Typical clinico-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.
Caffeine causes CNS stimulation, mainly, the cortex of the brain, respiratory and vasomotor centers. Increases mental and physical performance, reduces drowsiness, a sense of fatigue. Has a pronounced cardiotonic action: increases the strength and heart rate, increases blood pressure with hypotension.
Ergotamine causes vasoconstrictor action.
Caffeine accelerates the absorption of ergotamine.
INDICATIONS
- Migraine;
- arterial hypotension.
DOSING MODE
Inside, for 1-2 tablets. on reception during an attack of a headache, then - on 1 tab. 2-3 times / day for several days.
The maximum single dose is 2 tablets, daily - 4 tablets.
It is not recommended to use for a long time (to avoid the phenomena of ergotism): after 7 days of use in cases requiring longer treatment, take a break (3-4 days).
SIDE EFFECT
From the side of the central nervous system and peripheral nervous system: agitation, anxiety, tremor, anxiety, headache, dizziness, convulsions, paresthesias in the limbs, reflexes, tachypnea, insomnia; with sudden withdrawal - increased inhibition of the central nervous system, increased fatigue, drowsiness.
From the cardiovascular system: palpitation, tachycardia, cardialgia, increased blood pressure.
From the digestive system: nausea, vomiting, diarrhea.
Allergic reactions: swelling, itchy skin.
Other: with prolonged use - addiction, drug dependence, weakness in the legs, myalgia, Lerish syndrome (severe cyanosis, lack of pulse on the lower extremities, pain, impaired sensitivity to the distal type).
CONTRAINDICATIONS
hypersensitivity;
- Pregnancy;
lactation period.
Precautions: sleep disorders, anxiety disorders (agoraphobia, panic disorders), organic diseases of the cardiovascular system (including acute myocardial infarction, angina pectoris, severe atherosclerosis, paroxysmal tachycardia, frequent ventricular extrasystole, arterial hypertension, obliterating peripheral vascular diseases ), hepatic and / or renal failure, glaucoma, and advanced age.
PREGNANCY AND LACTATION
Contraindications: pregnancy, lactation.
APPLICATION FOR FUNCTIONS OF THE LIVER
With caution: kidney failure
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
With caution: liver failure
APPLICATION IN ELDERLY PATIENTS
With caution: the elderly.
OVERDOSE
Symptoms: increased severity of side effects, incl. nausea, vomiting, numbness in the fingers and toes, inhibition, drowsiness, epileptic seizures, stupor, coma.
Treatment: gastric lavage, reception of activated charcoal, if necessary - symptomatic therapy.
DRUG INTERACTION
Strengthens the pharmacological action of other drugs containing ergot alkaloids and caffeine.
Caffeine is an adenosine antagonist (large doses of adenosine may be required).
With the joint use of caffeine and barbiturates, primidone, anticonvulsant drugs (hydantoin derivatives, especially phenytoin), it is possible to increase metabolism and increase caffeine clearance; cimetidine, oral contraceptives, disulfiram, ciprofloxacin, norfloxacin - a decrease in the metabolism of caffeine in the liver (slowing its elimination and increasing blood concentrations).
Means that cause CNS stimulation, - excessive stimulation of the central nervous system is possible.
Mexiletine reduces caffeine withdrawal to 50%.
Nicotine increases the rate of caffeine withdrawal.
MAO inhibitors, furazolidone, procarbazine and selegiline - large doses of caffeine can cause the development of dangerous cardiac arrhythmias or a marked increase in blood pressure.
Caffeine reduces the absorption of calcium in the digestive tract.
Reduces the effect of narcotic analgesics and hypnotic drugs; increases - non-narcotic analgesics (increased absorption).
Increases the excretion of lithium drugs with urine.
Accelerates absorption and enhances the action of cardiac glycosides, increases their toxicity.
Joint use of caffeine with beta-blockers can lead to mutual suppression of therapeutic effects; with adrenergic bronchodilator drugs - to additional stimulation of the CNS and other additive toxic effects.
Caffeine can reduce the clearance of theophylline and, possibly, other xanthines, increasing the possibility of additive pharmacodynamic and toxic effects.
The vasoconstrictor effect of the drug is enhanced by alpha-adrenostimulants, beta-adrenoblockers, serotonin agonists (including sumatriptan), and nicotine.
Macrolides increase the toxicity of ergotamine (decreased hepatic clearance of caffeine).
