Pentalgin-n - instructions for use, analogs, use, indications, contraindications, action, side effects, dosage, tablet composition. Pentalgin H - analgesic for pain syndrome of various origins Pentalgin N tablets

The combined drug has analgesic, antipyretic and anti-inflammatory effects.

Metamizole sodium is an analgesic-antipyretic, a derivative of pyrazolone. It has a pronounced analgesic effect.

Naproxen - NSAIDs, has anti-inflammatory, analgesic and antipyretic effects associated with non-selective suppression of COX activity, which regulates the synthesis of prostaglandins.

Caffeine causes vasodilation of skeletal muscles, brain, heart, kidneys. Increases mental and physical performance, helps eliminate fatigue and drowsiness. Increases the permeability of histohematic barriers and increases the bioavailability of non-opioid analgesics, thereby enhancing the therapeutic effect.

Codeine stimulates opioid receptors in various parts of the central nervous system, which leads to the activation of the antinociceptive system and a change in the emotional perception of pain.

Phenobarbital and codeine increase the analgesic effect of metamizole sodium and naproxen.

Pharmacokinetics

The components of the drug are well absorbed in the gastrointestinal tract.

Metamizole sodium

In the intestinal wall, it is hydrolyzed to form the active metabolite, 4-methyl-amino-antipyrine, which in turn is metabolized to 4-formyl-amino-antipyrine and other metabolites. The binding of the active metabolite to proteins is 50-60%. Metabolites are excreted by the kidneys and excreted in breast milk.

Naproxen

Bioavailability is 95%. Binds to blood proteins. T 1 / 2 - 12-15 hours. Excreted in the urine mainly as a metabolite (dimethylnaproxen), in small quantities - with bile.

Well absorbed in the intestines. T 1/2 - 5 hours (sometimes up to 10 hours). It is excreted mainly by the kidneys in the form of metabolites, about 10% - unchanged.

Slightly binds to plasma proteins. Undergoes biotransformation in the liver (10% by demethylation passes into morphine). Excreted by the kidneys (5-15% - unchanged).

Phenobarbital

Bioavailability is 80%. Plasma protein binding - 50%. It penetrates well through the placental barrier. Biotransformed in the liver. The main metabolite has no pharmacological activity. Excreted by the kidneys, incl. 20-25% - unchanged.

Release form

Tablets are white or white with a yellowish or creamy tint, flat-cylindrical, with the abbreviated name of the drug "PENT-N" embossed on one side.

Excipients: potato starch, low molecular weight polyvinylpyrrolidone (povidone), sodium citrate, magnesium stearate.

10 pieces. - cellular contour packings (1) - packs of cardboard.

Dosage

The drug is prescribed for 1 tab. 1-3 times / day. The maximum daily dose is 4 tab.

The drug should not be taken for more than 5 days as an anesthetic and for more than 3 days as an antipyretic without a doctor's prescription.

Overdose

Symptoms: nausea, vomiting, gastralgia, drowsiness, tachycardia, cardiac arrhythmias, delirium, weakness, respiratory depression.

Treatment: induction of vomiting, gastric lavage through a tube, the appointment of adsorbents (activated carbon), symptomatic therapy aimed at maintaining vital functions.

Interaction

Simultaneous use of the drug with other non-opioid analgesics may lead to increased toxic effects.

Tricyclic antidepressants, oral contraceptives, allopurinol increase the toxicity of metamizole sodium, which is part of the drug.

Barbiturates, phenylbutazone and other inducers of microsomal liver enzymes weaken the action of metamizole sodium.

The simultaneous use of metamizole sodium with cyclosporine reduces the level of the latter in the blood.

Sedatives and tranquilizers enhance the analgesic effect of the drug.

Side effects

From the digestive system: epigastric pain, nausea, vomiting, constipation; with prolonged use in high doses - impaired liver function.

On the part of the hematopoietic system: rarely - hematopoietic depression (leukopenia, granulocytopenia, agranulocytosis).

From the side of the central nervous system: dizziness, drowsiness.

From the side of the cardiovascular system: palpitations.

From the urinary system: with prolonged use in high doses - impaired renal function.

Allergic reactions: skin rash, itching, urticaria.

Indications

mild and moderate pain syndrome of various origins (including pain in the joints, muscles, sciatica, algomenorrhea, neuralgia, headache, migraine, toothache);
febrile conditions, colds and other diseases accompanied by pain and inflammation.

Contraindications

severe liver failure;
severe renal failure;
peptic ulcer of the stomach and duodenum in the acute phase;
bronchial asthma;
bronchospasm;
anemia, leukopenia;
conditions accompanied by respiratory depression;
traumatic brain injury;
severe arterial hypertension;
acute myocardial infarction;
arrhythmias;
alcohol intoxication;
glaucoma;
deficiency of glucose-6-phosphate dehydrogenase;
pregnancy;
children's age up to 12 years;
hypersensitivity to the components of the drug.

With caution, the drug should be used for mild to moderate arterial hypertension, peptic ulcer of the stomach and / or duodenum in remission, as well as in elderly patients.

Application features

Use during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

If necessary, the appointment of the drug during lactation, breastfeeding should be discontinued.

Application for violations of liver function

The drug is contraindicated for use in severe liver dysfunction.

Application for violations of kidney function

The drug is contraindicated for use in severe renal dysfunction.

Use in children

Contraindication: children under 12 years of age.

Use in elderly patients

The drug should be used with caution in elderly patients.

special instructions

With prolonged (more than 5 days) taking the drug, it is necessary to monitor the picture of peripheral blood and liver function tests.

Taking the drug Pentalgin ® -N can make it difficult to establish a diagnosis in acute abdominal pain syndrome.

Patients with atopic bronchial asthma and hay fever have an increased risk of developing hypersensitivity reactions while taking the drug Pentalgin ® -N.

Against the background of the use of the drug, it is possible to change the results of doping control in athletes.

Influence on the ability to drive vehicles and control mechanisms

When taking the drug Pentalgin ® -N, you should refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

The active substance of the drug: comb. drug
ATX encoding: N02BB72
KFG: Analgesic-antipyretic combined composition
Registration number: LS-002271
Date of registration: 17.11.06
The owner of the reg. Award: PHARMSTANDART-LEKSREDSTVA OJSC (Russia)

Tablets white or white with a yellowish or creamy tinge, flat-cylindrical, embossed with the abbreviated name of the drug "PENT-N" on one side.
1 tab.
metamizole sodium
300 mg
naproxen
100 mg
caffeine
50 mg
phenobarbital
10 mg
codeine
8 mg

Excipients: potato starch, low molecular weight polyvinylpyrrolidone (povidone), sodium citrate, magnesium stearate.

10 pieces. - cellular contour packings (1) - packs of cardboard.
10 pieces. - cellular contour packings (2) - packs of cardboard.

The description of the drug is based on the officially approved instructions for use.

The combined drug has analgesic, antipyretic and anti-inflammatory effects.

Naproxen and metamizole sodium have analgesic and anti-inflammatory effects.

Codeine stimulates opioid receptors in various parts of the central nervous system, which leads to the activation of the antinociceptive system and a change in the emotional perception of pain.

Phenobarbital and codeine increase the analgesic effect of metamizole sodium and naproxen.

The components of the drug are well absorbed in the gastrointestinal tract.

Metamizole sodium

Naproxen

Bioavailability is 95%. Binds to blood proteins. T1 / 2 - 12-15 hours. Excreted in the urine mainly as a metabolite (dimethylnaproxen), in small quantities - with bile.

Well absorbed in the intestines. T1 / 2 - 5 hours (sometimes up to 10 hours). It is excreted mainly by the kidneys in the form of metabolites, about 10% - unchanged.

Slightly binds to plasma proteins. Undergoes biotransformation in the liver (10% by demethylation passes into morphine). Excreted by the kidneys (5-15% - unchanged).

Phenobarbital

Weak and moderate pain syndrome of various origins (including pain in the joints, muscles, sciatica, menstrual pain, neuralgia, headache, migraine, toothache);

Fever, colds and other diseases accompanied by pain and inflammation.

The drug is prescribed for 1 tab. 1-3 times / day. The maximum daily dose is 4 tab.

The drug should not be taken for more than 5 days as an anesthetic and for more than 3 days as an antipyretic without a doctor's prescription.

From the digestive system: epigastric pain, nausea, vomiting, constipation; with prolonged use in high doses - impaired liver function.

From the hemopoietic system: leukopenia, granulocytopenia, agranulocytosis.

From the side of the central nervous system: dizziness, drowsiness.

From the side of the cardiovascular system: palpitations.

From the urinary system: with prolonged use in high doses - impaired renal function.

Allergic reactions: skin rash, itching, urticaria.

severe liver failure;

Severe renal failure;

Peptic ulcer of the stomach and duodenum in the acute phase;

Bronchial asthma;

Bronchospasm;

Anemia, leukopenia;

Conditions accompanied by respiratory depression;

Traumatic brain injury;

Severe arterial hypertension;

Acute myocardial infarction;

arrhythmias;

Alcohol intoxication;

Glaucoma;

Deficiency of glucose-6-phosphate dehydrogenase;

Pregnancy;

Children's age up to 12 years;

Hypersensitivity to the components of the drug.

The drug should be used with caution in mild to moderate arterial hypertension, peptic ulcer of the stomach and / or duodenum in remission, as well as in elderly patients.

The drug is contraindicated for use during pregnancy and lactation (breastfeeding).

If necessary, the appointment of the drug during lactation, breastfeeding should be discontinued.

With prolonged (more than 5 days) taking the drug, it is necessary to monitor the picture of peripheral blood and liver function tests.

Taking the drug Pentalgin-N can make it difficult to establish a diagnosis in acute abdominal pain syndrome.

Patients with atopic bronchial asthma and hay fever have an increased risk of developing hypersensitivity reactions while taking the drug Pentalgin-N.

Against the background of the use of the drug, it is possible to change the results of doping control in athletes.

Influence on the ability to drive vehicles and control mechanisms

When taking Pentalgin-N, one should refrain from driving vehicles and engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Symptoms: nausea, vomiting, gastralgia, drowsiness, tachycardia, cardiac arrhythmias, respiratory depression, delirium, weakness.

Treatment: induction of vomiting, gastric lavage through a tube, the appointment of adsorbents (activated carbon), symptomatic therapy aimed at maintaining vital functions.

Simultaneous use of the drug with other non-opioid analgesics may lead to increased toxic effects.

Tricyclic antidepressants, oral contraceptives, allopurinol increase the toxicity of metamizole sodium, which is part of the drug.

Barbiturates, phenylbutazone and other inducers of microsomal liver enzymes weaken the action of metamizole sodium.

The simultaneous use of metamizole sodium with cyclosporine reduces the level of the latter in the blood.

Sedatives and tranquilizers enhance the analgesic effect of the drug.

The drug is approved for use as an over-the-counter drug.

The drug should be stored in a dry, dark place, out of the reach of children, at a temperature not exceeding 25°C. Shelf life - 3 years.

Composition of Pentalgin N

The composition of Pentalgin N includes active ingredients: analgin, naproxen, phenobarbital, caffeine And codeine.

Additional ingredients: potato starch, magnesium stearate, povidone, sodium citrate.

Pentalgin N is produced in the form of tablets of 10 pieces in a cell pack, 1-2 cells in a box.

Pentalgin N tablets are characterized by sedative, antispasmodic, analgesic, antipyretic And anti-inflammatory Effect.

This combination drug has

no analgesic, antipyretic And anti-inflammatory the action that causes its constituent components.

As is known, metamizole sodium and naproxen have analgesic and anti-inflammatory effects. Codeine is characterized by an action that stimulates the opiate receptors of the nervous system. As a result, the antinoceceptive system is activated and the emotional sensation of pain changes. Also, codeine, together with phenobarbital, increases the analgesic effect of the remaining components.

Caffeine has a dilating effect on blood vessels in the skeletal muscle, brain, heart, and kidneys. This increases mental and physical performance, reduces fatigue, drowsiness. In addition, the permeability of histohematic barriers and the bioavailability of non-narcotic drugs increase. analgesics enhancing the therapeutic effect of the drug.

All components of the drug undergo excellent absorption in the gastrointestinal tract. As a result metabolism several active metabolites. The protein binding index is about 60%. Substances are mainly excreted from the body in metabolites and a small part, approximately 10% - in unchanged form.

The main indications for the appointment of Pentalgin N are mild and moderate pain of various origins, for example:

joint, muscle and radiculitis pain;
pain during menstruation, neuralgia;
migraine, head And toothache.

Also, tablets are often prescribed for the treatment febrile conditions, colds and other diseases that may be accompanied by pain syndromes and inflammation.

hypersensitivity;
severe forms of hepatic or kidney failure;
exacerbation of gastric ulcer and duodenal ulcer;
lactation, pregnancy;
bronchial asthma, bronchospasm, other respiratory disorders;
under the age of 12;
deficiency of glucose-6-phosphate dehydrogenase;
anemia, leukopenia;
craniocerebral injuries;
alcohol intoxication;
cardiovascular disease and more.

During the period of treatment with Pentalgin N, negative effects may occur, often manifested by dyspeptic disorders - vomiting, nausea and constipation, skin allergic reactions as rashes, itching And hives. The occurrence of pain in epigastrium, dizziness, drowsiness And heartbeat. In rare cases, oppression of hematopoiesis develops, for example: leukopenia, agranulocytosis or granulocytopenia.

The instructions for use recommend taking tablets one at a time 1-3 times a day. In this case, the maximum allowable daily dosage is 4 tablets. This medicine can be taken as an anesthetic for up to 5 days, antipyretic - no more than 3 days. In other cases, specialist advice is required.

The use of the drug in high dosages for a long time can cause: nausea, vomiting, stomach pain, tachycardia, arrhythmia, weakness, drowsiness, breathing problems, delusional state.

In this case, treatment is carried out involving the induction of vomiting, gastric lavage using a probe, the intake of adsorbents and other symptomatic therapy that helps maintain important functions.

When the drug is combined with various non-narcotic analgesics, toxic effects may increase. Combinations with tricyclic antidepressants, contraceptives and Allopurinol are able to increase the toxicity of metamizole sodium, which is part of Pentalgin N. Simultaneous administration with barbiturates, phenylbutazone and a variety of inducers of microsomal hepatic enzymes may weaken the effect of metamizole sodium. When combined with metamizole sodium and Cyclosporine lowers its level of the first blood. Tranquilizers and various sedatives can enhance the analgesic effect of the drug.

The use of tablets for more than 5 days requires monitoring of the peripheral state of the blood and liver functions.

Sometimes the results of the analysis of doping control in athletes change. It may be difficult to establish a diagnosis in cases of acute abdominal pain syndrome. Patients suffering from atopic bronchial asthma or hay fever may, when taking these tablets, experience the development of various hypersensitivity reactions.

Over the counter.

Tablets are stored in a dry, dark place protected from children at a temperature not exceeding +25°C.

They have a similar effect: Ibuprofen, Paracetamol, Cardiomagnyl, Amizon And Analgin.

The combination with alcohol may increase the severity of side effects.

Various painkillers are especially popular with patients of different groups. Usually people try to relieve pain with pills when they can't go to the doctor. At the same time, reviews of Pentalgin N regarding its effectiveness are usually quite positive.

True, some patients are embarrassed that these tablets are with codeine, but since they quickly and reliably help get rid of pain, they are ready to take them at any time in different quantities. Sometimes there are messages in which users are interested: “Does Pentalgin N sell in pharmacies with or without a prescription?”.

It should be noted that doctors prescribe this drug quite rarely and not at all because it is with codeine. In fact, any pain indicates that there are disorders in the body and it urgently needs help.

Often this drug is taken by women suffering from menstrual irregularities in the form of painful periods. At the same time, many of the women call this medicine Pentalgin M and, of course, take it without a doctor's prescription.

Patients note that while not taking these pills, they suffered from headaches and nausea, as well as vomiting. Now they keep this medicine in their medicine cabinet or carry it in their purse.

Thus, for most patients, taking painkillers is an opportunity to delay the visit to the doctor. As a rule, during this time, the development of the disease occurs, which only strengthens and becomes chronic. It is known that such conditions are quite difficult and long-term to treat.

You can buy Pentalgin N in Moscow at any Russian pharmacy. At the same time, the price varies between 135-150 rubles.

Pentalgin N №10 tablets

Pentalgin is a combined drug from the group of non-selective NSAIDs (non-steroidal anti-inflammatory drug), cyclooxygenase inhibitor (COX-1 and COX-2). The composition includes 5 substances that complement each other's actions: paracetamol, metamizole, phenobarbital, codeine and caffeine. Release forms:

Tablets Pentalgin-IC, 10 tab. on the plate: paracetamol 200 mg, metamizole sodium (analgin) 300 mg, caffeine 20 mg, phenobarbital 10 mg and codeine 9.5 mg
Tablets Pentalgin-ICN, 12 tab. on the plate: paracetamol 300 mg, metamizole sodium (analgin) 300 mg, caffeine 50 mg, phenobarbital 10 mg and codeine 8 mg
Tablets Pentalgin-FS, 10 tab. on the plate: paracetamol 300 mg, metamizole sodium (analgin) 300 mg, caffeine 50 mg, phenobarbital 10 mg and codeine 8 mg

Pentalgin is indicated for the following diseases of the spine and its structures:

Bechterew's disease
Spinal tumor (both benign and malignant)
Scoliosis
Intervertebral hernia
Osteochondrosis
Spondylosis
Schmorl's hernia
Spinal injuries (bruise, fracture, dislocation, etc.)
Spondylitis
Kyphosis
Rheumatoid arthritis
Lordosis
Radiculitis
Spondylolisthesis
Postoperative period
Spinal stenosis

Pentalgin is contraindicated in the following diseases in a patient:

Pregnancy
lactation period
Children under 12
Allergy to the drug and its components
Recent traumatic brain injury
Anemia
Increased intracranial pressure
Glaucoma
Episodes of bronchospasm of unknown etiology
Ulcer in the intestines and stomach
Respiratory failure
Liver failure
kidney failure
Diabetes
Myocardial infarction, acute period
High blood pressure numbers
Glucose-6-phosphate dehydrogenase deficiency (hereditary congenital disease)
Increased nervous excitability
Sleepiness during the day and insomnia at night
Arrhythmia
Bronchial asthma

The action of Pentalgin is based on the complementarity of the constituent active substances. Paracetamol and metamizole are NSAIDs with non-selective blockade of COX-1 and COX-2, which allows you to stop the production of prostaglandins (inflammatory mediators) and reduce pain and inflammation.

Phenobarbital has a slight sedative effect, and also relieves spasm in the smooth muscles of blood vessels and striated muscles of the back, enhances the effect of NSAIDs.

Caffeine stimulates the nervous system, accelerates blood flow and enhances the action of paracetamol and metamizole.

Codeine belongs to narcotic analgesics, has a pronounced analgesic and antitussive effect, enhances the effect of phenobarbital and NSAIDs.

As a result, the patient feels an instant decrease in pain in the spine, after a few days of taking the inflammation of the tissues and their swelling decreases, the amplitude of active and passive movements in the back is restored, the patient returns to the usual way of life that he led before the exacerbation of the disease.

Pentalgin must be taken orally with a sufficient amount of liquid, 1-2 tablets 1-3 times a day. Taking with food or in the first 15-20 minutes after eating improves the absorption of the drug in the gastrointestinal tract. The maximum daily dosage is 4-5 tablets. The course of treatment is up to 5 days. If necessary, you can extend the treatment under the control of blood tests (general analysis and liver tests) or repeat at the next exacerbation of the disease.

Side effects of Pentalgin develop quite rarely:

Rash and itching on the skin
Dry mouth
Increased heart rate (tachycardia)
Pain in the abdomen
Decreased appetite
Nausea
Vomit
Headache
Trembling in the hands
Increased sleepiness
Cardiopalmus
constipation
Visual acuity deterioration
Quincke's edema (angioedema)
Dizziness
Edema
kidney failure
Liver failure

All side effects from the use of Pentalgin require discontinuation of the drug and the use of symptomatic medications.

If the prescribed dosage of Pentalgin is not observed and it is exceeded several times per day, signs of an overdose may develop:

Severe general weakness
Severe nausea and vomiting
Lowering blood pressure
Respiratory depression
Pale skin
Arrhythmia
Acute liver failure
Severe abdominal pain
Tachycardia (rapid heartbeat)

In case of an overdose of Pentalgin, you should urgently rinse the stomach, consult a doctor, take enterosorbents and symptomatic agents.

During pregnancy of any gestational age and during breastfeeding, Pentalgin is strictly contraindicated due to the negative effect of the drug on the fetus and infant (depresses breathing and organ formation).

Children under 12 years of age should not take Pentalgin because of the possible inhibition of the respiratory center.

Alcoholic drinks can reduce or disrupt the effect of the drug, cause the development of side effects, therefore it is recommended not to take alcohol within 3 hours after taking Pentalgin. After the last intake of alcoholic beverages, from 2 to 8 hours should also pass (the stronger the drink, the longer it takes to withstand).

Pyatirchatka, Sedalgin, etc.

Pentalgin-N is a combined drug with analgesic, antipyretic and anti-inflammatory effects.

Dosage form of Pentalgin-N - tablets: flat-cylindrical, from white to white with a cream or yellowish tint, with the abbreviated name of the drug "PENT-N" printed on one of the sides (in a cellular or non-cellular contour package 10 pcs., in a cardboard box 1 or 2 packs).

Composition of one tablet:

active substances: analgin (metamisole sodium) - 300 mg, naproxen - 100 mg, caffeine - 50 mg, phenobarbital - 10 mg, codeine (in the form of codeine or codeine phosphate) - 8 mg;
auxiliary components: potato starch, low molecular weight povidone (medical low molecular weight polyvinylpyrrolidone), sodium citrate, magnesium stearate.

Pharmacodynamics

The composition of Pentalgin-N includes active substances that have analgesic, antispasmodic, antipyretic, anti-inflammatory and sedative effects.

Metamizole sodium is a derivative of pyrazolone. It has analgesic and antipyretic effects.

Naproxen, being a non-steroidal anti-inflammatory drug, has anti-inflammatory, analgesic and antipyretic properties, which are due to non-selective inhibition of the activity of the cyclooxygenase enzyme responsible for the production of prostaglandins from arachidonic acid.

Caffeine helps to expand the blood vessels of skeletal muscle tissue, heart, brain, kidneys, increase physical and mental performance, reduce fatigue and drowsiness. By increasing the permeability of blood-tissue barriers and increasing the bioavailability of non-narcotic analgesics, caffeine leads to an increase in their therapeutic effect.

Codeine has the property of stimulating opioid receptors in various parts of the central nervous system, leading to the activation of the antinociceptive system and an improvement in the perception of pain at an emotional level.

Phenobarbital and codeine increase the analgesic effect of metamizole sodium and naproxen.

The active substances of the drug are well absorbed in the gastrointestinal tract.

Some pharmacokinetic characteristics of the active components of Pentalgin-N:

metamizole sodium: hydrolyzed in the intestinal wall, forming the active metabolite 4-methyl-amino-antipyrine, which is metabolized, in turn, to 4-formyl-amino-antipyrine and other metabolites. 50-60% of the active metabolite binds to plasma proteins. The substance can pass into breast milk. Metabolites are excreted in the urine;
naproxen: bioavailability is 95%, binds to plasma proteins. The half-life (T1 / 2) is from 12 to 15 hours. It is excreted mainly by the kidneys in the form of a metabolite (dimethylnaproxen), with bile - in small quantities;
caffeine: well absorbed in the intestines. T1 / 2 is 5 hours (in some cases - up to 10 hours). It is excreted mainly in the urine in the form of metabolites, unchanged - approximately 10%;
phenobarbital: bioavailability - about 80%, about 50% binds to plasma proteins. It has the ability to penetrate the placental barrier well. Metabolism occurs in the liver with the formation of metabolites, the main of which has no pharmacological activity. Excreted in the urine, including unchanged, - 20-25%;
Codeine: It binds insignificantly to plasma proteins. Metabolized in the liver. By demethylation, 10% of the substance is converted to morphine. It is excreted mainly by the kidneys, unchanged - 5-15%.

Contraindications

Absolute:

severe renal and / or liver dysfunction;
anemia, leukopenia;
bronchial asthma, bronchospasm;
respiratory depression;
gastric and / or duodenal ulcer in the acute stage;
severe degree of arterial hypertension;
acute myocardial infarction;
arrhythmias;
traumatic brain injury;
glaucoma;
deficiency of glucose-6-phosphate dehydrogenase;
state of alcoholic intoxication;
children's age up to 12 years;
pregnancy, lactation;
increased individual sensitivity to any component that is part of Pentalgin-N.

Relative (the use of the drug requires caution):

arterial hypertension of mild and moderate severity;
peptic ulcer of the stomach and / or duodenum in remission;
elderly age.

Pentalgin-N tablets are taken orally.

Overdose

With an overdose of Pentalgin-N, the following symptoms may develop: nausea, vomiting, drowsiness, weakness, gastralgia, cardiac arrhythmias, tachycardia, delirium, respiratory depression.

Treatment in case of overdose consists of induction of vomiting, gastric lavage through a tube, the use of adsorbents (eg, activated charcoal), symptomatic therapy aimed at maintaining the functioning of vital organs.

While taking Pentalgin-N, it may be difficult to establish a diagnosis in case of acute abdominal pain syndrome.

In patients with hay fever and atopic bronchial asthma, the risk of developing hypersensitivity reactions increases with the use of the drug.

In the case of prolonged (more than five days) administration of Pentalgin-N, it is necessary to monitor liver function indicators and the picture of peripheral blood.

During the period of use of the drug, the results of doping control in athletes may change.

Since Pentalgin-N can cause such side reactions as dizziness and drowsiness, when taking tablets, you should refrain from driving vehicles and performing potentially hazardous activities that require increased concentration and a quick psychomotor reaction.

According to the instructions, Pentalgin-N is contraindicated for use by pregnant and lactating women.

If necessary, the use of the drug during the lactation period, breastfeeding should be discontinued.

Children under 12 years of age are prohibited from prescribing Pentalgin-N.

The drug is contraindicated in patients with severe renal insufficiency.

With severe violations of liver function, it is not recommended to prescribe Pentalgin-N.

Elderly patients should be careful when taking the drug.

The use of Pentalgin-N simultaneously with certain drugs can lead to the development of the following effects:

non-opioid analgesics: increased toxic effects;
allopurinol, tricyclic antidepressants, oral contraceptives: increased toxicity of metamizole sodium;
phenylbutazone, barbiturates and other drugs that cause induction (increase in the rate of synthesis) of microsomal liver enzymes: weakening the action of metamizole sodium;
cyclosporine: decrease in its level in the blood;
tranquilizers and sedatives: increased analgesic effect of the drug.

Analogues of Pentalgin-N are Piralgin, Pentalgin, Baralgin M, Maksigan, Spazmalin, Sedalgin plus, Tetralgin, Banalgin, etc.

Store in a dry place, protected from light, at a temperature not exceeding 25 °C.

Keep away from children.

Shelf life - 3 years.

Released by prescription.

There are many reviews about Pentalgin-N, and they are mostly positive. Almost all who wrote a review, the drug helped to get rid of pain of various origins. Tablets have proven themselves well as an antipyretic for colds. Users note that the drug acts quickly, the analgesic effect persists for quite a long time. Many people prefer to have Pentalgin-N in their first aid kit.

The price of Pentalgin-N for a package of 10 tablets is approximately 210 rubles.

In this article, you can read the instructions for using the drug Pentalgin. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Pentalgin in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Pentalgin in the presence of existing structural analogues. Use for the treatment of headache, toothache and other pain and temperature in adults, children, as well as during pregnancy and lactation. The composition of the drug and the conditions for over-the-counter and prescription dispensing, depending on the presence of components prohibited for wide sale.

Pentalgin- a combined drug that has analgesic, anti-inflammatory, antispasmodic, antipyretic effects.

Paracetamol is an analgesic-antipyretic that has an antipyretic and analgesic effect due to the blockade of COX in the central nervous system and the effect on the centers of pain and thermoregulation.

Naproxen is a non-steroidal anti-inflammatory drug that has anti-inflammatory, analgesic and antipyretic effects associated with non-selective suppression of COX activity, which regulates the synthesis of prostaglandins.

Caffeine is a psychostimulant that causes vasodilation of skeletal muscles, heart, kidneys; increases mental and physical performance, helps to eliminate fatigue and drowsiness; increases the permeability of histohematic barriers and increases the bioavailability of non-narcotic analgesics, thereby enhancing the therapeutic effect. It has a tonic effect on the vessels of the brain.

Drotaverine - has a myotropic antispasmodic effect due to inhibition of PDE 4, acts on the smooth muscles of the gastrointestinal tract, biliary tract, genitourinary system, blood vessels.

Pheniramine is a blocker of histamine H1 receptors. It has an antispasmodic and mild sedative effect, reduces the effects of exudation, and also enhances the analgesic effect of paracetamol and naproxen.

Codeine has an analgesic effect due to the excitation of opioid receptors in various parts of the central nervous system, leading to stimulation of the antinociceptive system and a change in the emotional perception of pain.

Phenobarbital is a barbiturate that increases the analgesic efficacy of metamizole sodium and paracetamol.

Phenobarbital and codeine increase the analgesic effect of metamizole sodium and naproxen.

Compound

Paracetamol + Naproxen + Caffeine + Drotaverine hydrochloride + Pheniramine maleate + excipients (green tablets, do not contain codeine and are sold without a prescription).

Metamizole sodium + Naproxen + Caffeine + Phenobarbital + Codeine (in the form of phosphate) + excipients (Pentalgin N).

Paracetamol + Metamizole sodium + Caffeine + Phenobarbital + Codeine phosphate + excipients (Pentalgin ICN).

Paracetamol + Propyphenazone + Caffeine + Codeine phosphate + Phenobarbital + excipients (Pentalgin Plus).

Pharmacokinetics

The components of the drug are well absorbed in the gastrointestinal tract.

Metamizole sodium

Naproxen

Bioavailability is 95%. Binds to blood proteins. It is excreted in the urine mainly as a metabolite (dimethylnaproxen), in small amounts - with bile.

Caffeine

Well absorbed in the intestines. It is excreted mainly by the kidneys in the form of metabolites, about 10% - unchanged.

Codeine

Slightly binds to plasma proteins. Undergoes biotransformation in the liver (10% by demethylation passes into morphine). Excreted by the kidneys (5-15% - unchanged).

Phenobarbital

It penetrates well through the placental barrier. Biotransformed in the liver. The main metabolite has no pharmacological activity. Excreted by the kidneys, incl. 20-25% - unchanged.

Indications

pain syndrome of various origins, including pain in the joints, muscles, sciatica, algomenorrhea, neuralgia, toothache, headache (including those caused by spasm of cerebral vessels);
pain syndrome associated with spasm of smooth muscles, incl. with chronic cholecystitis, cholelithiasis, postcholecystectomy syndrome, renal colic;
post-traumatic and postoperative pain syndrome, incl. accompanied by inflammation;
colds accompanied by febrile syndrome (as a symptomatic therapy).

Release forms

Tablets (green OTC).

Tablets (H, ICN, Plus).

Instructions for use and dosage

The drug is prescribed 1 tablet 1-3 times a day. The maximum daily dose is 4 tablets.

The drug should not be taken for more than 5 days as an anesthetic and for more than 3 days as an antipyretic without a doctor's prescription.

Do not exceed the indicated doses of the drug.

Side effect

skin rash;
hives;
angioedema;
thrombocytopenia, leukopenia, agranulocytosis, anemia;
excitation;
anxiety;
increased reflexes;
tremor;
headache;
sleep disorders;
dizziness;
decreased concentration;
heartbeat;
arrhythmias;
increase in blood pressure;
erosive and ulcerative lesions of the gastrointestinal tract;
nausea, vomiting;
epigastric discomfort;
stomach ache;
constipation;
impaired renal function;
hearing loss;
noise in ears;
increased intraocular pressure in patients with angle-closure glaucoma;
dermatitis;
quickening of breathing.

Contraindications

erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
gastrointestinal bleeding;
complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including history);
severe liver failure;
severe renal failure;
anemia, leukopenia;
oppression of bone marrow hematopoiesis;
condition after coronary artery bypass grafting;
severe organic diseases of the cardiovascular system (including acute myocardial infarction);
paroxysmal tachycardia;
frequent ventricular extrasystole;
severe arterial hypertension;
alcohol intoxication;
glaucoma;
hyperkalemia;
deficiency of glucose-6-phosphate dehydrogenase;
pregnancy;
lactation period (breastfeeding);
children and adolescents up to 18 years of age;
hypersensitivity to the components of the drug.

Use during pregnancy and lactation

The use of the drug during pregnancy and lactation (breastfeeding) is contraindicated.

Use in elderly patients

The drug should be used with caution in elderly patients.

special instructions

The simultaneous use of the drug Pentalgin with other drugs containing paracetamol and / or NSAIDs, as well as with drugs to relieve the symptoms of colds, flu and nasal congestion should be avoided.

When using the drug Pentalgin for more than 5-7 days, peripheral blood parameters and the functional state of the liver should be monitored.

Paracetamol distorts the results of laboratory studies of glucose and uric acid in blood plasma.

If it is necessary to determine 17-ketosteroids, Pentalgin should be canceled 48 hours before the study. Note that naproxen increases bleeding time.

The effect of caffeine on the central nervous system depends on the type of nervous system and can be manifested by both excitation and inhibition of higher nervous activity.

During the treatment period, the patient should avoid alcohol.

Influence on the ability to drive vehicles and control mechanisms

In some cases, it is possible to reduce the concentration of attention and the speed of psychomotor reactions, therefore, during the period of treatment, the patient must be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

drug interaction

While taking the drug Pentalgin with barbiturates, tricyclic antidepressants, rifampicin, ethanol (alcohol), the risk of hepatotoxicity increases (these combinations should be avoided).

Paracetamol enhances the effect of indirect anticoagulants and reduces the effectiveness of uricosuric drugs.

Prolonged use of barbiturates reduces the effectiveness of paracetamol.

With the simultaneous use of paracetamol with ethanol (alcohol) increases the risk of acute pancreatitis.

Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxic action of paracetamol.

Diflunisal increases the plasma concentration of paracetamol by 50%, which increases the risk of hepatotoxicity.

Naproxen can cause a decrease in the diuretic effect of furosemide, an increase in the effect of indirect anticoagulants, increases the toxicity of sulfonamides and methotrexate, reduces the excretion of lithium and increases its concentration in blood plasma.

With the combined use of caffeine and barbiturates, primidone, anticonvulsants (hydantoin derivatives, especially phenytoin), it is possible to increase metabolism and increase clearance of caffeine; while taking caffeine and cimetidine, oral contraceptives, disulfiram, ciprofloxacin, norfloxacin - a decrease in caffeine metabolism in the liver (slowing its excretion and increasing blood concentrations).

Concomitant use of caffeinated beverages and other CNS stimulants may lead to excessive CNS stimulation.

With simultaneous use, drotaverine can weaken the anti-Parkinsonian effect of levodopa.

With the simultaneous use of pheniramine with tranquilizers, hypnotics, MAO inhibitors, ethanol (alcohol), it is possible to increase the inhibitory effect on the central nervous system.

Analogues of the drug Pentalgin

Structural analogues for the active substance:

Pentalgin Plus.
Plivalgin.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Pentalgin is a combination drug that has an effective anti-inflammatory and analgesic effect. The therapeutic effect of the drug is due to the five main active components that make up its composition. Instructions for use of Pentalgin tablets describe in detail its pharmacological properties and effects on the body. According to her, the drug has the ability to inhibit the synthesis of prostaglandins by blocking an enzyme such as cyclooxygenase in the central nervous system.

Pentalgin is a highly effective remedy for eliminating severe pain of various etiological nature. This non-steroidal and non-narcotic drug is able to cope with a strong pain syndrome, as well as have a high anti-inflammatory and antipyretic effect. That is, this drug very quickly eliminates pain, various spasms, lowers the temperature and eliminates the focus of inflammation.

The drug has analgesic, antispasmodic, psychostimulant properties and effectively blocks H1-histamine receptors. The action of the drug is provided by the following medicinal substances included in the composition:

Drotaverin.

Effectively eliminates spasms of any nature, has a beneficial effect on smooth muscles, bile ducts, genitourinary and vascular systems. The substance has a pronounced antispasmodic myotropic effect.

Paracetamol.

It is a non-narcotic analgesic that effectively lowers fever and eliminates pain. Its analgesic and antipyretic effect is due to the blockade of certain enzymes of the central nervous system, which leads to an effective effect on pain centers and regulates body temperature.

An anti-inflammatory non-steroidal component that quickly eliminates the inflammatory process, has an analgesic effect and is also able to reduce fever. The action of the substance is associated with the suppression of the cyclooxygenase enzyme, which regulates the synthesis of prostaglandins. Naproxen actively prevents the development of inflammation and pain.

Caffeine.

It expands the blood vessels of tissues and muscles, has a beneficial effect on the kidneys and heart, eliminates fatigue, drowsiness, and increases physical and mental performance. Caffeine enhances the bioavailability and effect of analgesics that are included in Pentalgin. It increases the permeability of barriers and increases the therapeutic effect of the drug. Caffeine has a tonic effect on the vessels of the brain.

Pheniramine.

It is a histamine receptor blocker. Effectively relieves spasms and pains of a different nature, enhances the analgesic effect of paracetamol and naproxen.

Indications

What helps Pentalgin? The tool has a very wide range of applications. The drug is effective for headaches, rheumatic pains, pain after surgery. The main indications for the use of the drug:

Also, these drugs are often prescribed:

in the complex therapy of acute respiratory viral infections and influenza;
at high temperature;
in the inflammatory process;
with pain in the muscles;
fever
pain after injury;
pain after surgery;
pain in gallstone disease;
with chronic cholecystitis;
renal colic.

The drug is a tablet. The maximum allowable dose of the drug is 4 tablets per day. It is important to know that long-term use of Pentalgin tablets can cause drug dependence. It is not recommended to use the drug in treatment for more than seven days. In case of such a need, it is required to control the functioning of the liver and kidneys, as well as the composition of the blood.

Contraindications

Pentalgin can not be used during childbearing and breastfeeding. Also, the drug is not used in the treatment of children under 12 years of age. Main contraindications:

tachycardia;
myocardial infarction;
kidney failure;
disorders in the liver;
nasal polyposis;
bronchial asthma;
intestinal bleeding;
individual intolerance.

With caution, it is necessary to take Pentalgin to elderly people with epilepsy.

Varieties of the drug

The drug Pentalgin N includes metamizole sodium, phenobarbital, codeine, naproxen and caffeine in its composition. The medicine is available in tablets, in a blister pack (10 pieces). Phenobarbital provides a sedative effect, calms the nervous system. Codeine blocks certain receptors and effectively eliminates pain. The drug is a non-narcotic analgesic. It has an analgesic effect and effectively copes with pain in various diseases.

Pentalgin N is used to eliminate any pain and feverish conditions. It is used after operations, for colds, neuralgia, myalgia, sciatica and other diseases. The drug very effectively relieves toothache, muscle pain and quickly eliminates migraines.

The medication is contraindicated in:

There is also such a medicinal variety as the drug Pentalgin icn. In its composition, this drug contains paracetamol, caffeine, phenobarbital, codeine phosphate, metamizole sodium. It is a combined medicine that has anti-inflammatory, analgesic and antipyretic effects. The drug effectively blocks pain by acting on the centers of inflammation. Reduces the peristalsis of the intestinal sphincters, relaxes smooth muscles, eliminates spasms.

The medicine is indicated to eliminate the pain syndrome of any etiology, is used for headaches, for colds, for rheumatism, after surgery. Also, the remedy perfectly eliminates toothache and muscle pain. The drug can not be used for a long time and uncontrolled.

Contraindications:

By-effect

The drug is very well tolerated by the body and rarely causes side effects. When taking the drug in rare cases, there may be such manifestations as:

nausea;
vomit;
stomach ache;
sleep disturbance;
anemia;
visual impairment;
failure of the heart rhythm;
noise in the ears;
increased intracranial pressure;
stool disorders;
allergic reaction.

You can not use Pentalgin together with other non-narcotic analgesics, with Aminophenazone, since the combined use of these drugs causes an increase in toxicity in the body. Paracetamol, which is part of the drug, enhances the effect of anticoagulants and reduces the effect of enzyme agents.
Treatment with Pentalgin during alcohol intoxication is prohibited, since codeine, which is part of the drug, enhances the oppressive effect of alcohol on the central nervous system.
Pentalgin enhances the effect of drugs such as Griseofulvin, Phenothiazine, Doxycycline, as well as estrogens and antidepressants. The effect of tranquilizers and sedatives enhances the analgesic effect of Pentalgin.
The use of the drug in large doses and its long-term use causes drug dependence. The drug should be taken one tablet 1-3 times a day. The tablet is swallowed whole and washed down with a sufficient amount of drinking water. Many patients are interested in - how long does Pentalgin work? All active components of the drug are quickly absorbed into the tissues of the stomach and enter the bloodstream, after which they begin to act in the body. Therapeutic and analgesic effects can be felt within 10-15 minutes after taking one tablet of the drug.
Taking the drug does not depend on food intake. The maximum dose (single) can be in special cases two tablets. The duration of treatment is usually prescribed for a period of 5-7 days. In case of urgent need, the drug can be continued under the supervision of the attending physician and regular monitoring of blood counts. Pentalgin can not be used in the treatment of children under 12 years of age.

In case of an overdose of the drug, vomiting, nausea, weakness, decreased heart rate and blood pressure may occur. Also, with an overdose, an allergic reaction, depression of the central nervous system, is manifested.

Carrying a fetus requires a pregnant woman to pay special attention to her health. Any intake of medications can cause the risk of developing various pathologies and developmental abnormalities in the unborn child. A pregnant woman needs to be as careful as possible when treating with medications. Any desire to take medications should be coordinated with a gynecologist who knows the peculiarities of the course of pregnancy.

The drug Pentalgin and its varieties Pentalgin N, Pentalgin icn should not be used during pregnancy! The instructions for the drug from the manufacturers of the drug prohibit its use during the period of bearing a child at any stage of pregnancy. It is better for a future mother to use other, less dangerous drugs to relieve pain and treat. Today, the pharmaceutical market offers pregnant women a large selection of various safe homeopathic remedies that are allowed to be used during gestation.

Pentalgin is also not used during the period of feeding a child. The active substances that make up the drug are very quickly absorbed into the bloodstream and penetrate into breast milk. For treatment with Pentalgin, it is better to transfer the child to artificial feeding or refuse to take this medication.

The drug is allowed after 12 years. Before the specified age, it is impossible to use Pentalgin in the treatment of children according to the instructions of the drug manufacturers. For children over 12 years of age, it is undesirable to use a single dose in the form of an allowable two tablets. Otherwise, the drug will have an extremely negative effect on the children's body. Also, treatment should be limited to two to three tablets per day. The instruction allows giving children 1 Pentalgin tablet three times a day.

If weakness, nausea, allergies, vomiting, dizziness, tinnitus and other negative side effects appear, the drug should be stopped and consulted with a doctor.

After operation

The drug is a very strong pain reliever, so it is often used to eliminate various pains after surgical interventions. Also, the drug can be effectively used after tooth extraction. It is undesirable to take two tablets once. The components of the drug are focused on fast action, so you should wait for the pain to subside.

This drug is widely used during the recovery period after major operations. You should be aware that a prescription for Pentalgin without codeine is not required to purchase the drug at a pharmacy. If the type of drug does not include codeine in its composition, the medicine can be freely bought at pharmacies.

The high efficiency of Pentalgin in eliminating pain after surgery is due to the active properties of the components of the drug. In the body, paracetamol binds to plasma proteins and firmly blocks the development of prostaglandins. Medicinal substances of the drug act directly on the receptors that cause pain.

Phenobarbital, which is part of the product, has a relaxing effect on the nervous system, calms nerve receptors and reduces excitability. The complex effect of all components of Pentalgin allows you to quickly and firmly eliminate stabbing, cutting, pulling pains after surgery.

Analogues

Today, the pharmaceutical market offers a wide variety of pain medications. Pentalgin has its advantages over other painkillers, but sometimes it becomes necessary to replace it with similar drugs. There are cheaper analogues of Pentalgin, which have a similar composition and effect. When choosing a drug from a group of analogues, it is important to consult with your doctor in advance. Perhaps, due to the characteristics of the organism, a similar drug will not work.

The main analogues of Pentalgin:

In the retail network of pharmacies, the price of the drug may vary. Approximate cost:

Pentalgin (12 pcs.) - 85-104 rubles;
Pentalgin (24 pcs.) - 160 -170 rubles;
Pentalgin icn (12 pcs.) - 50 rubles;
Pentalgin N with drotaverine - 56 -106 rubles;
Pentalgin N - 170 rubles.

Average price of analogues:

Pentamialgin - 130 rubles;
Pentalfen - 70 - 100 rubles;
Sedal M - 120 - 230 rubles;
Plivalgin - 50 rubles;
Sedalgin plus - 126 - 260 rubles.

1 tablet contains:

Active substances: metamizole sodium - 300 mg; naproxen - 100 mg; caffeine - 50 mg; phenobarbital - 10 mg; codeine (in the form of phosphate) - 8 mg;
Excipients: potato starch, low molecular weight polyvinylpyrrolidone (povidone), sodium citrate, magnesium stearate.

10 pieces. - cellular contour packings (1) - packs of cardboard.

Description of the dosage form

Tablets are white or white with a yellowish or creamy tint, flat-cylindrical, with the abbreviated name of the drug "PENT-N" embossed on one side.

pharmachologic effect

Anti-inflammatory, antipyretic, analgesic, antispasmodic, sedative.

It has the properties of sedatives (phenobarbital), non-narcotic analgesics and NSAIDs (metamizole, naproxen), enhanced by codeine (blocks opiate receptors) and caffeine (increases the permeability of histohematic barriers).

Pharmacokinetics

The components of the drug are well absorbed in the gastrointestinal tract.

Metamizole sodium

Naproxen

Bioavailability is 95%. Binds to blood proteins. T1 / 2 - 12-15 hours. Excreted in the urine mainly as a metabolite (dimethylnaproxen), in small quantities - with bile.

Well absorbed in the intestines. T1 / 2 - 5 hours (sometimes up to 10 hours). It is excreted mainly by the kidneys in the form of metabolites, about 10% - unchanged.

Slightly binds to plasma proteins. Undergoes biotransformation in the liver (10% by demethylation passes into morphine). Excreted by the kidneys (5-15% - unchanged).

Phenobarbital

Pharmacodynamics

The combined drug has analgesic, antipyretic and anti-inflammatory effects.

Metamizole sodium is an analgesic-antipyretic, a derivative of pyrazolone. It has a pronounced analgesic effect.

Naproxen - NSAIDs, has anti-inflammatory, analgesic and antipyretic effects associated with non-selective suppression of COX activity, which regulates the synthesis of prostaglandins.

Codeine stimulates opioid receptors in various parts of the central nervous system, which leads to the activation of the antinociceptive system and a change in the emotional perception of pain.

Phenobarbital and codeine increase the analgesic effect of metamizole sodium and naproxen.

Indications for use Pentalgin-n

Moderate pain syndrome: toothache and headache, myalgia, arthralgia, sciatica, neuralgia, algomenorrhea, etc.; febrile conditions, colds and other diseases accompanied by pain and inflammation.

Contraindications to the use of Pentalgin-n

Hypersensitivity, peptic ulcer of the stomach and duodenum (in the acute stage), blood diseases, conditions accompanied by respiratory depression, increased intracranial pressure, traumatic brain injury, acute myocardial infarction, cardiac arrhythmia, hypertension, alcohol intoxication, acute attack of bronchial asthma, glaucoma, severe liver and / or kidney dysfunction, pregnancy, breastfeeding, children under 12 years of age.

Pentalgin-n Use in pregnancy and children

Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.

Pentalgin-n side effects

From the nervous system and sensory organs: dizziness, drowsiness.

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis): granulocyto- or leukopenia, agranulocytosis.

From the digestive tract: nausea, vomiting, constipation, erosive and ulcerative lesions of the gastrointestinal tract.

Allergic reactions: skin rash, itching, urticaria.

Precautionary measures

Precautions should be prescribed in case of impaired liver and kidney function, gastric ulcer and duodenal ulcer (in remission), elderly patients. With prolonged use, it is necessary to control the composition of peripheral blood. During therapy, alcohol should be avoided and administered with caution during work to drivers of vehicles and people whose profession is associated with an increased concentration of attention.