Universal reference book for medicines
Product name: PARALEN EXTRA (PARALEN EXTRA)

Active substance: caffeine, paracetamol

Type: Analgesic-antipyretics of combined composition

Manufacturer: ZENTIVA (Czech Republic)
A typical clinical and pharmacological article
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Combined drug, the effect of which is determined by the components that make up its composition.

Caffeine exerts a psychostimulant (stimulates the psychomotor centers of the brain), an analeptic effect, enhances the effect of analgesics, eliminates drowsiness and a feeling of fatigue, increases physical and mental performance.

Paracetamol - antipyretic and analgesic action (due to inhibition of COX and inhibition of prostaglandin synthesis affects the center of thermoregulation in the hypothalamus and pain impulses in the central nervous system).

INDICATIONS
Pain syndrome (mild to moderate):

- headache;

- Migraine;

- ossalgia;

- myalgia;

- neuralgia;

- Arthralgia;

- algodismenorea;

- toothache.

Feverish syndrome, colds, flu.

DOSING MODE
Inside adults - 2 tab.
4 times / day with an interval of at least 4 hours. The maximum daily dose is 8 tablets.
Duration of application - no more than 10 days.

SIDE EFFECT
Allergic reactions (skin rash, angioedema, urticaria), dyspeptic disorders (including nausea, epigastric pain).

In rare cases - hemolytic anemia, thrombocytopenia.

With prolonged use in large doses - hepatotoxicity, nephrotoxicity, pancytopenia.

CONTRAINDICATIONS
hypersensitivity;

- severe hepatic and / or renal insufficiency;

- epilepsy;

- deficiency of glucose-6-phosphate dehydrogenase.

With caution: pregnancy, lactation, congenital hyperbilirubinemia (Gilbert syndrome, Dubin-Johnson and Rotor syndrome), children's age (up to 12 years).

PREGNANCY AND LACTATION
With caution: pregnancy, lactation.

APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe renal failure.

APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in severe hepatic insufficiency.

APPLICATION FOR CHILDREN
With caution: children's age (up to 12 years).

SPECIAL INSTRUCTIONS
Excessive consumption of caffeinated products (coffee, tea) on the background of treatment can cause symptoms of an overdose.

With prolonged (more than 1 week) treatment, monitoring of the peripheral blood picture and the functional state of the liver is necessary.
Without consulting a doctor take no more than 3 days in the treatment of febrile syndrome and no more than 5 days - with pain.
Can change the results of tests of doping control athletes.

It is difficult to diagnose with the symptom complex "acute abdomen."

In patients with atopic bronchial asthma, pollinosis, there is an increased risk of allergic reactions.

During treatment should be abandoned the use of ethanol (increased risk of hepatotoxicity).

OVERDOSE
Symptoms: pallor of the skin, decreased appetite, nausea, vomiting;
hepatonecrosis (the severity of necrosis due to intoxication directly depends on the degree of overdose), an increase in the activity of "liver" transaminases, an increase in prothrombin time; a detailed clinical picture of liver damage manifests itself after 1-6 days.
Treatment: the introduction of donors of SH-groups and precursors of the synthesis of glutathione-methionine after 8-9 hours after an overdose and N-acetylcysteine ​​after 12 hours.

To prevent late hepatotoxic action, gastric lavage is performed.

DRUG INTERACTION
Increases the effect of MAO inhibitors.

Reduces the effectiveness of uricosuric drugs.

Caffeine accelerates the absorption of ergotamine.

Under the influence of paracetamol, the time of chloramphenicol elimination is increased by 5 times.

With prolonged use, paracetamol can enhance the effect of anticoagulants (dicumarin derivatives).

Simultaneous reception of paracetamol and ethanol increases the risk of hepatotoxic effects and acute pancreatitis.

Barbiturates, phenytoin, ethanol, rifampicin, phenylbutazone, tricyclic antidepressants and other stimulants of microsomal oxidation increase the production of hydroxylated active metabolites, causing the possibility of severe intoxication development with small overdoses.

Inhibitors of microsomal oxidation (cimetidine) reduce the risk of hepatotoxic effects.

Metoclopramide and domperidone are increased, and colestyramine reduces absorption.

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