Pentalgin instructions for use for children dosage. What helps Pentalgin: instructions for use

Content

Currently, there are many new drugs. Some of them are dispensed by pharmacies without a doctor's prescription, while others are strictly by prescription. It is useful for people to know what Pentalgin tablets are - instructions for use, how the medicine works, in what cases it helps, whether it can be given to children, what are the warnings.

What is Pentalgin

The release form of the drug is in the form of tablets. In the photo, Pentalgin tablets (Pentalgin) are capsules coated with a green embossed shell. A slice of green tablets, sometimes with white patches. Pentalgin is packaged in blister packs of 2, 4, 12 tablets. The outer packaging is a cardboard box. You can buy Pentalgin in a pharmacy without a doctor's prescription. The shelf life of tablets is two years from the date of manufacture, it is necessary to store the drug in a dry, dark place.

What helps Pentalgin

The drug has a combined pharmacological action: analgesic; antipyretic (lowers temperature, relieves inflammation); antispasmodic action. Pentalgin helps to eliminate pain syndrome of various nature:

in joints, muscles;
toothache, headache;
with spasm of smooth muscles of internal organs;
postoperative, caused by inflammation;
symptomatic in febrile conditions during a cold.

For toothache

A good result is achieved when Pentalgin is used for toothache. The drug, due to the combined pharmacological action, simultaneously relieves pain and fights the inflammatory process of pulpitis. The effect is achieved half an hour after taking the drug, but if the drug does not help, the dose should not be increased. You need to see a dentist to treat the inflammation.

For a headache

The drug is an analgesic. Doctors recommend using Pentalgin for headaches. With migraine, the drug has the ability to dilate blood vessels, which improves the blood supply to the brain and the patient's well-being. The effect of relieving pain is increased by blocking pain receptors with the drug, so Pentalgin received positive feedback in the fight against headaches.

With menstruation

The occurrence of pain in the lower abdomen with algomenorrhea (menstruation) is associated with excessive synthesis of prostaglandins: they cause contraction of the uterus, spasm of the pelvic vessels. Due to the stagnation of blood, the tissues receive less oxygen, and this is the cause of the excitation of pain receptors. Pentalgin from pain during menstruation relieves pain by regulating the synthesis of prostaglandins, reducing the frequency of uterine muscle contraction and by blocking pain receptors.

From temperature

Effective is the use of Pentalgin for colds. It helps to eliminate all the symptoms of influenza, sore throat: normalize the temperature, fight inflammation in the body and relieve pain in febrile conditions. The combined effect of the drug is the reason why doctors often prescribe Pentalgin at a temperature.

Instructions for use Pentalgin

The drug is produced by the manufacturer with an annotation for its use. Instructions for use of the drug Pentalgin contains:

description of pharmacological properties;
information about the active and excipients that are part of the drug;
a list of the patient's conditions when the drug can be used;
a warning about side effects that may occur when using the drug;
contraindications for use.

Compound

The combined action of Pentalgin is due to the properties of five active substances. The composition of Pentalgin tablets depends on the type of drug. The manufacturer produces a drug with four names: this allows you to choose the right drug for a person's individual sensitivity to analgesics. The composition of Pentalgin of all four varieties necessarily includes paracetamol.

It begins to anesthetize, acting on the centers of thermoregulation and pain, relieves spasm. Together with an analgesic, it has an anti-inflammatory, antipyretic effect. In combination with paracetamol, the manufacturer uses other active substances. The composition of Pentalgin additionally includes four substances, the names of which are indicated in the instructions. The active elements of the drug together with paracetamol can be:

Naproxen. This non-steroidal substance regulates the synthesis of prostaglandins, which are responsible for muscle contraction. It relieves spasm, inflammation, lowers the temperature.
Caffeine. It tends to dilate blood vessels, increases brain activity, relieves signs of fatigue, drowsiness, and increases the effect of other painkillers.
Drotaverine hydrochloride. Relieves spasm of smooth muscles of the genitourinary system, gastrointestinal tract, biliary tract, blood vessels.
Pheniramine maleate. It blocks the synthesis of histamine, has a sedative effect, fights inflammation. The substance relieves spasm, increases the effect of paracetamol and naproxen.
Propyphenazone.
Codeine. It is a narcotic element. It acts on opioid receptors and changes the perception of pain. Reduces the degree of excitation of the center responsible for coughing, enhances the effect of anti-inflammatory, sedative substances. Prolonged use may cause drug dependence.
Phenobarbital. Refers to barbiturates, increases the analgesic effect of paracetamol and metamizole.
Metamizole sodium. Non-steroidal drug, has an analgesic effect.

Indications for use

The instructions for the drug contain recommendations for when you can use the tablets. Indications for the use of Pentalgin are as follows:

with pain in muscles and bones caused by arthralgia, myalgia, neuralgia, algomenorrhea, migraine, Bechterew's disease, sciatica, rheumatoid arthritis, spinal hernia;
with pain caused by spasm, with diseases: chronic cholecystitis, cholelithiasis, renal colic;
after surgery, in case of pain and inflammation;
with chills, high fever, inflammatory process with colds.

Dosage

How to take Pentalgin? The instruction contains the maximum norms for taking the drug. The dosage of Pentalgin is one tablet half an hour before or after meals with the use of large amounts of water, the daily rate is three tablets, in special cases four. It is necessary to observe an interval of four hours between doses of the medicine. When using the drug to normalize the temperature, the course of treatment is three days, it is not recommended to use pills to relieve pain for longer than five days. The duration of treatment, the number of doses is determined by the doctor.

Side effects

The instruction warns that there is a danger of a reaction to the use of the drug from the internal organs and systems. Side effects of Pentalgin can be as follows:

allergic manifestations in the form of pruritus, rash, urticaria;
changes in the composition of the blood, anemia;
increased heart rate, arrhythmia, increased blood pressure;
dizziness, increased agitation, anxiety, sleep disturbance, decreased attention;
pain in the stomach, diarrhea, nausea, constipation, vomiting, loss of appetite;
hearing loss, visual acuity, tinnitus;
disruption of the liver and kidneys.

Contraindications

People should not drink the drug on their own, because there are contraindications to the use of Pentalgin:

hypersensitivity, allergy to active substances;
pregnancy;
lactation period when breastfeeding a child;
children under the age of 12;
gastrointestinal bleeding;
severe renal dysfunction, renal failure;
paroxysmal tachycardia;
hypertension;
diabetes;
oppression of bone marrow hematopoiesis;
respiratory depression, asthma;
myocardial infarction.

It is not recommended to use tablets while taking other drugs, because in combination with other active substances, the toxicity of the drug may increase or the effect of the drug may decrease. It is forbidden to use Pentalgin and alcohol, you can not take pills while driving, because they reduce attention. It is necessary to carefully take Pentalgin to older people, patients with viral hepatitis, alcoholic liver damage, with epilepsy.

This page contains detailed instructions for use. Pentalgina. The available dosage forms of the painkiller are listed (tablets H, ICN, Plus, green without codeine and without a prescription), as well as its analogues. Information is provided on the side effects that Pentalgin can cause, on interactions with other drugs. In addition to information about the diseases for the treatment and prevention of which the drug is prescribed (headache and toothache, temperature), the algorithms for admission, possible dosages for adults and children are described in detail, the possibility of use during pregnancy and lactation is specified. Annotation to Pentalgin supplemented by reviews of patients and doctors. The composition of the drug.

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.

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).

Release forms

Tablets (Green, OTC, no Codeine).

Tablets (H, ICN, Plus).

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.

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. 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).

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.

special instructions

The simultaneous use of the drug Pentalgin with other drugs containing paracetamol and / or non-steroidal anti-inflammatory drugs (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 an increased concentration of attention and speed of psychomotor reactions.

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.

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.

Use in elderly patients

The drug should be used with caution in elderly patients.

Use in children

Pentalgin is contraindicated in children and adolescents under the age of 18 years.

Use during pregnancy and lactation

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

To date, pharmacological companies produce several varieties of the drug Pentalgin - the composition of the medicines differs depending on the full name. The effectiveness of each of the drugs is evaluated in accordance with the causes that cause pain.

Composition of Pentalgin tablets

The type of pain reliever in question is the only type that is available without a prescription. Its formula has recently been improved in such a way as to eliminate pain not only due to inflammation and nervous tension, but also due to vascular spasms.

The new or green Pentalgin has a composition without codeine and:

naproxen;
drotaverine;
paracetamol;
pheniramine maleate;
anhydrous caffeine.

The combination of these 5 components provides antispasmodic, anti-inflammatory, analgesic and mild antipyretic effect.

It is important to note that the possibility of over-the-counter purchase of such Pentalgin does not preclude the need to consult with your doctor. The fact is that the ingredients of the drug produce a lot of negative side effects, especially for the digestive and cardiovascular systems. Moreover, the content of caffeine in high concentration provokes an increase in blood pressure, which is unacceptable for people suffering from hypertension.

Composition of Pentalgin Plus

This type of drug differs in the content of an additional analgesic - propyphenazone. This ingredient has a low anti-inflammatory activity, but has pronounced analgesic and antipyretic properties. The combination with the rest of the components of the drug allows you to achieve the fastest possible effect even with a very strong pain syndrome.

Full composition:

codeine phosphate;
phenobarbital;
caffeine;
propyphenazone.

As a rule, the described type of Pentalgin is prescribed for diseases and injuries of the joints, muscles, nerve infringement, toothache and headache. Sometimes it is used to relieve the symptoms of a febrile syndrome.

Composition of Pentalgin-ICN

The presented form of the line of analgesics refers to painkillers of high intensity. The combination of active chemical compounds provides stable and rapid relief of pain even in chronic diseases of the cardiovascular and nervous system. Pentalgin-ICN successfully relieves the clinical manifestations of migraine, spasms of smooth muscles.

The drug consists of the following ingredients:

metamizole sodium;
codeine phosphate;
paracetamol;
caffeine;
phenobarbital.

Like the previous version of Pentalgin, the medicine in question is dispensed only with a prescription issued by a doctor.

Composition of Pentalgin N or Neo

The last form of the drug is made without paracetamol. Such Pentalgin has excellent antispasmodic and analgesic properties, but has less pronounced anti-inflammatory and antipyretic activity. This is due to the inclusion in the composition of naproxen, a non-steroidal substance with high pain relief indicators.

LSR-005571/10-170610

Trade name of the drug: Pentalgin®

Dosage form:

film-coated tablets.

Composition per tablet.
Active substances: paracetamol - 325 mg, naproxen - 100 mg, caffeine anhydrous - 50 mg, drotaverine hydrochloride - 40 mg, pheniramine maleate - 10 mg.

Excipients:
Core: microcrystalline cellulose, potato starch, sodium croscarmellose, hyprolose (hydroxypropyl cellulose (Clucel EF)), citric acid monohydrate, butylhydroxytoluene (E 321), magnesium stearate, talc, quinoline yellow dye (E 104), indigo carmine (E 132).
Shell: hypromellose (hydroxypropylmethylcellulose), povidone (medium molecular weight polyvinylpyrrolidone), polysorbate-80 (tween-80), titanium dioxide, talc, quinoline yellow dye, indigo carmine (E 132). Description: light green to green film-coated tablets, biconvex capsule-shaped with bevelled edges, scored on one side and embossed with PENTALGIN on the other. On the cut, the tablet is light green in color with white patches.

Pharmacotherapeutic group:

analgesic (non-narcotic analgesic + non-steroidal anti-inflammatory drug + psychostimulant + antispasmodic + H1-histamine receptor blocker). ATX Code: N02BE71

Pharmacological properties

Combined drug, has analgesic, anti-inflammatory, antispasmodic, antipyretic effect.

Paracetamol is a non-narcotic analgesic that has an antipyretic and analgesic effect due to the blockade of cyclooxygenase 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 the activity of cyclooxygenase, which regulates the synthesis of prostaglandins.

Caffeine - 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 phosphodiesterase IV, acts on smooth muscles in the gastrointestinal tract, biliary tract, genitourinary and vascular systems.

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

Indications for use
Pain syndrome of various origins, including pain in the joints, muscles, sciatica, menstrual pain, neuralgia, toothache and headache (including headache caused by spasm of cerebral vessels).

Pain associated with spasm of smooth muscles, including chronic cholecystitis, cholelithiasis, postcholecystectomy syndrome, renal colic.

Post-traumatic and postoperative pain syndrome, including accompanied by inflammation.

Colds, accompanied by febrile syndrome (as a symptomatic therapy).

Contraindications
Hypersensitivity to the components of the drug, 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 non-steroidal anti-inflammatory drugs, including including a history of severe hepatic and / or renal failure, depression 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 premature beats, severe arterial hypertension, hyperkalemia, children under 18 years of age, pregnancy and lactation.

Carefully- cerebrovascular diseases, diabetes mellitus, peripheral arterial disease, a history of ulcerative lesions of the gastrointestinal tract, mild or moderate renal and hepatic insufficiency, viral hepatitis, alcoholic liver damage, benign hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor syndrome), epilepsy and a tendency to convulsive seizures, deficiency of glucose-6-phosphate dehydrogenase, old age.

If you have one of the listed diseases/conditions, be sure to consult your doctor before taking the drug.

Dosage and administration

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

The duration of treatment is not more than 3 days as an antipyretic and not more than 5 days as an anesthetic. Continuation of treatment with the drug is possible only after consulting a doctor. Do not exceed the indicated dose!

Side effect
Allergic reactions: skin rash, itching, urticaria, angioedema;

On the part of the hematopoietic organs: thrombocytopenia, leukopenia, agranulocytosis, anemia, methemoglobinemia;

From the nervous system: agitation, anxiety, increased reflexes, tremor, headache, sleep disturbances, dizziness, decreased concentration;

From the side of the cardiovascular system: palpitations, arrhythmias, increased blood pressure;

From the digestive system: erosive and ulcerative lesions of the gastrointestinal tract, nausea, vomiting, epigastric discomfort, abdominal pain, constipation, impaired liver function;

From the urinary system: impaired renal function; From the sensory organs: hearing loss, tinnitus, increased intraocular pressure in patients with angle-closure glaucoma;

Others: dermatitis, tachypnea (rapid breathing).

If any of the side effects listed in the instructions get worse, or if you notice any other side effects not listed in the instructions, tell your doctor.

Overdose

Symptoms: pallor of the skin, anorexia (lack of appetite), abdominal pain, nausea, vomiting, gastrointestinal bleeding, agitation, restlessness, confusion, tachycardia, arrhythmia, hyperthermia (fever), frequent urination, headache, tremor or muscle twitching; epileptic seizures, increased activity of "liver" transaminases, hepatonecrosis, increased prothrombin time. Symptoms of impaired liver function may appear 12-48 hours after an overdose. In severe overdose, liver failure develops with progressive encephalopathy, coma, death; acute renal failure with tubular necrosis; arrhythmia, pancreatitis. If you suspect an overdose, you should immediately seek medical help.

Treatment: gastric lavage followed by activated charcoal. The specific antidote for paracetamol poisoning is acetylcysteine. The introduction of acetylcysteine is relevant for 8 hours. With gastrointestinal bleeding, it is necessary to administer antacids and gastric lavage with an ice-cold 0.9% sodium chloride solution; maintenance of lung ventilation and oxygenation; with epileptic seizures - intravenous administration of diazepam; maintaining fluid and salt balance.

Interaction with other drugs
Simultaneous administration of the drug with barbiturates, tricyclic antidepressants, rifampicin and alcoholic beverages should be avoided (the risk of hepatotoxicity increases).

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

Prolonged use of barbiturates reduces the effectiveness of paracetamol. The simultaneous use of paracetamol with ethanol 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.

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

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

special instructions
Simultaneous use of the drug with other drugs containing paracetamol and / or other non-steroidal anti-inflammatory drugs, as well as with drugs to relieve the symptoms of "cold", flu and nasal congestion, should be avoided.

When using the drug 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, the drug should be discontinued 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. system and can be manifested both by excitation and inhibition of higher nervous activity.

During treatment, you should not drink alcohol-containing drinks. In some cases, it is possible to reduce the concentration of attention and the speed of psychomotor reactions, therefore, during the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Release form
Film-coated tablets.
2, 10 or 12 tablets in a blister pack made of polyvinyl chloride film and printed lacquered aluminum foil.
1 or 2 blister packs together with instructions for use in a cardboard pack.

Storage conditions
In a dry, dark place at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

Best before date
2 years. Do not use after the expiry date stated on the package.

Terms of dispensing from pharmacies
Over the counter.

Name and address of the manufacturer / organization accepting claims:
Pharmstandard-Leksredstva OJSC 305022, Russia, Kursk, st. 2nd Aggregatnaya, 1 a/18
JSC "Pharmstandard-Tomskhimfarm" 634009, Russia, Tomsk, Lenin Ave., 211

Pentalgin (Pentalgin)

Compound

1 tablet of Pentalgin-IC contains:
Metamizole sodium - 300 mg;
Paracetamol - 200 mg;
Caffeine - 20 mg;
Phenobarbital - 10 mg;
Codeine phosphate - 9.5 mg (in terms of codeine - 7 mg);
Excipients.

1 tablet of Pentalgin-ICN contains:
Metamizole sodium - 300 mg;
Paracetamol - 300 mg;
Caffeine - 50 mg;
Phenobarbital - 10 mg;
Codeine phosphate - 8 mg;
Excipients.

1 tablet of Pentalgin-FS contains:
Metamizole sodium - 300 mg;
Paracetamol - 300 mg;
Caffeine - 50 mg;
Phenobarbital - 10 mg;
Codeine phosphate - 8 mg;
Excipients.

pharmachologic effect

Pentalgin is a combined analgesic, antipyretic and anti-inflammatory drug. The composition of the drug includes 5 active components, the pharmacological properties of which determine the pharmacological properties of the drug Pentalgin:
Paracetamol and metamizole sodium are non-selective non-steroidal anti-inflammatory drugs with a pronounced antipyretic and analgesic effect, metamizole sodium also has a pronounced anti-inflammatory effect. The mechanism of action of these substances is based on their ability to inhibit the synthesis of prostaglandins by inhibiting the enzyme cyclooxygenase.
Phenobarbital - has a pronounced antispasmodic, muscle relaxant and sedative activity, enhances the therapeutic effects of non-steroidal anti-inflammatory drugs.
Codeine is a drug in the group of narcotic analgesics that reduces the excitability of the cough center and has an analgesic effect. In therapeutic doses, it does not cause oppression of the respiratory center and does not affect the secretory activity of the bronchi. With frequent use of codeine, as well as taking large doses, the development of drug dependence is possible. Helps enhance the action of sedative and non-steroidal anti-inflammatory drugs.
Caffeine - stimulates the central nervous system, prevents the development of collapse, enhances the therapeutic effects of paracetamol and metamizole sodium.

After oral administration, the active components of the drug are well absorbed in the gastrointestinal tract.
Metamizole sodium is biotransformed in the intestinal walls, no unchanged substance is found in the bloodstream. The degree of communication of the active metabolite of metamizole with plasma proteins reaches 50-60%. Metabolized in the liver, excreted mainly by the kidneys in the form of pharmacologically active and inactive metabolites.
Paracetamol is highly bound to plasma proteins. Paracetamol and caffeine are metabolized in the liver, excreted mainly by the kidneys as metabolites. The elimination half-life of paracetamol is 1 to 4 hours.
Phenobarbital is metabolized in the liver and is an inducer of microsomal liver enzymes. It is excreted mainly by the kidneys in the form of metabolites, the half-life is about 3-4 days.
Codeine penetrates well through the blood-brain barrier, accumulates in the body, mainly the accumulation of codeine is noted in adipose tissue, lungs, liver and kidneys. Hydrolysis of codeine under the action of tissue esterases is noted, after which conjugation with glucuronic acid occurs in the liver. Metabolites of codeine have analgesic activity. It is excreted mainly by the kidneys in the form of metabolites, some part is excreted in the bile.

Indications for use

The drug is used to treat patients with acute pain syndrome of various localization, including:
Arthralgia, myalgia, neuralgia, headache and toothache of various etiologies.
Algodysmenorrhea.
Migraine and migraine-like headaches.
In addition, the drug can be used as a symptomatic therapy in patients with influenza and SARS to relieve fever, inflammation and muscle pain.

Mode of application

The drug is taken orally, it is recommended to swallow the tablet whole, without chewing or crushing, with the necessary amount of water. An interval of at least 4 hours between doses of the drug should be observed. The duration of the course of treatment and the dose of the drug is determined by the attending physician individually for each patient.
Adults and adolescents over the age of 12 with acute non-prolonged pain syndrome are usually prescribed 1 tablet of the drug once.
Adults and adolescents over the age of 12 with prolonged pain syndrome, which is accompanied by various diseases of the musculoskeletal system and the nervous system, are usually prescribed 1 tablet of the drug 1-3 times a day. The maximum duration of the course of treatment is 5 days, unless otherwise prescribed by the attending physician.
Adults and adolescents over the age of 12 years as an antipyretic agent are usually prescribed 1 tablet of the drug 1-3 times a day. The maximum duration of the course of treatment is 3 days, unless otherwise prescribed by the attending physician.

The maximum daily dose of the drug is 4 tablets.
With prolonged use of the drug, the development of drug dependence is possible.
If it is necessary to use the drug for more than 7 days in a row, it is necessary to monitor liver function and the morphological composition of the blood.

Side effects

When using the drug in patients, the development of such side effects was noted:
From the gastrointestinal tract: nausea, vomiting, dryness of the oral mucosa, pain in the epigastric region, loss of appetite, digestive disorders, stool disorders (both constipation and diarrhea may develop). In addition, it is possible to increase the activity of liver enzymes, which, as a rule, is not accompanied by jaundice.
From the side of the central and peripheral nervous system: increased fatigue, disturbed sleep and wakefulness, impaired coordination of movements, anxiety, headache, irritability, tremor of the extremities.
From the side of the cardiovascular system and the hematopoietic system: increased blood pressure, heart rhythm disturbances, extrasystole, anemia, including hemolytic, sulfhemoglobinemia, methemoglobinemia.
From the senses: blurred vision, increased intraocular pressure, tinnitus.

Allergic reactions: skin rash, itching, urticaria, Lyell's syndrome, Stevens-Johnson syndrome, bronchospasm, Quincke's edema.
Others: impaired liver and / or kidney function, acute renal failure, renal colic, interstitial nephritis, increased sweating, asthenia, shortness of breath, low blood sugar. With prolonged use of the drug and a sharp cessation of its administration, the development of a withdrawal syndrome is possible.
It should be borne in mind that the use of the drug may affect the results of doping control in athletes.
The use of the drug in some cases complicates the diagnosis in patients with acute abdominal pain.
With the development of side effects, it is necessary to stop taking the drug and contact your doctor.

Contraindications

Increased individual sensitivity to the components of the drug.
Severe liver and / or kidney disease.
Erosive and ulcerative lesions of the stomach and duodenum.
Violations of the function of the hematopoietic system, including thrombocytopenia, leukopenia, anemia.
Diseases of the cardiovascular system, including acute myocardial infarction, arrhythmia, arterial hypertension.
The period of pregnancy and lactation, as well as children under 12 years of age.

The drug is contraindicated in patients who have recently suffered a traumatic brain injury, as well as with increased intracranial pressure of various etiologies.
The drug should not be prescribed to patients with glaucoma, glucose-6-phosphate dehydrogenase deficiency and a tendency to bronchospasm. In addition, the drug is not prescribed for conditions that are accompanied by respiratory depression.
The drug should be used with caution in patients suffering from bronchial asthma, diabetes mellitus, impaired liver and / or kidney function, and elderly patients.
Caution should be exercised when prescribing the drug to patients whose work is related to the management of potentially dangerous mechanisms and driving a car.

Pregnancy

The drug is contraindicated for use during pregnancy.
If necessary, the use of the drug during lactation should decide on the interruption of breastfeeding.

drug interaction

With the combined use of the drug with anti-inflammatory nonsteroidal drugs and aminophenazone, an increase in the toxic effect of both drugs is noted.
With the combined use of the drug with coumarin anticoagulants, there is an increase in their therapeutic effect.
Paracetamol reduces the effectiveness of drugs that are extensively metabolized in the liver.
With the combined use of the drug with rifampicin, a decrease in the therapeutic effects of paracetamol is noted.
Cimetidine with simultaneous use reduces the toxicity of paracetamol and enhances its pharmacological effects.
With the combined use of the drug with oral contraceptives, tricyclic antidepressants and allopurinol, an increase in the toxic effect of metamizole sodium is noted.
When combined, inducers of microsomal liver enzymes reduce the effectiveness of metamizole sodium.
Metamizole sodium with simultaneous use reduces the level of cyclosporine in the blood.

Codeine, when combined, enhances the effects of drugs that depress the central nervous system.
There is a mutual enhancement of effects when using monoamine oxidase inhibitors, tricyclic antidepressants and codeine.
Caffeine, when combined, reduces the effectiveness of drugs that depress the central nervous system and enhances the pharmacological action of non-steroidal anti-inflammatory drugs.
Phenobarbital accelerates the biotransformation of quinidine, doxycycline, estrogen and carbamazepine.
With the combined use of the drug with drugs that depress the central nervous system, there is an increase in the action of phenobarbital.
Valproic acid and sodium valproate, when used simultaneously, help to reduce the metabolism of phenobarbital.
The combined use of the drug with ethanol is contraindicated.

Overdose

When using excessive doses of the drug, patients develop nausea, vomiting, cardiac arrhythmias, allergic reactions, feelings of weakness, hypotension, pallor of the skin, pain in the epigastric region and hepatonecrosis. With a further increase in the dose, inhibition of the respiratory center and the central nervous system is possible.
In case of overdose, gastric lavage, enterosorbents and symptomatic therapy are indicated. Paracetamol poisoning can be treated with N-acetylcysteine and oral methionine.

Release form

Tablets Pentalgin-IC 10 pieces in a blister, 1 blister in a carton.
Tablets Pentalgin-ICN 12 pieces in a blister, 1 blister in a carton.
Tablets Pentalgin-FS 10 pieces in a blister, 1 blister in a carton. Attention!
Description of the drug Pentalgin" on this page is a simplified and supplemented version of the official instructions for use. Before purchasing or using the drug, you should consult a doctor and read the annotation approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the dose and methods of its use.