Fighting pain attacks in the abdomen with the drug baralgin. What does baralgin help with?

Baralgin is a drug from the group of NSAIDs, non-selective (blocks both COX-1 and COX-2), a derivative of pyrazolones. The main active ingredient of this product is metamizole sodium. There are several forms of release of Baralgin:

Baralgin M tablets – 500 mg of active substance each
Solution for injection Baralgin M – 500 mg of active substance in each ml, in an ampoule of 5 ml (2.5 g in each ampoule)
Baralgin injection solution - 5 ml ampoule contains 2.5 g of metamizole sodium, 0.01 g of pitofenone hydrochloride and 0.0001 g of fenpiverinium bromide
Baralgin tablets - 0.5 g metamizole sodium, 0.005 g pitofenone hydrochloride and 0.0001 g fenpiverinium bromide in each tablet

Indications for use of Baralgin

Baralgin is indicated for almost any lesion of the spine and its structures that is accompanied by pain:

Spinal column injuries (fractures, bruises, dislocations, etc.)
Spinal tumors (both malignant and benign)
Postoperative period following spinal surgery

Contraindications

There are a number of diseases and conditions in the patient for which Baralgin is contraindicated:

Allergy to the drug and its components
Porphyria
Feeding a baby with breast milk
Pregnancy before 12 weeks and after 28 weeks of gestation
Glucose-6-phosphate dehydrogenase enzyme deficiency
Angle-closure glaucoma
Bronchial asthma
Kidney and liver failure
Frequent fainting
Severe heart rhythm disturbances

Operating principle

The main active ingredient of Baralgin is metamizole sodium. It blocks cyclooxygenase fractions 1 and 2, causing a pronounced analgesic effect, and also reduces locally elevated tissue temperature and inflammatory processes in them. These effects are achieved due to the cessation of the production of prostaglandins (inflammatory mediators) and an increase in the threshold of pain sensitivity in the brain.

Fenpiverinium is an anticholinergic with a ganglion-blocking effect. Those. This substance, by blocking nerve impulses through certain receptors, helps reduce the tone of smooth muscles located in the walls of blood vessels, which helps improve blood flow.

Pitophenone is an antispasmodic with an effect similar to papaverine. It also affects the tone of smooth muscles, reducing it and normalizing blood flow, and also slightly reduces the tone of the striated muscles of the back.

Thus, after taking Baralgin, the patient feels a reduction in pain, restoration of spinal mobility, acceleration of tissue repair processes and the patient’s recovery.

Mode of application

Baralgin in tablet form

Tablets should be taken orally with a sufficient amount of liquid, preferably immediately after a meal (reduces the likelihood of side effects and improves absorption of substances). The frequency of administration is 1-2 tablets 3-4 times a day. The interval between doses should be at least 5 hours. The maximum daily dosage is 3 g (6 tablets). The course of treatment is from 5 days to 2 weeks. If necessary, it can be extended under the supervision of the attending physician.

Baralgin in the form of a solution for injection

It should be administered intramuscularly or intravenously. A single dosage ranges from 2 to 5 ml. The maximum daily dosage is 10 ml. Children weighing 5-8 kg - 0.1-0.2 ml into the gluteal or thigh muscle. With body weight from 9 to 15 kg - 0.2-0.5 ml into the gluteal muscle or into a vein. Children weighing from 16 to 23 kg - 0.3-0.8 ml of Baralgin. In the case when the child weighs 24-30 kg - 0.4-1 ml of the drug. With a weight of 31-45 kg - from 0.5 to 1.5 ml. And at 46-53 kg - 0.8-1.8 ml. If the patient weighs more than 53 kg or is older than 15 years, adult dosages of Baralgin are prescribed. The course of treatment with injection forms of the drug is a maximum of 5 days, after which, if necessary, the patient is transferred to tablet forms.

Side effects

In case of individual intolerance, Baralgin can cause a number of side effects. The main ones:

Itchy skin rash
Anaphylactic shock
Quincke's edema
Discomfort or pain in the abdominal area
Constipation
Decrease in blood pressure figures
Increased heart rate
Dizziness
Red color of urine
Dry mouth
Decrease in single and daily amount of urine
Decrease in red blood cells, platelets and white blood cells

If such symptoms occur, you should stop taking the drug and, if necessary, prescribe symptomatic medications.

If the daily dosage of Baralgin is exceeded, some symptoms may develop:

Renal or liver failure
Respiratory dysfunction
Nausea and vomiting
Headache

To treat such conditions, it is necessary to immediately stop taking the drug, induce vomiting, rinse the stomach and take sorbents. If necessary, symptomatic agents.

special instructions

During pregnancy from 1 to 12 weeks and from 28 weeks before birth, Baralgin is contraindicated. During the period from 13 to 27 weeks, the drug is allowed only under the strict supervision of a doctor and if absolutely necessary. During lactation, if it is necessary to take Baralgin, feeding the baby with breast milk is possible 2 days after the last dose of this medicine.

Baralgin is allowed for children with strict adherence to the dosages of the drug. The tablet form is possible for reception only after 6 years.

Alcoholic drinks do not affect the effect of the drug.

Baralgin's analogs

Analgin, Spazmalgon, Spazmalgin, Trigan, etc.

Photo of the drug

Latin name: Baralgin

ATX code: N02BB02

Active substance: Metamizole sodium, Pitophenone, Fenpiverinium bromide

Manufacturer: Aventis Pharma (India)

Description is valid on: 09.10.17

Baralgin is a combined antispasmodic and analgesic drug.

Active substance

Metamizole sodium (Metamizole sodium).

Release form and composition

Available in two dosage forms.

Tablets are packed in blisters of 10 pieces. A cardboard box contains 1, 2, 5 and 10 blisters.

The solution for injection is available in 5 ml dark glass ampoules. There are 5 ampoules in a cardboard package.

pharmachologic effect

A non-narcotic analgesic characterized by analgesic, antipyretic and weak anti-inflammatory effects.

Indications for use

Pain syndrome (moderate or weak), spasms of smooth muscles of internal organs: biliary colic, renal colic, intestinal colic, spasms of the bladder and ureter, chronic colitis, biliary dyskinesia, postcholecystectomy syndrome, algodismenorrhea, diseases of the pelvic organs.

Baralgin is used for arthralgia, neuralgia, myalgia, and sciatica. As an auxiliary treatment, the drug is used for pain after surgical interventions and diagnostic procedures.

Contraindications

Individual hypersensitivity to the active substance and pyrazolone derivatives,
inhibition of bone marrow hematopoiesis,
glucose-6-phosphate dehydrogenase deficiency,
severe liver or kidney failure,
severe angina,
tachyarrhythmia,
angle-closure glaucoma,
decompensated CHF,
prostatic hyperplasia,
intestinal obstruction,
collapse,
megacolon,
pregnancy (first trimester and last 6 weeks) and lactation period.

Baralgin in ampoules should not be administered intravenously to children under three months of age or weighing less than 5 kg. Children under five years of age are not recommended to use the drug in tablet form. Other contraindications include liver and kidney failure, the “aspirin” triad, bronchial asthma, a tendency to arterial hypotension, and hypersensitivity to other NSAIDs.

Instructions for use (method and dosage)

A single dose of the drug for persons over 15 years of age is 500 mg (1 tablet).

The maximum dose can be up to 1000 mg or 2 tablets. A single dose is taken 2–3 times a day, unless otherwise prescribed by the attending physician.

The maximum daily dose of the drug reaches 3000 mg or 6 tablets. The average duration of treatment is 5 days if the drug is prescribed as an anesthetic.

IV, IM. For adults and adolescents over 15 years of age, a single dose is 2–5 ml (IV or IM), the daily dose is up to 10 ml.
For children and infants, the daily dose is set taking into account body weight (infants 5–8 kg - 0.1–0.2 ml intramuscularly; children 9–15 kg - 0.2–0.5 ml intravenously or IM; children 16–23 kg - 0.3–0.8 ml IV or IM; children 24–30 kg - 0.4–1 ml IV or IM; 31–45 kg - 0.5–1.5 ml IV or IM; 46–53 kg - 0.8–1.8 ml IV or IM.
IV administration of the drug should be carried out slowly (1 ml over 1 minute), with the patient lying down and under the control of blood pressure, heart rate and respiration. The injection solution must be at body temperature.

The course of treatment with the drug is approximately 3 days if it is prescribed as an antipyretic. Increasing the daily dose of Baralgin in ampoules or tablets, as well as changing the duration of treatment, is possible only under the supervision of an appropriate doctor.

Side effects

The use of the drug may cause the following side effects:

Allergic reactions, including urticaria (including on the mucous membranes of the nasopharynx and conjunctiva), toxic epidermal necrolysis (Lyell's syndrome), angioedema, in rare cases Stevens-Edzhonson syndrome, bronchospastic syndrome, anaphylactic shock.
Lecopenia, thrombocytopenia, and agranulocytosis may be observed on the part of the hematopoietic organs.
From the urinary system, in some cases, oliguria, impaired renal function, anuria, interstitial nephritis, proteinuria, and red staining of urine may occur.

In the process of using Baralgin, anticholinergic effects such as reduced sweating, dry mouth, tachycardia, accommodation paresis, and difficulty urinating may occur. With intramuscular administration of ampoules, infiltrates are possible at the injection site.

Overdose

Among the main symptoms of an overdose of the drug are low blood pressure, vomiting, confusion, drowsiness, nausea, pain in the epigastric region, impaired liver and kidney function, convulsions.

In the event of an overdose, gastric lavage should be carried out immediately. The appointment of activated charcoal, as well as symptomatic therapy, will also be effective.

Analogs

Analogues according to the ATX code: Analgin, Analgin ExtraKap, Baralgin M, Metamizole sodium, Optalgin.

Do not decide to change the drug on your own; consult your doctor.

special instructions

It is not recommended to consume ethanol while using Baralgin.
If the duration of treatment exceeds 2 weeks, it is necessary to monitor the pattern of peripheral blood and the functional state of the liver. The drug should be discontinued if agranulocytosis is suspected or if thrombocytopenia is present.
With intravenous administration, the risk of developing anaphylactic shock is slightly higher than with oral use, despite the fact that intolerance to this drug is quite rare.
An increased risk of developing allergic reactions is observed in patients with hay fever and bronchial asthma. Parenteral administration is used in cases where oral administration is not possible or in the presence of malabsorption from the gastrointestinal tract. With the introduction of more than 2 ml of Baralgin in ampoules, special care is required due to the increased risk of lowering blood pressure. The process of intravenous administration should be carried out slowly, in a supine position and preferably under medical supervision.
For intramuscular administration of Baralgin in ampoules, it is necessary to use a long needle. Due to the release of a metabolite, urine may turn red. When using the drug, care should be taken when driving a vehicle and when engaging in dangerous activities that require quick mental and physical reactions.

During pregnancy and breastfeeding

The use of the drug during pregnancy is contraindicated.

In childhood

In old age

Information is absent.

Drug interactions

The toxicity of Baralgin increases with simultaneous therapy with oral contraceptives, tricyclic antidepressants and Allopurinol. A decrease in the effectiveness of the drug is observed when treated with inducers of microsomal enzymes (phenylbutazone, barbiturates).
An increase in the severity of negative reactions is observed during treatment with other non-narcotic analgesics. The analgesic effect of the drug is enhanced by simultaneous therapy with sedatives. Severe hyperthermia is observed during treatment with phenothiazine derivatives, Chlorpromazine.
Simultaneous treatment with Penicillin, administration of colloidal blood substitutes, and radiocontrast agents is unacceptable. The active component is able to fight for binding with proteins during treatment with Indomethacin, glucocorticosteroids, and indirect anticoagulants. Propranolol, histamine receptor blockers and Codeine enhance the effect of the active substance.

Baralgin is a non-narcotic analgesic. The half-life of the product is 14-15 minutes. The active active component of the injections is sodium metamizole, it is 500 mg in 1 ml of the product. The ampoule holds 5 ml. Another component is water for injection. The effect of the anesthetic is enhanced by the following components: fenpiverinium bromide and pitofenone hydrochloride. The symbiosis of the components makes it possible to achieve the maximum amount of painkiller in the blood in a short time.

The pharmacological effect of Baralgin injections lasts a long time. Thanks to its components, an intramuscular injection of Baralgin removes spasmodic contractions of smooth muscles and provides an analgesic effect on pain.

How to use it correctly

Injections are prescribed by a doctor. They are done when:

Intramuscular administration of baralgin is not painless. First, the contents of the ampoule are heated to body temperature (in order to reduce pain during administration).

Intravenous administration of the medicine is allowed in exceptional situations, under the supervision of a healthcare professional. If it enters the bloodstream quickly, the drug can cause cardiac arrest.

The rate at which the product enters the vein should be up to one milliliter per minute; the procedure is performed while the person is lying down. Breathing parameters, pulse, arterial pressure are analyzed. When Baralgin is administered in amounts over 2 ml, blood pressure can rapidly drop.

The instructions provide for the use of the product by injection without medical consultation to relieve pain of identified origin. To reduce fever, use only according to medical advice. This is done when other antipyretic drugs are ineffective.

For problems with the bladder, the drug is used if it is known for sure that there is no internal bleeding (the components of the drug can cause an increase in blood loss due to the expansion of the vascular lumen). Intramuscular administration will improve the condition of those who experience pain from the movement of stone formations through the ureter. Baralgin can be used for a maximum of three days in the absence of medical advice. If after this period the pain does not go away, then you need to quickly consult a doctor to determine the diagnosis and prescribe the correct treatment course.

Doses, frequency of use:

Intramuscularly injected 5 ml twice a day;
The medication is used intravenously for renal and biliary colic in an amount of maximum 3 ml at a time; Baralgin must be diluted when injected into a vein with isotonic sodium chloride solution.

Side effects

Due to improper use of the drug, systemic inhibition of hematopoietic function may occur. A week after continuous use of the drug, slight anemia appears.

When more than the prescribed daily dosage is administered, the renal system suffers, as a result of which urine is not excreted and protein appears in it. Severe cases - the development of toxic nephritis. An abscess may occur with intramuscular injection.

Also the side effects are:

Phlebitis, soreness in the injection area;
Burning sensation, itching;
Leukopenia (sometimes - thrombocytopenia, agranulocytosis);
Quincke's edema;
The appearance of a rash;
Interruptions in kidney activity - anuria, reddish staining of urine, proteinuria, oliguria, in some cases - acute interstitial nephritis;
The presence of bronchospasm;
Anaphylactoid signs;
Arrhythmia;
A rapid decrease in blood pressure;
Sometimes there are syndromes: Lyell or Stevens-Johnson.

The drug should not be used by pregnant women at any time

Given the threat to the mother’s life, if only baralgin helps, a serious question arises about abortion. Baralgin tablets can be taken by children over 5 years of age. Before this age, you can use the medicine in the form of intravenous or intramuscular injections. In children from three months of age, weighing more than 5 kg, the drug is administered exclusively intramuscularly: 50-100 mg per 10 kilograms of weight (0.1-0.2 ml of 50% solution). A single dose is allowed a maximum of three times per day.

If you are breastfeeding, you will not have to resort to Baralgin. The components of the product pass into the milk and lead to damage to the internal organs of the child.

Also contraindications are:

Intestinal obstruction, intussusception;
Imperfect functioning of the kidneys and liver;
Angle-closure form of glaucoma;
Anemia, ischemia in the uncompensated stage;
Bronchial asthma or other diseases that can lead to bronchospasm;
Particularly noticeable susceptibility to pyrazolones, metamizole sodium;
There is a risk of hemolysis in the presence of congenital deficiency of glucose-6-phosphate dehydrogenase;
Allergies to analgesics - edema, rhinitis, urticaria;
Age category up to three months, weight up to 5 kg;
Instability in the functioning of the bone marrow;
There is a risk of porphyria attacks when Baralgin is used by people with acute intermittent hepatic porphyria;
Reduced blood pressure, hemodynamic disorders.

Special instructions

When taking cytostatic drugs simultaneously, treatment with Baralgin should be done exclusively under medical supervision. If you need to be treated for a long time, then the composition of the blood is monitored from time to time. When agranulocytosis is caused by the presence of metamizole in the body and its duration is 7 days, it is life-threatening. The occurrence of this condition is not related to dosage.

You should stop using Baralgin if your temperature rises with chills, pain in the mouth, or the appearance of erosions on the mucous membranes. Obvious neutropenia also requires discontinuation of the drug. Anaphylaxis is often present in patients with a history of allergic reactions or bronchial asthma. Patients with rashes, rhinosinusitis, and intolerances to dyes and alcohol are also at risk. Baralgin should not be used when there is significant pain in the abdominal cavity in the absence of an accurate diagnosis.

Baralgin is administered intramuscularly with long needles.

Intravenous injections are not given to patients under 1 year of age.

Driving while being treated with Baralgin is possible, but you should be careful with large dosages.

In case of overdose, symptomatic therapy is needed. There is the option of using hemodialysis, forced diuresis. Diazepam is given intravenously if there are seizures.

Compound with other drugs

Baralgin increases the sedative effect of alcohol. Taking other non-narcotic analgesics together with Baralgin will cause an increase in toxic effects. When taken with cyclosporine, plasma levels need to be monitored.

Read these instructions carefully before you start using this medicine.
Save the instructions, you may need them again.
If you have any questions, consult your doctor.
This medicine is prescribed for you personally and should not be given to others because it may harm them even if they have the same symptoms as you.

INSTRUCTIONS for medical use of the drug Baralgin® M

Registration number: P N011538/01-140211
Trade name of the drug: Baralgin® M.
International nonproprietary name: metamizole sodium.
Dosage form: pills.
Compound
One tablet contains:
active substance: metamizole sodium - 500 mg;
Excipients: macrogol 4000 47 mg, magnesium stearate 3 mg.
Description
Round, flat tablets from white to almost white in color with BARALGIN-M engraved on one side, scored on the other and chamfered on both sides.
Pharmacotherapeutic group: non-narcotic analgesic.
ATX code: N02BB02.

Pharmacological properties

Pharmacodynamics
An analgesic non-narcotic drug, a pyrazolone derivative, non-selectively blocks cyclooxygenase and reduces the formation of prostaglandins from arachidonic acid.
It prevents the conduction of painful extra- and proprioceptive impulses along the Gaulle and Burchard bundles, increases the threshold of excitability of the thalamic centers of pain sensitivity, and increases heat transfer.
A distinctive feature is the insignificant anti-inflammatory effect, which causes a weak effect on water-salt metabolism (retention of sodium and water ions) and the mucous membrane of the gastrointestinal tract. It has an analgesic, antipyretic and some antispasmodic (in relation to the smooth muscles of the urinary and biliary tract) effect.
Pharmacokinetics
Metamizole sodium is well and quickly absorbed from the gastrointestinal tract. After oral administration, metamizole sodium is completely metabolized to form active 4-N-methylaminoantipyrine. The connection of the active metabolite with blood plasma proteins is 50-60%. Mainly excreted by the kidneys. After taking 1 g of metamizole sodium, the renal clearance for 4-N-methylaminoantipyrine was 5±2 ml/min. The half-life is 2.7 hours.
In therapeutic doses it passes into breast milk.
In patients with liver cirrhosis, the half-life of 4-N-methylaminoantipyrine increased threefold and was about 10 hours.

Indications for use

Pain syndrome (mild and moderate severity): including neuralgia, myalgia, arthralgia, biliary colic, intestinal colic, renal colic, trauma, burns, decompression sickness, herpes zoster, orchitis, radiculitis, myositis, postoperative pain syndrome, headache, toothache, algodismenorrhea.
Feverish syndrome (infectious and inflammatory diseases, insect bites - mosquitoes, bees, gadflies, etc., post-transfusion complications).

Contraindications

Hypersensitivity to metamizole sodium and other components of the drug, as well as other pyrazolones (phenazone, propyphenazone) or pyrazolidines (phenylbutazone, oxyphenbutazone), including, for example, a history of agranulocytosis when taking one of these drugs.
- Disorders of bone marrow hematopoiesis (for example, after treatment with cytostatics) or diseases of the hematopoietic system.
- History of bronchospasm or other anaphylactic reactions (eg, urticaria, rhinitis, angioedema) when taking analgesic drugs such as salicylates, paracetamol, diclofenac, ibuprofen, indomethacin, naproxen.
- Congenital deficiency of glucose-6-phosphate dehydrogenase (risk of hemolysis).
- Children's age (up to 15 years).
- Pregnancy (first and third trimester)
- Lactation period
- Acute intermittent hepatic porphyria (risk of developing porphyria attacks)

Carefully

Arterial hypotension (systolic blood pressure below 100 mmHg), decreased circulating blood volume, hemodynamic instability (myocardial infarction, multiple trauma, incipient shock), incipient heart failure, high fever (increased risk of a sharp decrease in blood pressure).
- Diseases in which a significant decrease in blood pressure may be of increased danger (patients with severe coronary heart disease and stenosis of the cerebral arteries).
- Alcoholism.
- Bronchial asthma, especially in combination with concomitant polypous rhinosinusitis; chronic urticaria and other types of atopy (allergic diseases, in the development of which a significant role belongs to a hereditary predisposition to sensitization: hay fever, allergic rhinitis, etc.) (increased risk of developing
anaphylactic/anaphylactoid reactions).
- Alcohol intolerance (reaction to even small amounts of certain alcoholic beverages with symptoms such as itching, watery eyes and severe redness of the face) (increased risk of developing anaphylactic/anaphylactoid reactions).
- Intolerance to dyes (eg tartrazine) or preservatives (eg benzoates) (increased risk of anaphylactic/anaphylactoid reactions).
- Severe liver and kidney dysfunction (low doses are recommended due to the possibility of slowing the excretion of metamizole sodium).
- Pregnancy (second trimester).
If you have one of these diseases or conditions, consult your doctor before taking this medicine.

Pregnancy and lactation

Pregnancy
During the first trimester of pregnancy, Baralgin M should not be taken. In the second trimester of pregnancy, Baralgin M should be taken according to strict medical indications and if the expected benefit to the mother outweighs the potential risk to the fetus. The use of metamizole sodium in the third trimester of pregnancy is also contraindicated: the possibility of premature closure of the ductus arteriosus (Batalov) and perinatal complications due to the effect on the ability of maternal and fetal platelets to aggregate cannot be ruled out, since metamizole sodium is a cyclooxygenase inhibitor, albeit a weak one.
Lactation period
After taking Baralgin M, breastfeeding should be stopped for 48 hours.

Directions for use and doses

A single dose for adults and adolescents over 15 years of age is 500 mg (1 tablet). The maximum single dose can reach 1000 mg (2 tablets). Unless otherwise prescribed, a single dose may be taken 2-3 times daily. The maximum daily dose is 2000 mg (4 tablets). Duration of administration - no more than 5 days when prescribed as an anesthetic and no more than 3 days as an antipyretic.
The tablets should be taken with plenty of water.
Increasing the daily dose of the drug or the duration of treatment is possible only under the supervision of a physician.

Side effect

Side effects were classified as follows: very common (≥10%), common (≥1.<10%), нечастые (≥0,1, <1%), редкие (≥0,01, <0,1%), очень редкие (<0,01%).
Anaphylactic/anaphylactoid reactions
In rare cases, metamizole sodium may cause anaphylactic or anaphylactoid reactions, which in very rare cases can be severe and life-threatening. They can occur even if the drug has been taken many times before without any complications.
Such drug reactions may develop immediately or several hours after taking metamizole sodium.
Typically, milder anaphylactic or anaphylactoid reactions manifest themselves in the form of skin and mucosal symptoms (itching, burning, flushing, urticaria, swelling) or in the form of shortness of breath or complaints from the gastrointestinal tract.
Milder reactions may progress to severe forms with centralized urticaria, severe angioedema (especially involving the larynx), severe bronchospasm, cardiac arrhythmias, a sharp decrease in blood pressure (which is sometimes preceded by an increase in blood pressure) and the development of circulatory shock.
In persons with bronchial asthma syndrome and intolerance to analgesic drugs, these reactions usually manifest themselves in the form of attacks of bronchial asthma.
Other reactions from the skin and subcutaneous tissues
In addition to the cutaneous manifestations of anaphylactic/anaphylactoid reactions listed above, fixed drug dermatitis may occur infrequently, rash may rarely occur, and in some cases Stevens-Johnson syndrome or Lyell's syndrome (toxic epidermal necrolysis) may develop.
Blood and lymphatic system disorders
Rarely: leukopenia, in very rare cases agranulocytosis and thrombocytopenia. These reactions are immunological reactions in nature. They can occur even if the drug has been taken many times before without any complications. Agranulocytosis can threaten the patient's life and even lead to death.
Typical symptoms of agranulocytosis are lesions of the mucous membranes (oral cavity and pharynx, anorectal region and genital organs), sore throat, and fever. It should be remembered that if the patient receives antibiotic therapy, then the typical manifestations of agranulocytosis may be minimally expressed. The erythrocyte sedimentation rate is significantly increased, while lymph node enlargement is mild or absent.
Typical symptoms of thrombocytopenia are an increased tendency to bleeding and the appearance of petechiae on the skin and mucous membranes.
Isolated hypotonic reactions
Infrequently, after taking the drug, an isolated transient decrease in blood pressure is possible (possibly pharmacologically caused and not accompanied by other manifestations of anaphylactic/anaphylactoid reactions); in rare cases, the decrease in blood pressure can be very pronounced.
Other reactions
In very rare cases, especially in patients with kidney disease, an acute deterioration of kidney function (acute renal failure), in some cases with oliguria, anuria or proteinuria, may occur. In some cases, acute interstitial nephritis may occur.
Infrequently, urine may turn red due to the presence of a metabolite in the urine - rubazonic acid.

Overdose

Symptoms
In case of overdose, the following symptoms may occur: nausea, vomiting, abdominal pain, decreased renal function/acute renal failure with oliguria (for example, due to the development of interstitial nephritis), more rarely, symptoms from the central nervous system (dizziness, drowsiness, tinnitus, delirium, impaired consciousness, coma, convulsions) and a sharp decrease in blood pressure (sometimes progressing to shock), as well as heart rhythm disturbances (tachycardia), hypothermia, shortness of breath, acute agranulocytosis, hemorrhagic syndrome, acute liver failure, paralysis of the respiratory muscles. After high doses, excretion of a non-toxic metabolite (rubazonic acid) through the kidneys may cause red urine.
Treatment
If no more than 1-2 hours have passed after taking the drug, you can induce vomiting and perform gastric lavage through a tube; give saline laxatives, activated carbon. In case of overdose, forced diuresis is indicated. The main metabolite (4-N-methylaminoantipyrine) can be eliminated by hemodialysis, hemofiltration, hemoperfusion or plasma filtration. With the development of convulsive syndrome, intravenous administration of diazepam and fast-acting barbiturates.

Interaction with other drugs

With cyclosporine
When used simultaneously with cyclosporine, a decrease in its concentration in the blood may occur; therefore, when they are used together, monitoring of the concentration of cyclosporine in the blood is required.
With other non-narcotic analgesic drugs
The simultaneous use of metamizole sodium with other non-narcotic analgesic drugs can lead to mutual enhancement of toxic effects.
With tricyclic antidepressants, personal contraceptives, allopurinol Tricyclic antidepressants, oral contraceptives, allopurinol disrupt the metabolism of metamizole sodium in the liver and increase its toxicity.
With barbiturates, phenylbutazone and other inducers of microsomal liver enzymes Barbiturates, phenylbutazone and other inducers of microsomal liver enzymes weaken the effect of metamizole sodium.
With sedatives and tranquilizers
Sedatives and tranquilizers enhance the analgesic effect of the drug. Concomitant use with chlorpromazine or other phenothiazine derivatives can lead to the development of severe hyperthermia.
With drugs that are highly bound to protein (oral hypoglycemic agents, indirect anticoagulants, glucocorticosteroids and indomethacin) Metamizole sodium, displacing oral hypoglycemic drugs, indirect anticoagulants, glucocorticosteroids and indomethacin from its binding to plasma proteins, increases their activity.
With myelotoxic drugs
Myelotoxic drugs enhance the hematotoxicity of the drug.
With thiamazole and sarcolysine
Thiamazole and sarcolysine increase the risk of developing leukopenia.
With codeine, H2 blockers and propranolol
Codeine, H2-histamine receptor blockers and propranolol enhance the effects of metamizole sodium.
Radiocontrast agents, colloidal blood substitutes and penicillin should not be used during treatment with metamizole sodium (increased risk of anaphylactic/anaphylactoid reactions).

special instructions

When treating patients receiving cytotoxic drugs, metamizole sodium should only be taken under medical supervision.
The following conditions cause an increased risk of developing hypersensitivity reactions to metamizole sodium:
- bronchial asthma, especially with concomitant polypous rhinosinusitis;
- chronic urticaria;
- alcohol intolerance (hypersensitivity to alcohol);
- intolerance or hypersensitivity to dyes (for example, tartrazine) or preservatives (for example, benzoate).
In the case of using metamizole sodium in such patients, strict medical supervision of their condition is necessary and it is necessary to have means to provide them with emergency assistance in the event of the development of anaphylactic/anaphylactoid reactions.
With long-term use, it is necessary to monitor the peripheral blood picture. While taking metamizole sodium, agranulocytosis may develop, and therefore, if an unmotivated rise in temperature, chills, sore throat, difficulty swallowing, stomatitis, erosive and ulcerative lesions of the oral cavity, vaginitis or proctitis is detected, a decrease in the number of neutrophils in the peripheral blood is less than 1500 in mm3, you must stop taking the drug and consult a doctor.
It is unacceptable to use the drug to relieve acute abdominal pain (until the cause is determined).
In patients with impaired liver and kidney function, it is recommended to avoid taking metamizole sodium in high doses.

To relieve pain, spasm of blood vessels and muscles, Baralgin is prescribed. The drug is not addictive and is characterized by a minimum of side effects compared to analogues. Before using the medicine, read the instructions for use.

Composition of Baralgin

The drug is produced in three dosage forms: ampoules with a solution for intravenous or intramuscular administration, tablets. Somewhat less commonly, you can find Baralgin in pharmacies in the form of rectal suppositories. Each package of medicine comes with detailed instructions for use.

Until 2009, the composition of Baralgin tablets contained 3 active components: pitofenone hydrochloride, metamizole sodium, fenpiverinium bromide. After 2009, the drug was renamed Baralgin M (lat. Baralgin M). It contains only metamizole sodium.

The concentration of substances for different dosage forms corresponds to:

pharmachologic effect

Baralgin M is a non-narcotic analgesic that belongs to pyrazolone derivatives. The drug has an analgesic, anti-inflammatory, antipyretic effect. When it enters the digestive tract, the active substance breaks down into metabolites that bind to plasma proteins and are then adsorbed in the liver.

The maximum concentration of the active component in the blood plasma is observed after 2 hours. The half-life is approximately 3 hours. In patients with liver disease, this period can increase to 8-10 hours. Baralgin injections have an analgesic effect superior to tablets.

What does Baralgin help with?

The drug is used to eliminate pain and relieve spasms from smooth muscles. According to the instructions, you need to take the medication if you have the following diseases or conditions:

neuralgia (local pain along the nerve);
radiculitis;
arthritis;
toothache;
biliary colic with cholecystitis;
pyelonephritis;
osteochondrosis;
menalgia (painful menstruation).

Directions for use and dosage

The duration of treatment and the amount of the drug used must correspond to the instructions or be established by the doctor, based on the indications, the patient’s condition, and the form of the drug. To avoid the development of unforeseen complications and adverse reactions, self-medication is strictly prohibited.

Baralgin in ampoules

Before injection, the ampoule with the solution is warmed to body temperature. Baralgin is administered intravenously at a rate of 1 ml/minute. Throughout the administration period, medical personnel should monitor heart rate and blood pressure levels. Baralgin is administered intramuscularly at a dose of 2.5-5 ml. The total daily dosage should not be more than 10 ml, and the duration of treatment should not be 5 days.

The drug in tablets is taken regardless of food intake. According to the instructions, a single dose should be 500 mg (1 tablet). You are allowed to consume no more than 3000 mg per day. Baralgin is taken as a pain reliever for 5 days. When using tablets instead of antipyretic drugs, the course of treatment should not exceed 3 days.

Candles

Rectal suppositories should be administered after bowel movements, 1 suppository 2-4 times a day. The frequency and duration of use can be set individually for each patient, taking into account the frequency of pain and diagnosis.

special instructions

The instructions for the drug contain a list of features that should be taken into account when taking Baralgin:

With long-term use of Baralgin, it is necessary to regularly monitor blood counts.
Due to the high probability of drug incompatibility, mixing several drugs in one syringe is strictly prohibited.
When taking pills and after injections, urine may sometimes turn red.

During pregnancy

The active components of Baralgin penetrate into breast milk and through the placenta, which is why it is prohibited to use the medicine during breastfeeding, the first and second trimester of pregnancy. The use of an analgesic in the 3rd trimester of pregnancy is possible strictly for medical reasons.

Drug interactions

When taking Baralgin and other drugs simultaneously, various interactions are possible. The instructions contain the following information:

Group or name of medications	Drug interactions
Oral contraceptives, tricyclic antidepressants, Allopurinol.	The toxicity of metamizole sodium increases.
Barbiturates, inducers of microsomal enzymes.	The effectiveness of the analgesic decreases.
Sedative (calming) drugs.	The analgesic effect is enhanced.
Derivatives of Phenothiazine, Chlorpromazine.	There is marked hyperthermia.
Penicillin, anticoagulants.	The chance of side effects increases.
Indomethacin, Codeine, glucocorticosteroids, histamine receptor blockers.	Enhance the pharmacological action of metamizole sodium.

Side effects

During treatment with an analgesic, the following undesirable reactions of the body may occur:

arrhythmia;
anaphylactic shock;
erythema;
immune thrombocytopenia;
hives;
angioedema;
epidermal necrolysis;
drop in blood pressure;
interstitial nephritis (decreased renal function).

Overdose

Injections and tablets should be taken strictly according to the instructions. If the dosage regimen is not followed, the following adverse reactions are possible:

tachycardia;
respiratory muscle paralysis;
nausea;
reducing blood pressure to critically low levels;
epigastric pain;
convulsions;
vomit;
drowsiness;
hypothermia (drop in body temperature);
noise in ears;
agranulocytosis (decreased white blood cell count);
loss of consciousness.

When the first symptoms of an overdose appear, you should immediately consult a doctor. Hemodialysis and forced diuresis are not used for treatment. There is no complete antidote. Enterosorbents and saline laxatives are prescribed. In case of acute poisoning, gastric lavage is performed.

Contraindications

According to the instructions, people with glomerulonephritis, a history of myocardial infarction, and alcoholism should take the analgesic with caution. It is strictly forbidden to start treatment if there are the following contraindications:

pathologies of the hematopoietic system - agranulocytosis, neutropenia (decreased number of neutrophils);
chronic kidney disease;
deficiency of glucose-6-phosphate dehydrogenase;
individual intolerance;
bronchial asthma;
severe liver diseases.

Terms of sale and storage

Analogs

If there are contraindications or the medicine is not available in the pharmacy, ask your doctor to select an analogue. Structural synonyms include:

Optalgin is a non-narcotic analgesic based on metamizole sodium. Can be used to treat children over 5 years of age.

Analgin is an analogue of baralgin in tablets. It has analgesic and antipyretic properties. Contraindicated if you are prone to bronchospasm.
Analgin-Ultra is a complete analogue of Analgin. It differs from the previous drug in cost and composition of the tablet shell.

Baralgina price

The drug is available only with a prescription. Approximate cost of medicine in Moscow.