ультра нельзя принимать одновременно с другими анальгезирующими и противовоспалительными средствами. Препарат отменяют за 48 часов до хирургического вмешательства, проведения анализа на определение 17-кетостероидов и концентрации в моче 5-ксииндолилуксусной кислоты. Пациентам, которые придерживаются диеты с ограничением потребления соли, следует учитывать, что каждая таблетка содержит около 25 мг натрия. Лекарственное взаимодействие Алгезир Ультра не принимают одновременно с другими НПВС, поскольку возрастает риск развития побочных эффектов. Магний- и алюминийсодержащие антациды уменьшают абсорбцию напроксена, пробенецид увеличивает его концентрацию в плазме крови. При сочетанном применении с циклоспорином возрастает риск развития почечной недостаточности. При одновременном применении препаратов, которые в значительной степени связываются с белками плазмы (например, антикоагулянтов, дифенина, фенитоина), возможно усиление их действия или передозировка. Напроксен может ингибировать натрийуретическое действие фуросемида, уменьшать гипотензивное действие бета-адреноблокаторов (в том числе пропранолола), а также увеличивать риск развития почечной недостаточности вследствие применения ингибиторов ангиотензин-превращающего фермента. Напроксен способствует увеличению концентрации лития в плазме, а также замедляет экскрецию сульфаниламидов, фенитоина и метотрексата, из-за чего увеличивает вероятность развития их токсического действия. Миелотоксические средства усиливают проявления гематотоксичности Алгезира Ультра. Аналоги Аналогами препарата Алгезир Ультра являются: Налгезин, Налгезин Форте, Напроксен, Напроксен-Акри. Сроки и условия хранения Хранить в недоступном для детей, защищенном от света и влаги месте, при температуре до 25 °С. Срок годности – 2 года. Условия отпуска из аптек Таблетки, покрытые пленочной оболочкой, 275 мг отпускаются без рецепта, таблетки, покрытые пленочной оболочкой, 550 мг – по рецепту.

Источник: http://www.neboleem.net/algezir-ultra.php

Алгезир Ультра Инструкция по применению: 1. Форма выпуска и состав 2. Показания к применению 3. Противопоказания 4. Способ применения и дозировка 5. Побочные действия 6. Особые указания 7. Лекарственное взаимодействие 8. Аналоги 9. Сроки и условия хранения 10. Условия отпуска из аптек Таблетки, покрытые пленочной оболочкой, Алгезир УльтраАлгезир Ультра – нестероидный противовоспалительный препарат (НПВП). Форма выпуска и состав Лекарственная форма – таблетки, покрытые пленочной оболочкой: круглые, двояковыпуклые (275 мг) или продолговатые, двояковыпуклые, со скругленными концами, с риской (550 мг), голубого цвета, на поперечном разрезе видны 2 слоя, внутренний – белого или бело-желтоватого цвета (по 5, 10, 12 или 15 шт. в контурных ячейковых упаковках, в пачке картонной 1, 2, 3, 5, 6 либо 10 упаковок). В 1 таблетке содержится: Действующее вещество: напроксен натрия – 275 или 550 мг, Дополнительные компоненты: кремния диоксид коллоидный (аэросил), коповидон, сахар молочный (лактоза), макрогол 6000, целлюлоза микрокристаллическая, гипромеллоза (гидроксипропилметилцеллюлоза), тальк, титана диоксид, кальция стеарат, краситель бриллиантовый голубой. Показания к применению Лихорадочный синдром при инфекционных и «простудных» заболеваниях, Болевой синдром слабой или умеренной степени выраженности: посттравматический болевой синдром с воспалением (растяжения и ушибы), послеоперационная боль (в челюстно-лицевой хирургии, ортопедии, травматологии, гинекологии), головная боль, зубная боль, мигрень, миалгия, оссалгия, люмбоишиалгия, невралгия, аднексит, альгодисменорея, Заболевания опорно-двигательного аппарата: псориатический, ревматоидный, подагрический и ювенильный хронический артрит, ревматическое поражение мягких тканей, болезнь Бехтерева (анкилозирующий спондилоартрит), бурсит, тендовагинит, остеоартроз периферических суставов и позвоночника, в том числе с корешковым синдромом, Инфекционно-воспалительные заболевания ЛОР-органов с выраженным болевым синдромом: отит, тонзиллит, фарингит (в составе комплексной терапии). Таблетки Алгезир Ультра применяют для симптоматической терапии (снижения повышенной температуры тела, уменьшения боли и воспаления) и на прогрессирование заболевания не влияет. Противопоказания Абсолютные: Угнетение костномозгового кроветворения, Нарушение гемостаза, цереброваскулярное или другие кровотечения, Выраженная почечная недостаточность (клиренс креатинина меньше 20 мл/минуту), Период после проведения аортокоронарного шунтирования, Обострение воспалительного заболевания кишечника (неспецифического язвенного колита, болезни Крона), Активное желудочно-кишечное кровотечение, эрозивно-язвенные изменения слизистой оболочки желудка или 12-перстной кишки, Анамнестические данные о приступе бронхообструкции, ринита, крапивницы после приема любого НПВП, в том числе ацетилсалициловой кислоты, Детский и подростковый возраст до 15 лет, Беременность и лактация, Гиперчувствительность к компонентам препарата. Относительные (Алгезир Ультра принимают с осторожностью): Клиренс креатинина от 20 до 60 мл/минуту, Сахарный диабет, Дислипидемия/гиперлипидемия, Цереброваскулярные заболевания, Ишемическая болезнь сердца, Тяжелые соматические заболевания, Заболевания периферических артерий, Хроническая сердечная недостаточность, Курение, Частое употребление алкоголя, Наличие инфекции Helicobacter pylori, Язвенные поражения желудочно-кишечного тракта в анамнезе, Пожилой возраст, Длительное лечение с применением НПВП, Одновременный прием селективных ингибиторов обратного захвата серотонина (в том числе циталопрама, пароксетина, флуоксетина, сертралина), антикоагулянтов (например, варфарина), пероральных глюкокортикостероидов (например, преднизолона), антиагрегантов (в том числе клопидогрела, ацетилсалициловой кислоты). Способ применения и дозировка Алгезир Ультра следует принимать внутрь во время еды: глотать таблетки целиком и запивать достаточным количеством жидкости. Рекомендуемые дозы: Болевой синдром: 550-1100 мг, при заболеваниях, сопровождающихся очень сильными болями, но при условии отсутствия анамнестических данных о болезнях желудочно-кишечного тракта, возможно увеличение суточной дозы до 1650 мг, однако продолжительность такого лечения не должна превышать 2 недели, Повышенная температура тела: первая доза – 550 мг, далее каждые 6-8 часов – по 275 мг, Мигрень: при болевом синдроме – по 550 мг 2 раза в сутки, если в течение 4-6 недель интенсивность, длительность и частота приступов мигрени не уменьшаются, препарат следует отменить, при первых признаках мигренозного приступа рекомендуется принять 825 мг, при необходимости через 30 минут – еще 275-550 мг, Гинекологические боли (альгодисменорея, аднексит, боль после введения внутриматочной спирали и др.): начальная доза – 550 мг, далее каждые 6-8 часов – по 275 мг, Острый приступ подагры: начальная доза – 825 мг, через 8 часов – 550 мг, далее каждые 8 часов – по 275 мг до прекращения приступа, Ревматические заболевания: по 550-1100 мг 2 раза в сутки (утром и вечером) в зависимости от клинической ситуации. Обычная суточная доза составляет 550-1100 мг в 2 приема. Пациентам, у которых боль является основным симптомом, больным, переводимым на Алгезир Ультра с высоких доз другого НПВП, а также при выраженной ночной боли и/или утренней скованности рекомендуемая начальная суточная доза составляет 825-1650 мг. Побочные действия Со стороны пищеварительной системы: язвенные стоматиты, диарея/запор, мелена, дискомфорт в эпигастрии, тошнота, боль в животе, рвота, рвота с кровью, кровотечения и перфорации желудочно-кишечного тракта, нарушение функции печени, повышение активности печеночных ферментов, гастропатии, связанные с приемом НПВП (поражение антрального отдела желудка в виде язв, эрозий, кровоизлияний, эритемы слизистой оболочки), желтуха, гепатит, Со стороны сердечно-сосудистой системы: одышка, отеки, сердцебиение, васкулит, застойная сердечная недостаточность, Со стороны мочеполовой системы: нефротический синдром, гематурия, почечный папиллярный некроз, почечная недостаточность, интерстициальный нефрит, гломерулонефрит, нарушения менструального цикла, Со стороны центральной нервной системы: затруднение концентрации внимания, нарушение сна, сонливость, головная боль, головокружение, бессонница, мышечная слабость, замедление скорости реакции, миалгия, асептический менингит, недомогание, когнитивная дисфункция, депрессия, Со стороны кроветворных органов: гемолитическая анемия, тромбоцитопения, лейкопения, апластическая анемия, гранулоцитопения, эозинофилия, Со стороны дыхательной системы: эозинофильная пневмония, Со стороны органов чувств: нарушение зрения, снижение слуха, шум в ушах, Со стороны кожных покровов: экхимозы, зуд, повышенная потливость, фотодерматозы, алопеция, тромбоцитопеническая пурпура, Аллергические реакции: крапивница, кожная сыпь, синдром Стивенса-Джонсона, мультиформная экссудативная эритема, эпидермальный токсический некролиз (синдром Лайелла), ангионевротический отек, Прочие реакции: гипогликемия, гипергликемия, гипертермия, жажда. Особые указания Во избежание развития нежелательных реакций со стороны желудочно-кишечного тракта рекомендуется принимать Алгезир Ультра в минимальной эффективной дозе минимально возможным коротким курсом. Если лихорадка и/или боль сохраняются либо усиливаются, следует обратиться к врачу. У пациентов с почечной недостаточностью во время лечения напроксеном необходимо контролировать клиренс креатинина. Если этот уровень ниже 20 мл/минуту, принимать препарат не рекомендуется. Пациентам с повышенной чувствительностью к другим анальгетикам, нарушением свертываемости крови и бронхиальной астмой перед применением Алгезира Ультра нужно проконсультироваться с врачом. Пациентам, которые проходят терапию антикоагулянтами, необходимо учитывать, что напроксен может увеличивать время кровотечения. Концентрация несвязанного напроксена повышается при циррозе печени (в том числе хроническом алкогольном), поэтому таким пациентам рекомендуется принимать более низкие дозы. Снижение дозы необходимо и людям пожилого возраста. Без назначения врача Алгезир Ультра нельзя принимать одновременно с другими анальгезирующими и противовоспалительными средствами. Препарат отменяют за 48 часов до хирургического вмешательства, проведения анализа на определение 17-кетостероидов и концентрации в моче 5-ксииндолилуксусной кислоты. Пациентам, которые придерживаются диеты с ограничением потребления соли, следует учитывать, что каждая таблетка содержит около 25 мг натрия. Лекарственное взаимодействие Алгезир Ультра не принимают одновременно с другими НПВС, поскольку возрастает риск развития побочных эффектов. Магний- и алюминийсодержащие антациды уменьшают абсорбцию напроксена, пробенецид увеличивает его концентрацию в плазме крови. При сочетанном применении с циклоспорином возрастает риск развития почечной недостаточности. При одновременном применении препаратов, которые в значительной степени связываются с белками плазмы (например, антикоагулянтов, дифенина, фенитоина), возможно усиление их действия или передозировка. Напроксен может ингибировать натрийуретическое действие фуросемида, уменьшать гипотензивное действие бета-адреноблокаторов (в том числе пропранолола), а также увеличивать риск развития почечной недостаточности вследствие применения ингибиторов ангиотензин-превращающего фермента. Напроксен способствует увеличению концентрации лития в плазме, а также замедляет экскрецию сульфаниламидов, фенитоина и метотрексата, из-за чего увеличивает вероятность развития их токсического действия. Миелотоксические средства усиливают проявления гематотоксичности Алгезира Ультра. Аналоги Аналогами препарата Алгезир Ультра являются: Налгезин, Налгезин Форте, Напроксен, Напроксен-Акри. Сроки и условия хранения Хранить в недоступном для детей, защищенном от света и влаги месте, при температуре до 25 °С. Срок годности – 2 года. Условия отпуска из аптек Таблетки, покрытые пленочной оболочкой, 275 мг отпускаются без рецепта, таблетки, покрытые пленочной оболочкой, 550 мг – по рецепту.

Источник: http://www.neboleem.net/algezir-ultra.php

ИНСТРУКЦИЯ
по медицинскому применению препарата



Регистрационный номер:

ЛСР-002736/09



Торговое название препарата: Алгезир Ультра®


Международное непатентованное название (МНН): напроксен


Лекарственная форма:

Таблетки, покрытые пленочной оболочкой





Состав:


Активное вещество: напроксен натрия – 275 мг и 550 мг.


Вспомогательные вещества: кальция стеарат, коповидон, кремния диоксид коллоидный (аэросил), сахар молочный (лактоза), целлюлоза микрокристаллическая, тальк, гипромеллоза (гидроксипропилметилцеллюлоза), макрогол 6000, титана диоксид, краситель бриллиантовый голубой - достаточное количество до получения таблетки с оболочкой массой 360 мг и 720 мг.




Описание:


Таблетки, покрытые пленочной оболочкой голубого цвета, круглые, двояковыпуклой формы (при дозировке 275 мг) или двояковыпуклые, продолговатой формы со скругленными концами, с риской (при дозировке 550 мг). На поперечном разрезе видны два слоя, внутренний слой белого или белого с желтоватым оттенком цвета.




Фармакотерапевтическая группа:


Нестероидный противовоспалительный препарат (НПВП).




Код АТХ М01АЕ02




Фармакологические свойства:


Алгезир Ультра, представляет собой препарат напроксена, обладает обезболивающим, жаропонижающим и противовоспалительным действием. Механизм действия связан с неселективным подавлением активности циклооксигеназы 1 (ЦОГ1) и циклооксигеназы 2 (ЦОГ2).


Таблетки, покрытые пленочной оболочкой, хорошо растворяются, быстро всасываются из желудочно-кишечного тракта (ЖКТ) и обеспечивают быстрое наступление обезболивающего эффекта.




Фармакокинетика:


Абсорбция из ЖКТ - быстрая и полная, биодоступность - 95% (прием пищи практически не влияет ни на полноту, ни на скорость всасывания). Время достижения максимальной концентрации (TCmax) - через 1-2 часа, связь с белками плазмы >, 99%.


Период полувыведения (T1/2) составляет 12-15 ч. Метаболизм - в печени до диметилнапроксена с участием изофермента CYP2C9. Клиренс - 0.13 мл/мин/кг. Выводится на 98% почками, 10% из них выводится в неизмененном виде, с желчью - 0.5-2.5%. Равновесная концентрация определяется к приему 4-5 доз препарата (2-3 дня). При хронической почечной недостаточности (ХПН) возможна кумуляция метаболитов.


Показания:


Алгезир Ультра используется для симптоматической терапии (для уменьшения боли, воспаления и снижения повышенной температуры тела) и на прогрессирование основного заболевания не влияет.


· Заболевания опорно-двигательного аппарата (ревматоидный артрит, псориатический, ювенильный хронический артрит, анкилозирующий спондилоартрит (болезнь Бехтерева), подагрический артрит, ревматическое поражение мягких тканей, остеоартроз периферических суставов и позвоночника, в том числе с корешковым синдромом, тендовагинит, бурсит).


· Болевой синдром слабой или умеренной степени выраженности: невралгия, оссалгия, миалгия, люмбоишиалгия, посттравматический болевой синдром (растяжения и ушибы), сопровождающийся воспалением, послеоперационная боль (в травматологии, ортопедии, гинекологии, челюстно-лицевой хирургии), головная боль, мигрень, альгодисменорея, аднексит, зубная боль.


· В составе комплексной терапии инфекционно-воспалительных заболеваниях уха, горла и носа с выраженным болевым синдромом (фарингит, тонзиллит, отит).


· Лихорадочный синдром при "простудных" и инфекционных заболеваниях.






Противопоказания:


· Гиперчувствительность к напроксену, с анамнестическими данными о приступе бронхообструкции, ринита, крапивницы после приема ацетилсалициловой кислоты или иного нестероидного противовоспалительного препарата (НПВП) (полный или неполный синдром непереносимости ацетилсалициловой кислоты - риносинусит, крапивница, полипы слизистой оболочки носа, бронхиальная астма).


· Период после проведения аортокоронарного шунтирования.


· Эрозивно-язвенные изменения слизистой оболочки желудка или 12- перстной кишки, активное желудочно-кишечное кровотечение.


· Воспалительные заболевания кишечника, в фазе обострения (неспецифический язвенный колит (НЯК), болезнь Крона).


· Цереброваскулярное кровотечение или иные кровотечения и нарушение гемостаза.


· Выраженная почечная недостаточность (клиренс креатинина менее 20 мл/мин).


· Угнетение костномозгового кроветворения.


· Беременность, период грудного вскармливания.


· Дети и подростки младше 15 лет.






С осторожностью:


Хроническая сердечная недостаточность, ишемическая болезнь сердца, цереброваскулярные заболевания, дислипидемия/гиперлипидемия, сахарный диабет, заболевания периферических артерий, курение, клиренс креатинина от 20 до 60 мл/мин, язвенные поражения ЖКТ в анамнезе, наличие инфекции Нelicobacter pуlori, длительное использование НПВП, частое употребление алкоголя, тяжёлые соматические заболевания, пожилой возраст, одновременный приём пероральных глюкокортикостероидов (в т.ч. преднизолона), антикоагулянтов (в т.ч. варфарина), антиагрегантов (в т.ч. ацетилсалициловой кислоты, клопидогрела), селективных ингибиторов обратного захвата серотонина (в т.ч. циталопрама, флуоксетина, пароксетина, сертралина). Для снижения риска развития нежелательных явлений со стороны ЖКТ следует использовать минимальную эффективную дозу минимально возможным курсом.




Беременность и период лактации:


Алгезир Ультра не рекомендуется применять в период беременности и кормления грудью.




Способ применения и дозы:


Внутрь. Таблетки следует принимать не разжевывая, с достаточным количеством воды или другой жидкости, возможно, применять во время еды.


Обычная суточная доза, используемая для облегчения боли, составляет 550-1100 мг.


При очень сильных болях и отсутствии в анамнезе желудочно-кишечных заболеваний, врач может увеличить суточную дозу до 1650 мг, но не более чем на 2 недели.


При использовании препарата в качестве жаропонижающего средства начальная доза составляет 550 мг, далее принимается по 275 мг каждые 6-8 часов.


Для снятия болевого синдрома при мигрени рекомендуется по 550 мг дважды в день. Однако лечение должно быть прекращено, если частота, интенсивность и длительность приступов мигрени не уменьшаются в течение 4 - 6 недель. При первых признаках мигренозного приступа следует принять 825 мг, а при необходимости еще 275-550 мг спустя 30 минут.


Для облегчения менструальных болей, болей после введения ВМС (внутриматочных спиралей) и других гинекологических болей (аднексит) рекомендуется назначение препарата в начальной дозе, составляющей 550 мг, далее по 275 мг каждые 6-8 часов.


При остром приступе подагры начальная доза составляет 825 мг, далее 550 мг спустя 8 часов, а затем 275 мг каждые 8 часов до прекращения приступа.


При ревматоидных заболеваниях (ревматоидный артрит, остеоартрит и анкилозирующий спондилоартрит) обычная начальная доза препарата составляет от 550 мг до 1100 мг, дважды в день утром и вечером. Начальная суточная доза, составляющая от 825 мг до 1650 мг, рекомендуется пациентам с выраженной ночной болью и/или выраженной утренней скованностью, пациентам, переводимым на лечение напроксеном с высоких доз других НПВП, и пациентам, у которых боль является ведущим симптомом. Обычно суточная доза составляет 550-1100 мг, назначаемые в два приема.




Побочное действие:


- Со стороны пищеварительной системы: гастропатии, связанные с приемом нестероидных противовоспалительных препаратов (поражение антрального отдела желудка в виде эритемы слизистой оболочки, кровоизлияний, эрозий и язв), тошнота, рвота, дискомфорт в эпигастрии, боль в животе, диарея, запор, язвенные стоматиты, кровотечения и перфорации ЖКТ, повышение активности "печеночных" ферментов, нарушение функции печени, желтуха, гепатит, рвота с кровью, мелена.


- Со стороны центральной нервной системы: головокружение, головная боль, сонливость, депрессия, нарушение сна, бессонница, недомогание, миалгия и мышечная слабость, затруднение концентрации внимания и замедление скорости реакции, когнитивная дисфункция, асептический менингит.


- Со стороны кожных покровов: зуд, экхимозы, повышенная потливость, тромбоцитопеническая пурпура, алопеция, фотодерматозы.


- Со стороны органов чувств: шум в ушах, снижение слуха, нарушение зрения.


- Со стороны сердечно-сосудистой системы: отеки, одышка, сердцебиение, застойная сердечная недостаточность, васкулит.


- Со стороны мочеполовой системы: гломерулонефрит, гематурия, интерстициальный нефрит, нефротический синдром, почечная недостаточность, почечный папиллярный некроз, нарушение менструального цикла.


- Со стороны кроветворных органов: эозинофилия, гранулоцитопения, лейкопения, тромбоцитопения, апластическая анемия, гемолитическая анемия.


- Со стороны дыхательной системы: эозинофильная пневмония.


- Аллергические реакции: кожная сыпь, крапивница, ангионевротический отек, эпидермальный токсический некролиз (синдром Лайелла), мультиформная экссудативная эритема, синдром Стивенса-Джонсона.


- Другие: жажда, гипертермия, гипергликемия, гипогликемия.




Передозировка:


Значительная передозировка препарата может характеризоваться сонливостью, диспепсическими расстройствами (изжога, тошнота, рвота, боль в животе), слабостью, шумом в ушах, в тяжелых случаях – рвота с кровью, мелена, судороги и почечная недостаточность.


Лечение: промывание желудка, активированный уголь – 0,5 г/кг, симптоматическая терапия. Гемодиализ не эффективен.




Взаимодействие с другими лекарственными средствами:


Не следует применять препарат одновременно с другими нестероидными противовоспалительными препаратами (возрастает риск развитие побочных эффектов).


При одновременном приеме фенитоина, дифенина, антикоагулянтов или других лекарственных препаратов, связывающихся в значительной степени с белками плазмы, возможно усиление действия или передозировка этих препаратов.


Препарат Алгезир Ультра может снижать антигипертензивное действие пропранолола или других бета-адреноблокаторов, а также может увеличивать риск почечной недостаточности, связанной с применением ингибиторов АПФ. Под действием напроксена ингибируется натрийуретическое действие фуросемида.


Ингибирование почечного клиренса лития приводит к увеличению концентраций лития в плазме. Прием пробенецида увеличивает концентрацию напроксена в плазме. Циклоспорин увеличивает риск развития почечной недостаточности.


Напроксен замедляет экскрецию метотрексата, фенитоина, сульфаниламидов, увеличивая риск развития их токсического действия.


Антацидные препараты, содержащие магний и алюминий, уменьшают абсорбцию напроксена.


Миелотоксические лекарственные средства усиливают проявления гематотоксичности препарата.


Особые указания:


Не превышайте доз, указанных в инструкции, для снижения риска развития нежелательных явлений со стороны ЖКТ следует использовать минимальную эффективную дозу минимально возможным коротким курсом.


Если боль и лихорадка сохраняются или становятся сильнее, следует обратиться к врачу.


При лечении антикоагулянтами следует иметь в виду, что напроксен может увеличивать время кровотечения.


Пациентам с бронхиальной астмой, с нарушением свертываемости крови, а также пациентам с повышенной чувствительностью к другим анальгетикам перед приемом Алгезира Ультра следует проконсультироваться с врачом.


С осторожностью следует назначать пациентам с заболеваниями печени и почечной недостаточностью. У пациентов с почечной недостаточностью необходимо контролировать уровень клиренса креатина. При уровне клиренса креатинина ниже 20 мл/мин, назначать препарат не рекомендуется.


При хроническом алкогольном и других формах цирроза концентрация несвязанного напроксена повышается, поэтому таким пациентам рекомендуются более низкие дозы.


Алгезир Ультра не следует принимать вместе с другими противовоспалительными и болеутоляющими препаратами, за исключением назначений врача.


Пациентам пожилого возраста рекомендуются более низкие дозы.


Следует избегать приема препарата в течение 48 часов до хирургического вмешательства.


При необходимости определения 17-кетостероидов в моче препарат следует отменить за 48 часов до исследования. Напроксен способен также влиять на результат определения концентрации 5-гидроксииндолилуксусной кислоты в моче.


Каждая таблетка Алгезира Ультра содержит приблизительно 25 мг натрия. При ограничении потребления соли, это необходимо учитывать.




Форма выпуска:

Таблетки, покрытые пленочной оболочкой 275 и 550 мг.

По 5, 10, 12 и 15 таблеток в контурную ячейковую упаковку из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной.


По 1, 2, 3, 5, 6 или 10 контурных ячейковых упаковок вместе с инструкцией по применению помещают в пачку из картона.




Условия хранения:


Список Б. Хранить в сухом, защищенном от света месте при температуре не выше 250С. Хранить в не доступном для детей месте.




Срок годности:


2 года. Не использовать после истечения срока годности.




Отпуск из аптек:


Таблетки, покрытые пленочной оболочкой, 275 мг отпускается без рецепта.


Таблетки, покрытые пленочной оболочкой, 550 мг отпускается по рецепту врача.


Применять по назначению врача.

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Торговое название: АНАЛЬГИН АВЕКСИМА
Международное непатентованное название: метамизол натрия
Химическое рациональное название:
1-фенил-2,3-диметил-4-метиламинопиразолон-5-N-метансульфонат натрия

Лекарственная форма: таблетки
Состав: Активное вещество: метамизол натрия – 500 мг. Вспомогательные вещества: крахмал картофельный, кальция стеарат, сахароза (сахар), тальк.
Описание
Таблетки белого или белого со слегка желтоватым оттенком цвета, плоскоцилиндрические с фаской и риской.
Фармакотерапевтическая группа: анальгезирующее ненаркотическое средство.
Код АТХ: N02BB02
Фармокологические свойства
Обладает обезболивающим, жаропонижающим и слабым противовоспалительным действием, является производным пиразолона.
Фармакодинамика
АНАЛЬГИН АВЕКСИМА неселективно блокирует циклооксигеназу и снижает образование простагландинов из арахидоновой кислоты, препятствует проведению болевых экстра- и проприоцептивных импульсов. АНАЛЬГИН АВЕКСИМА обладает слабо выраженным противовоспалительным эффектом, обуславливающим малое влияние на водно-солевой обмен (задержка натрия и воды) и слизистую ЖКТ. Оказывает спазмолитическое действие на гладкую мускулатуру мочевых и желчных путей. Действие развивается через 20-40 минут после приема внутрь.
Фармакокинетика
Хорошо и быстро всасывается из ЖКТ, что обеспечивает быстрое развитие клинического эффекта. При приеме в терапевтических дозах проникает в материнское молоко. Максимальная концентрация в плазме достигается через 1-1,5 ч после приема внутрь. В стенках кишечника гидролизуется с образованием активного метаболита, 4-метил-амино-антипирина, который в свою очередь метаболизируется в 4-формил-амино-антипирин и другие метаболиты. Уровень связывания активного метаболита с белками составляет 50-60 %. Экскреция метаболитов проходит через почки. Кроме того, метаболиты выделяются с грудным молоком.
Показания к применению
Лихорадочный синдром на фоне инфекционно-воспалительных заболеваний, головная боль различного генеза, болевой синдром слабой и умеренной выраженности: невралгия, миалгия, артралгия, желчная колика, кишечная колика, почечная колика, травмы, радикулит, миозит, послеоперационный болевой синдром, альгодисменорея.
Противопоказания
Гиперчувствительность, угнетение кроветворения (агранулоцитоз, нейтропения), печеночная и/или почечная недостаточность, наследственная гемолитическая анемия, связанная с дефицитом глюкозо-6-фосфатдегидрогеназы и другие виды анемии, астма индуцированная приемом ацетилсалициловой кислоты, салицилатов и других нестеройдных противовоспалительных средств, лейкопения, беременность (особенно в I триместре и в последние 6 недель), период лактации, детский возраст до 8 лет.
С осторожностью
С осторожностью следует принимать препарат при заболеваниях почек (пиелонефрит, гломерулонефрит – в т.ч. в анамнезе), при умерено выраженных нарушениях печени и почек, бронхиальной астме, предрасположенностью к развитию артериальной гипотензии, длительном злоупотреблении алкоголем.
Способ применения и дозы
Внутрь, после еды, взрослым назначают по 250-500 мг 2-3 раза в сутки, максимальная разовая доза – 1000 мг, суточная – 3000 мг. Разовые дозы для
детей 8-14 лет – 250-300 мг, кратность назначения 2-3 раза в сутки. Продолжительность приема без консультации с врачом не более 5 дней.
Побочное действие
Со стороны мочевыделительной системы: нарушение функции почек, олигурия, анурия, протеинурия, интерстициальный нефрит, окрашивание
мочи в красный цвет. Аллергические реакции: крапивница (в т.ч. на коньюнктиве и слизистых оболочках носоглотки), ангионевротический отек, в редких случаях – злокачественная экссудативная эритема (синдром Стивенса-Джонсона), токсический эпидермальный некролиз (синдром Лаейлла), бронхоспастический синдром, анафилактический шок. Со стороны органов кроветворения: агранулоцитоз, лейкопения, тромбоцитопения. Прочие: снижение артериального давления.
Передозировка
Симптомы: тошнота, рвота, гастралгия, олигурия, гипотермия, снижение артериального давления, тахикардия, одышка, шум в ушах, сонливость, бред,
нарушение сознания, острый агранулоцитоз, геморрагический синдром, острая почечная и/или печеночная недостаточность, судороги, паралич
дыхательной мускулатуры.
Лечение: промывание желудка, солевые слабительные, активированный уголь, проведение форсированного диуреза, гемодиализ, при развитии судорожного синдрома – внутривенное введение диазепама и быстродействующих барбитуратов.
Взаимодействие с другими лекарственными средствами
Одновременное назначение с другими ненаркотическими анальгетиками, трициклическими антидепрессантами, контрацептивными гормональными
лекарственными средствами и аллопуринолом может привести к усилению токсичности. Седативные и анксиолитические лекарственные средства усиливают
анальгезирующий эффект метамизола натрия. Метамизол натрия усиливает эффекты алкоголя, одновременное применение с хлорпромазином или
фенотиазином может привести к развитию выраженной гипертермии. Рентгеноконтрастные лекарственные средства, коллоидные кровезаменители
и пенициллин не должны применяться во время лечения метамизолом натрия. При одновременном назначении циклоспорина снижается концентрация
последнего в крови. Метамизол натрия вытесняет из связи с белком пероральные гипогликемические препараты, непрямые антикоагулянты, кортикостероиды и индометацин, увеличивают их активность. Фенилбутазон, барбитураты и другие индукторы микросомального окисления печени при одновременном назначении уменьшают эффективность метамизола натрия.
Особые указания
При лечении детей до 8 лет и больных, получающих цитостатические лекарственные средства, прием АНАЛЬГИНА АВЕКСИМА должен проводится только под наблюдением врача. У больных с атопической бронхиальной астмой и поллинозами имеется повышенный риск развития аллергических реакций. На фоне приема АНАЛЬГИНА АВЕКСИМА возможно развитие агранулоцитоза, в связи с чем, при выявлении немотивированного подъема температуры, озноба, болей
в горле, затрудненного глотания, стоматита, а также при развитии явлений вагинита или проктита необходимо контролировать картину периферической
крови. Недопустимо использование для снятия острых болей в животе (до выяснения причины).
Форма выпуска
Таблетки 500 мг. 10 таблеток в упаковке контурной безъячейковой. 10 таблеток в упаковке контурной ячейковой.
1 или 2 контурные ячейковые упаковки вместе с инструкцией по применению в пачке из картона. Контурные ячейковые или безъячейковые упаковки вместе с равным количеством инструкций по применению в групповой упаковке.
Условия хранения
В сухом, защищенном от света и недоступном для детей месте.
Условия отпуска
Без рецепта.
Производитель/организация, принимающая претензии
ООО «Анжеро-Судженский химико-фармацевтический завод». 652473, Россия, Кемеровская обл., г. Анжеро-Судженск, ул. Герцена, д. 7. Тел./факс (38453)5-23-51.

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