Citovir-3, 50 ml syrup

Pharmacotherapeutic group: immunostimulant
ATX code: L03AХ
Pharmacological properties:

Pharmacodynamics: the drug is a means of etiotropic and immunostimulatory therapy, has mediated antiviral action against influenza A and B pathogens, as well as other viruses that cause acute respiratory diseases. In in vitro researches the preparation specifically suppresses (inhibits) reproduction (replication) of SARS-CoV-2 virus which is the causative agent of a new coronavirus infection (COVID-19).
The degree of pathogen inhibition increases with increasing drug concentration (dose-effect linearity is shown).
It reduces the severity of basic clinical symptoms of influenza and acute respiratory infections, as well as reduces the duration of the disease and contributes to its uncomplicated course.
Increases secretory immunoglobulin A (slgA) content in nasopharynx mucosa – entry gateway for infection, increasing local immunoresistance to respiratory infections of viral and bacterial nature.
During prophylactic action the preparation increases potential metabolic activity of innate immunity cells (neutrophil granulocytes and monocytes) that in case of infection increases their ability to absorb and destroy bacterial and viral agents due to intensification of fermentative (oxidative) activity, synthesis of cationic proteins and increasing of the number of phagocytic cells. In this case the initial state of metabolic activity of cells of innate immunity in the absence of infectious agents does not change, being within normal values.
Bendazol induces in the body the production of endogenous interferon, has immunomodulatory effect (normalizes immune response of the body). Enzymes, the production of which is induced by interferon in cells of various organs, inhibit the replication of viruses.
Alpha-glutamyl-tryptophan (thymogen) is a synergistic immunomodulating effect of bendazole, normalizing the T-cell link of immunity.
Ascorbic acid activates humoral immunity, normalizes capillary permeability, thereby reducing inflammation, and shows antioxidant properties, neutralizing oxygen radicals that accompany the inflammatory process, increases resistance to infection.
Pharmacokinetics: When taken orally the drug is completely absorbed from the gastro-intestinal tract. Bioavailability of bendazole is about 80%, alpha-glutamyl-tryptophan – not more than 15% and ascorbic acid – up to 70%. Ascorbic acid is absorbed in the gastrointestinal tract (mainly in the jejunum). Binding with plasma proteins is 25%. TCmax after oral administration is 4 hours. Easily penetrates into leukocytes, platelets and then into all tissues, penetrates through the placenta. Gastrointestinal diseases (gastric and 12 duodenal ulcers, bowel motility disorders, helminth infestation, giardiasis), consumption of vegetable and fruit juices, alkaline drinking reduce ascorbic acid binding in the intestine. Ascorbic acid is metabolized mainly in the liver to deoxyascorbic acid, then to oxalic acetic acid and diketogulonic acid. It is excreted by the kidneys, through the intestines, with sweat, breast milk unchanged and as metabolites. The products of bendazole biotransformation in blood are two conjugates formed due to methylation and carboethoxylation of imino group of imidazole ring of bendazole: 1-methyl-2-benzylbenzimidazole and 1-carboethoxy-2-benzylbenzimidazole. Bendazole metabolites are excreted in the urine. Alphaglutamyl-tryptophan is broken down by petidases into L-glutamic acid and L-tryptophan, which are used by the body in protein synthesis.

Indications

Headache, Runny nose (rhinitis), Flu, Fever, Colds, Sore throat, Cough, Prevention of flu and coldsProphylaxis and complex therapy of flu and acute respiratory viral infections in children from one year old.

Composition

Active ingredients:
Alpha-glutamyl-tryptophan sodium
[Timogen sodium]
(in terms of alpha-glutamyl-tryptophan) 0.15 mg
Ascorbic acid 12 mg
Bendazol hydrochloride (dibazole) 1.25 mg
Excipients:
Saccharose 800.0 mg
Purified water up to 1 ml

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How to take, the dosage

Inhaled 30 minutes before the meal.
For treatment:
In children aged 1 to 3 years – 2 ml 3 times a day, children aged 3 to 6 years – 4 ml 3 times a day, children aged 6 to 10 years – 8 ml 3 times a day, children aged over 10 years – 12 ml 3 times a day.
The course of treatment is 4 days. If after 3 days of treatment no improvement occurs or symptoms are aggravated or new symptoms appear it is necessary to consult the doctor.
Preventive measures:
In case of direct contact with the patients with flu and other ARVI:
In children aged 1 to 3 years old – 2 ml 3 times a day; children aged 3 to 6 years old – 4 ml 3 times a day; children aged 6 to 10 years old – 8 ml 3 times a day; children aged over 10 years old – 12 ml 3 times a day.
The course of action lasts 4 days.
The prophylactic courses are repeated in 3 weeks if necessary (till the epidemic situation is normalized).
Only take the preparation in accordance with the way of application and in such doses as it is specified in the instruction. If necessary, please talk to your doctor before taking the drug.

Interaction

No interaction of alpha-glutamyl-tryptophan with drugs was detected. Bendazole prevents an increase in total peripheral vascular resistance due to the use of non-selective beta-adrenoblockers. It enhances the hypotensive (blood pressure reduction) effect of hypotensive and diuretic drugs. Phentolamine enhances the hypotensive effect of bendazole. Ascorbic acid increases the blood concentration of tetracycline-type antibacterial drugs and benzylpenicillin. Improves intestinal absorption of iron preparations (Fe). Reduces the effectiveness of heparin and indirect anticoagulants. Acetylsalicylic acid (ASA), oral contraceptives, fresh juices and alkaline drinking reduce its absorption and assimilation. When concomitant use with ASA, urinary excretion of ascorbic acid is increased and excretion of ASA is reduced. ASA reduces absorption of ascorbic acid by about 30%. Ascorbic acid increases the risk of crystalluria when using drugs containing acetylsalicylic acid (ASA) and short-acting sulfonamides, delays renal excretion of acids, increases excretion of drugs with an alkaline reaction (including alkaloids), reduces the blood concentration of oral contraceptives. Simultaneous use reduces the chronotropic effect of isoprenaline. Reduces the therapeutic effect of antipsychotic drugs (neuroleptics) – phenothiazine derivatives, tubal reabsorption of amphetamine and tricyclic antidepressants. Barbiturates and primidone increase excretion of ascorbic acid with urine. Concomitant use with antiviral drugs and agents of symptomatic therapy of influenza and acute respiratory viral infections is possible. Consult your doctor if you are taking the drugs mentioned in the section or other drugs.

Special Instructions

Control of blood glucose concentration is recommended after repeated course.

Influence on driving and operating machinery: The drug does not affect the ability to drive vehicles, operate moving machinery and engage in other potentially dangerous activities requiring increased concentration and quick psychomotor reactions.

Synopsis

The syrup is colorless to yellow in color.

Contraindications

hypersensitivity to the drug components, diabetes mellitus, pregnancy, children under 1 year of age. If necessary, please consult your physician before taking the drug.

Side effects

There may be a short-term decrease in blood pressure. Allergic reactions: urticaria. In these cases, the drug is discontinued and symptomatic treatment, antihistamines are prescribed. Consult your doctor if you experienced the mentioned side effects or other side effects not specified in the instructions. If the side effects mentioned in the instructions worsen, tell your doctor.

Overdose

No cases of overdose have been described.

Pregnancy use

during pregnancy administration of the drug is not recommended due to insufficient clinical data. During breastfeeding the drug may be used if the estimated benefit to the mother exceeds the potential risk to the baby. If it is necessary to take the drug during breastfeeding, please consult your doctor.