The fight against pain attacks in the abdomen with the drug baralgin. What helps baralgin

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

Tablets Baralgin M - 500 mg of the active substance each
Solution for injection Baralgin M - 500 mg of the active substance in each ml, in a 5 ml ampoule (2.5 g in each ampoule)
Solution for injection Baralgin - in a 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 of metamizole sodium, 0.005 g of pitofenone hydrochloride and 0.0001 g of fenpiverinium bromide in each tablet

Indications for use Baralgin

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

Injuries of the spinal column (fractures, bruises, dislocations, etc.)
Spinal tumors (both malignant and benign)
Postoperative period due to spinal surgery

Contraindications

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

Allergy to the drug and its components
porfiria
Feeding the baby with breast milk
Pregnancy up to 12 weeks and after 28 weeks of gestation
Deficiency of the enzyme glucose-6-phosphate dehydrogenase
Angle-closure glaucoma
Bronchial asthma
Renal and liver failure
Frequent fainting
Severe cardiac arrhythmias

Operating principle

The main active ingredient of Baralgin is metamizole sodium. It blocks cyclooxygenase 1 and 2 fractions, causing a pronounced analgesic effect, and also reduces locally elevated tissue temperature and inflammation 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 drug with ganglioblocking action. Those. this substance, due to the blockade of nerve impulses through certain receptors, helps to reduce the tone of smooth muscles located in the walls of blood vessels, which helps to improve blood flow.

Pitophenone is an antispasmodic with an action 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 decrease in pain, restoration of spinal mobility, acceleration of tissue repair and recovery of the patient.

Mode of application

Baralgin in the form of tablets

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 multiplicity of reception 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 injections

It should be administered intramuscularly or intravenously. A single dosage is from 2 to 5 ml. The maximum daily dosage is 10 ml. Children weighing 5-8 kg - 0.1-0.2 ml in the gluteal or femoral muscle. With a body weight of 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. With a patient weighing more than 53 kg or older than 15 years, adult dosages of Baralgin are prescribed. The course of treatment with injectable forms of the drug is a maximum of 5 days, after which, if necessary, the patient is transferred to tablet forms.

Side effects

Baralgin with individual intolerance can cause a number of side effects. The main ones are:

Itchy skin rash
Anaphylactic shock
Quincke's edema
Discomfort or pain in the abdomen
Constipation
Decrease in blood pressure figures
Increased heart rate
Dizziness
Red 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, the drug should be discontinued and, if necessary, symptomatic agents should be prescribed.

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

Renal or liver failure
Respiratory dysfunction
Nausea and vomiting
Headache

For the treatment of such conditions, it is necessary to immediately stop taking the drug, induce vomiting, wash the stomach and take sorbents. If necessary, symptomatic agents.

special instructions

During pregnancy for a period of 1 to 12 weeks and from 28 weeks before delivery, Baralgin is contraindicated. In 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, breastfeeding is possible 2 days after the last dose of this medication.

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 preparation

Latin name: Baralgin

ATX Code: N02BB02

Active substance: Metamizole sodium, Pitophenone, Fenpiverinium bromide

Manufacturer: Aventis Pharma (India)

The description applies to: 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. The cardboard box contains 1, 2, 5 and 10 blisters.

The solution for injection is available in 5 ml dark glass ampoules. In a carton box 5 ampoules.

pharmachologic effect

Non-narcotic analgesic, characterized by analgesic, antipyretic and weak anti-inflammatory action.

Indications for use

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

Baralgin is used for arthralgia, neuralgia, myalgia, sciatica. As an auxiliary therapeutic agent, 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,
deficiency of glucose-6-phosphate dehydrogenase,
severe liver or kidney failure,
severe angina,
tachyarrhythmia,
angle-closure glaucoma,
decompensated CHF,
prostatic hyperplasia,
intestinal obstruction,
collapse,
megacolon,
pregnancy (I trimester and last 6 weeks) and lactation.

Baralgin in ampoules should not be administered intravenously to children under the age of three months or weighing less than 5 kg. Children under the age of five years are not recommended to use the drug in tablets. 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 tab.).

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

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

In / in, in / m. For adults and adolescents over 15 years of age, a single dose is 2-5 ml (in / in or / m), 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 / m; children 9-15 kg - 0.2-0.5 ml / in 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.
In / in the introduction of the drug should be carried out slowly (1 ml for 1 min), in the position of 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. An increase in the daily dose of Baralgin in ampoules or tablets, as well as a change in the duration of treatment is possible only under the supervision of an appropriate physician.

Side effects

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

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

Analogues

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

Do not make the decision to change the drug yourself, consult your doctor.

special instructions

In the process of using Baralgin, it is not recommended to use ethanol.
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, a long needle must be used. Due to the excretion of the metabolite, it is possible to stain the urine red. During the use of the drug, care should be taken when driving a vehicle, and when engaging in hazardous activities that require a quick mental and physical reaction.

During pregnancy and breastfeeding

The use of the drug during pregnancy is contraindicated.

In childhood

In old age

Information is absent.

drug interaction

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 in the treatment of microsomal enzyme inducers (phenylbutazone, barbiturates).
An increase in the severity of negative reactions is observed in the treatment of other non-narcotic analgesics. The analgesic effect of the drug is enhanced with simultaneous therapy with sedatives. Severe hyperthermia is observed during treatment with phenothiazine derivatives, Chlorpromazine.
Simultaneous treatment with Penicillin, the introduction of colloidal blood substitutes, radiopaque substances is unacceptable. The active component is able to enter into a struggle for communication with proteins in the treatment of indomethacin, glucocorticosteroids, 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 drug is 14-15 minutes. The active active ingredient of the injections is metamizole sodium, it is 500 mg in 1 ml of the drug. The ampoule holds 5 ml. Another component is water for injection. The action of the anesthetic is enhanced by the components - this is fenpiverinium bromide and pitofenone hydrochloride. The symbiosis of the components provides the ability to achieve the maximum amount of anesthetic in the blood in a short time.

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

How to use correctly

The injections are prescribed by a doctor. They are made with:

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

Intravenous administration of the drug is allowed in exceptional situations, with the supervision of a health worker. If it enters the blood soon, the action of the drug can cause cardiac arrest.

The rate of entry of the drug into the vein should be up to one milliliter per minute, the procedure is performed when the person is lying down. Breathing parameters, pulse, arterial pressure are analyzed. With the introduction of Baralgin in an amount of more than 2 ml, blood pressure may drop rapidly.

The instruction provides for the use of the drug in injections without medical advice to get rid of the pain of the identified origin. To reduce the temperature, use only according to medical advice. This is done when other antipyretic drugs are ineffective.

For problems with the bladder, the remedy 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 someone who is experiencing pain from the movement of a stone formation through the ureter. It is allowed to use Baralgin in the absence of a medical recommendation for a maximum of three days. If after this period the pain has not gone away, then it is necessary to contact the doctor as soon as possible to determine the diagnosis and prescribe the correct treatment course.

Doses, frequency of use:

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

Side effects

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

With the introduction of more than the prescribed daily dosage, the renal system suffers, as a result of which urine is not excreted, 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 the activity of the kidneys - anuria, urine staining in a reddish hue, 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

With the threat to life existing for the mother, 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 the age of three months, with a weight of 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 a day.

When breastfeeding, you will not have to resort to Baralgin. The components of the product enter the milk and lead to lesions of the internal organs of the child.

Also contraindications are:

Intestinal obstruction, its invagination;
Imperfection of the kidneys, liver;
Angle-closure 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 deficiencies 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 work of the bone marrow;
The likelihood of attacks of porphyria is when using Baralgin by people who have acute intermittent hepatic porphyria;
Reduced blood pressure, hemodynamic disturbances.

Special instructions

With the simultaneous use of cytostatic agents, Baralgin should be treated exclusively under medical supervision. If you need to be treated for a long time, then from time to time the composition of the blood is monitored. 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 the dosage.

Refuse to use Baralgin should be when the temperature rises with chills, pain in the oral cavity, the appearance of erosion on the mucous membranes. Explicit neutropenia also provides for the abolition of the drug. Anaphylaxis is often present in patients with allergic reactions, bronchial asthma in the past. Patients with rashes, rhinosinusitis, intolerances to dyes and alcohol are also at risk. You can not use Baralgin when there is significant pain in the abdominal cavity in the absence of an accurate diagnosis.

Intramuscularly, Baralgin is injected with long needles.

Do not give intravenous injections to patients under the age of 1 year.

Transport management during treatment with Baralgin is possible, but care should be taken at high dosages.

In case of overdose, symptomatic therapy is needed. There is an option to use hemodialysis, forced diuresis. Diazepam is given intravenously if there are convulsions.

Connection 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 this leaflet carefully before you start using this medicine.
Save the instructions, they may be needed again.
If you have any questions, please contact your doctor.
This medicine has been prescribed for you personally and should not be shared with others as it may harm them even if they have the same symptoms as you.

INSTRUCTIONS for the medical use of the drug Baralgin® M

Registration number: P N011538/01-140211
Trade name of the drug: Baralgin® M.
International non-proprietary 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
White to off-white round flat tablets, debossed with BARALGIN-M on one side, notched on the other side and chamfered on both sides.
Pharmacotherapeutic group: analgesic non-narcotic agent.
ATX code: N02BB02.

Pharmacological properties

Pharmacodynamics
Non-narcotic analgesic agent, a derivative of pyrazolone, non-selectively blocks cyclooxygenase and reduces the formation of prostaglandins from arachidonic acid.
It prevents the conduction of extra-painful and proprioceptive impulses along the Gaulle and Burchard bundles, increases the excitability threshold of the thalamic centers of pain sensitivity, and increases heat transfer.
A distinctive feature is the slight severity of the 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 analgesic, antipyretic and some antispasmodic (in relation to the smooth muscles of the urinary and biliary tract) action.
Pharmacokinetics
Metamizole sodium is well and rapidly 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%. Predominantly 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 cirrhosis of the liver, the half-life of 4-N-methylaminoantipyrine increased three times and was about 10 hours.

Indications for use

Pain syndrome (mild and moderate severity): including neuralgia, myalgia, arthralgia, biliary colic, intestinal colic, renal colic, injuries, burns, decompression sickness, herpes zoster, orchitis, sciatica, myositis, postoperative pain syndrome, headache, toothache, algomenorrhea.
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, indications of a history of the development of agranulocytosis when taking one of these drugs.
- Violations 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 attacks of porphyria)

Carefully

Arterial hypotension (systolic blood pressure below 100 mm Hg), decrease in 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 arteries of the brain).
- Alcoholism.
- Bronchial asthma, especially in combination with concomitant polyposis rhinosinusitis; chronic urticaria and other types of atopy (allergic diseases, in the development of which a significant role belongs to 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 facial flushing) (increased risk of anaphylactic/anaphylactoid reactions).
- Intolerance to dyes (eg tartrazine) or preservatives (eg benzoates) (increased risk of anaphylactic/anaphylactoid reactions).
- Severe violations of the liver and kidneys (it is recommended to use low doses due to the possibility of slowing down 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, you can not take Baralgin M. 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 arterial (Batalov) duct 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, although weak.
lactation period
After taking Baralgin M, breastfeeding should be stopped for 48 hours.

Dosage and administration

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 a day. The maximum daily dose is 2000 mg (4 tablets). Duration of admission - 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 a sufficient amount of water.
An increase in the daily dose of the drug or the duration of treatment is possible only under medical supervision.

Side effect

Side effects were classified as follows: very common (≥10%), frequent (≥1,<10%), нечастые (≥0,1, <1%), редкие (≥0,01, <0,1%), очень редкие (<0,01%).
Anaphylactic/anaphylactoid reactions
In rare cases, metamizole sodium can cause anaphylactic or anaphylactoid reactions, which in very rare cases can be severe and life-threatening. They can occur even if the drug was previously taken many times without any complications.
Such drug reactions can develop immediately or several hours after taking metamizole sodium.
Usually, milder anaphylactic or anaphylactoid reactions manifest as skin and mucosal symptoms (itching, burning, flushing, urticaria, edema) or as shortness of breath or gastrointestinal complaints.
Milder reactions can 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 with intolerance to analgesic drugs, these reactions usually manifest themselves in the form of asthma attacks.
Other skin and subcutaneous tissue reactions
In addition to the skin manifestations of anaphylactic / anaphylactoid reactions listed above, fixed drug dermatitis can rarely occur, a rash can rarely occur, and in some cases Stevens-Johnson syndrome or Lyell's syndrome (toxic epidermal necrolysis) may develop.
Blood and lymphatic system disorders
Rare: leukopenia, in very rare cases agranulocytosis and thrombocytopenia. These reactions are immunological reactions in nature. They can occur even if the drug was previously taken many times 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, fever. It should be remembered that if the patient receives antibiotic therapy, then the typical manifestations of agranulocytosis may be minimally pronounced. The erythrocyte sedimentation rate increases significantly, while lymph node enlargement is mild or absent.
Typical symptoms of thrombocytopenia are an increased tendency to bleed 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, there may be an acute deterioration in kidney function (acute renal failure), in some cases with oliguria, anuria or proteinuria. In some cases, acute interstitial nephritis may occur.
Infrequently, it is possible to stain urine red due to the presence of a metabolite, rubazonic acid, in the urine.

Overdose

Symptoms
In case of overdose, the following symptoms may occur: nausea, vomiting, abdominal pain, decreased kidney 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 taking high doses, excretion through the kidneys of a non-toxic metabolite (rubazonic acid) can cause red staining of urine.
Treatment
If no more than 1-2 hours have passed after taking the drug, then you can induce vomiting, wash the stomach through a tube; give saline laxatives, activated charcoal. At overdose the forced diuresis is shown. The main metabolite (4-N-methylaminoantipyrine) can be eliminated by hemodialysis, hemofiltration, hemoperfusion, or plasma filtration. With the development of a convulsive syndrome - intravenous administration of diazepam and high-speed 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 analgesics
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 action of metamizole sodium.
With sedatives and tranquilizers
Sedatives and tranquilizers enhance the analgesic effect of the drug. Simultaneous use with chlorpromazine or other phenothiazine derivatives can lead to the development of severe hyperthermia.
With drugs that have a high protein binding (oral hypoglycemic agents, indirect anticoagulants, glucocorticosteroids and indomethacin) Metamizole sodium, displacing oral hypoglycemic drugs, indirect anticoagulants, glucocorticosteroids and indomethacin from the connection with plasma proteins, increases their activity.
With myelotoxic drugs
Myelotoxic drugs increase the manifestation of hematotoxicity of the drug.
With thiamazole and sarcolysin
Thiamazole and sarcolysin increase the risk of leukopenia.
With codeine, H2-histamine receptor blockers and propranolol
Codeine, H2-histamine receptor blockers and propranolol enhance the effects of metamizole sodium.
Radiopaque agents, colloidal blood substitutes and penicillin should not be used during treatment with metamizole sodium (increased risk of anaphylactic / anaphylactoid reactions).

special instructions

In the treatment of patients receiving cytostatic agents, taking metamizole sodium should be carried out only under the supervision of a physician.
An increased risk of developing hypersensitivity reactions to metamizole sodium is caused by the following conditions:
- bronchial asthma, especially with concomitant polypous rhinosinusitis;
- chronic urticaria;
- alcohol intolerance (hypersensitivity to alcohol);
- intolerance or hypersensitivity to dyes (eg tartrazine) or preservatives (eg benzoate).
In the case of the use of metamizole sodium in such patients, strict medical supervision of their condition is necessary and it is necessary to have the means to provide them with emergency care in case of development of anaphylactic / anaphylactoid reactions.
With prolonged use, it is necessary to control the picture of peripheral blood. Against the background of taking metamizole sodium, the development of agranulocytosis is possible, 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, a decrease in the number of neutrophils in the peripheral blood is less than 1500 in mm3 it is necessary to stop taking the drug and consult a doctor.
It is unacceptable to use the drug to relieve acute pain in the abdomen (until the cause is clarified).
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, characterized by a minimum of side effects, compared with analogues. Before using the medicine, read the instructions for use.

The composition of Baralgin

The drug is made in three dosage forms: ampoules with a solution for intravenous or intramuscular injection, tablets. Somewhat less often in pharmacies you can find Baralgin in the form of rectal suppositories. Detailed instructions for use are attached to each package with medicine.

The composition of Baralgin in tablets until 2009 contained 3 active ingredients: pitofenone hydrochloride, metamizole sodium, fenpiverinium bromide. After 2009, the drug was renamed to Baralgin M (lat. Baralgin M). It included 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 then are adsorbed in the liver.

The maximum concentration of the active component in the blood plasma is observed after 2 hours. The half-life is about 3 hours. In patients with liver disease, this period may increase to 8-10 hours. Baralgin's injections are superior to tablets in terms of analgesic effect.

What helps Baralgin

The drug is used to eliminate pain, relieve spasms from smooth muscle muscles. According to the instructions, it is necessary to take the medication in the presence of the following diseases or conditions:

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

Method of application and dosage

The duration of treatment and the amount of the drug used must comply with the instructions or be established by the doctor, based on the indications, the patient's condition, and the form of the drug. In order 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. During the entire period of administration, medical personnel should monitor the heart rate and blood pressure. Baralgin is administered intramuscularly at a dose of 2.5-5 ml. The total daily dosage should not exceed 10 ml, and the duration of treatment should not exceed 5 days.

The drug in tablets is drunk regardless of the meal. According to the instructions, a single dose should be 500 mg (1 tablet). It is allowed to consume no more than 3000 mg per day. As an anesthetic, Baralgin is drunk 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 emptying the intestines, 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 occurrence of pain syndrome and diagnosis.

special instructions

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

With prolonged use of Baralgin, it is necessary to regularly monitor blood counts.
Due to the high likelihood of drug incompatibility, mixing several drugs in one syringe is strictly prohibited.
When taking pills and after injections, it is sometimes possible to stain the urine red.

During pregnancy

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

drug interaction

With the simultaneous use of Baralgin and other drugs, various interactions are possible. The instruction contains the following information:

Group or name of drugs	drug interaction
Oral contraceptives, tricyclic antidepressants, Allopurinol.	The toxicity of metamizole sodium increases.
Barbiturates, microsomal enzyme inducers.	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 observed, the following adverse reactions are possible:

tachycardia;
paralysis of the respiratory muscles;
nausea;
lowering blood pressure to critically low levels;
epigastric pain;
convulsions;
vomit;
drowsiness;
hypothermia (drop in body temperature);
noise in ears;
agranulocytosis (decrease in the level of leukocytes);
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. Assign enterosorbents, saline laxatives. In acute poisoning, gastric lavage is done.

Contraindications

According to the instructions, it is worth taking an analgesic with caution for people with glomerulonephritis, a history of myocardial infarction, and alcoholism. It is strictly forbidden to start treatment in the presence of the following contraindications:

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

Terms of sale and storage

Analogues

If there are contraindications or there is no medicine in the pharmacy, ask your doctor to choose 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, antipyretic properties. Contraindicated in patients with a tendency to bronchospasm.
Analgin-Ultra is a complete analogue of Analgin. It differs from the previous drug in the cost and composition of the tablet shell.

Price Baralgin

The drug is released only by prescription. Approximate cost of medicine in Moscow.