Citramon P Reneval, tablets 10 pcs

• moderate pain syndrome of various etiologies: headache, migraine, toothache, neuralgia, arthralgia, myalgia, algodysmenorrhea;
• fever conditions with acute respiratory infections, influenza and rheumatic diseases.

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Active ingredient

Acetylsalicylic acid, Caffeine, Paracetamol

Composition

1 tablet contains:
active ingredient: acetylsalicylic acid 240 mg, paracetamol 180 mg, caffeine 30 mg

How to take, the dosage

Citramon-P is taken orally (during or after meals) 1 tablet every 4 hours; in case of pain syndrome – 1-2 tablets; average daily dose – 3-4 tablets, maximum daily dose – 8 tablets.

The course of treatment – not more than 7-10 days.

The drug should not be taken more than 5 days as an analgesic and more than 3 days as an antipyretic (without a doctor’s prescription and monitoring.)

Other dosages and routes of administration are determined by the doctor.

Interaction

It increases the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs.

Simultaneous use with other NSAIDs, methotrexate increases the risk of side effects.

Decreases the effectiveness of spironolactone, furosemide, hypotensive drugs, and antipodagic drugs that promote uric acid excretion.

Barbiturates, rifampicin, salicylamide, antiepileptic drugs and other stimulants of microsomal oxidation contribute to the formation of toxic metabolites of paracetamol that affect liver function.

Metoclopramide accelerates absorption of paracetamol.

The T1/2 of chloramphenicol is increased 5-fold under paracetamol exposure. When repeated administration of paracetamol may increase the effect of anticoagulants (dicumarin derivatives).

The simultaneous administration of paracetamol and ethanol increases the risk of hepatotoxic effects.

Caffeine accelerates absorption of ergotamine.

Special Instructions

With caution the drug should be prescribed to patients with bronchial asthma and gout.
It is not recommended to prescribe the drug in children, especially in chickenpox and influenza, because of the high risk of Reye’s syndrome.

Do not prescribe Citramon concomitantly with barbiturates, anticonvulsants, salicylates, and rifampicin.

Patients taking Citramon should refrain from drinking alcohol.

If the drug needs to be prescribed during pregnancy, the anticipated benefit to the mother must be weighed against the potential risk to the fetus. If it is necessary to prescribe Citramon for short-term use during lactation, discontinuation of breastfeeding is not required.

Contraindications

• hypersensitivity;
• Gastrointestinal erosive lesions (acute phase);
• Gastrointestinal bleeding;
• Hypersensitivity.”aspirin” asthma;
• hemophilia;
• hemorrhagic diathesis;
hypoprothrombinemia;
• portal hypertension;
• avitaminosis K;
• renal insufficiency;
• deficiency of glucose-6-phosphate dehydrogenase;
• severe arterial hypertension;
• severe course of CHD;
• glaucoma;
• high excitability;
• disorders of sleep;
• surgical interventions accompanied by bleeding.

Cautions: gout, liver disease.

Side effects

In immune system: hypersensitivity reactions, including anaphylaxis, anaphylactic shock, rhinitis, nasal congestion.

Skin and subcutaneous tissue: itching, skin and mucous membrane rash, including erythematous rash; urticaria, angioedema, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.

Gastrointestinal disorders: Dyspeptic disorders, including nausea, vomiting, epigastric discomfort and pain, heartburn, abdominal pain; gastrointestinal inflammation, gastrointestinal erosive and ulcerative lesions, which may in rare cases cause gastrointestinal bleeding and perforations with associated laboratory and clinical manifestations.

Hepatobiliary disorders: increased activity of liver enzymes, usually without development of jaundice, hepatonecrosis (dose-dependent effect).

Endocrine disorders: hypoglycemia, up to hypoglycemic coma.

Neurological disorders: headache, dizziness, tremor, paresthesias, anxiety, agitation, irritability, sleep disorders, insomnia, anxiety, general weakness, tinnitus.

Cardiac disorders: tachycardia, palpitations, arterial hypertension.

Blood and lymphatic system disorders: anemia, sulfatehemoglobinemia and methemoglobinemia (cyanosis, shortness of breath, pain in the heart area), hemolytic anemia, due to the antiplatelet antiaggregant effect on platelets acetylsalicylic acid may increase the risk of bleeding. Bleeding has been observed, such as intraoperative hemorrhages, hematomas, bleeding from the genitourinary system, nasal bleeding, bleeding from the gums, gastrointestinal bleeding and brain hemorrhages.

Other: Bleeding may lead to acute and chronic posthemorrhagic anemia/iron deficiency anemia (due to so-called hidden microbleeding) with corresponding laboratory manifestations and clinical symptoms such as asthenia, pale skin, hypoperfusion; noncardiac pulmonary edema.

Overdose

Symptoms (caused by acetylsalicylic acid): in mild intoxication – nausea, vomiting, gastralgia, dizziness, tinnitus; severe intoxication – lethargy, drowsiness, collapse, seizures, bronchospasm, difficult breathing, anuria, bleeding. Initially, central pulmonary hyperventilation leads to respiratory alkalosis (dyspnea, choking, cyanosis, evaporation). As intoxication intensifies, progressive respiratory paralysis and decoupling of oxidative phosphorylation cause respiratory acidosis.

Treatment: continuous monitoring of acid-base balance and electrolyte balance; depending on the state of metabolism – administration of sodium hydrocarbonate, sodium citrate or sodium lactate. Increasing reserve alkalinity enhances excretion of acetylsalicylic acid by alkalinizing the urine.

In addition, the alkalinity reserve is increased by increasing the excretion of acetylsalicylic acid.

Similarities

Ascophen-P, Coffil-plus, Citramon Ultra, Citramon P, Citramon-ExtraCap, Ascophen ULTRA, Brustrio