Citramon P, tablets 20 pcs

Acetylsalicylic acid has antipyretic and anti-inflammatory effects, relieves pain, especially caused by inflammation, and moderately inhibits platelet aggregation and thrombosis, improves microcirculation in the inflammation focus.

Caffeine increases reflex excitability of the spinal cord, excites respiratory and vasomotor centers, dilates blood vessels of skeletal muscles, brain, heart and kidneys, decreases platelet aggregation; it reduces sleepiness and fatigue. In this combination, a low dose of caffeine has practically no stimulating effect on the central nervous system, but helps to regulate the tone of the brain vessels.

Paracetamol has analgesic, antipyretic and weak anti-inflammatory effects, due to its effect on the thermoregulation center in the hypothalamus and a weak ability to inhibit the synthesis of prostaglandins (Pd) in peripheral tissues.

Indications

Active ingredient

Composition

Active substances:

Acetylsalicylic acid – 240 mg,

Paracetamol – 180 mg,

Caffeine monohydrate or caffeine (caffeine anhydrous)-30 mg.

Auxiliary substances:

Cocoa – 14 mg,

Citric acid – 5 mg,

Potato starch – 63 mg,

povidone low molecular weight (polyvinylpyrrolidone low molecular weight medical) – 4 mg,

talc – 9 mg,

calcium stearate-5 mg.

How to take, the dosage

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

Over the body (during or after meal), 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 is not more than 3-5 days.

Interaction

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

Simultaneous use with other nonsteroidal anti-inflammatory drugs, 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, affecting liver function.

Methocpopramide accelerates absorption of paracetamol.

The elimination time of chloramphenicol is 5 times longer under the influence of paracetamol. When repeated administration of paracetamol may increase the effect of anticoagulants (dicumarin derivatives). Caffeine accelerates absorption of ergotamine.

The simultaneous use of the drug and alcohol-containing fluids increases the risk of toxic liver damage.

Special Instructions

Do not prescribe the drug in children younger than 15 years of age because of the high risk of Reye’s syndrome. Reye syndrome is manifested by prolonged vomiting, acute encephalopathy, liver enlargement.

Acetylsalicylic acid slows blood clotting. If the patient is going to have surgery, it is necessary to warn the doctor about taking the drug in advance.

In patients with a predisposition to accumulation of uric acid, taking this drug may provoke a gout attack.

Alcohol should be avoided while taking the drug (increased risk of gastrointestinal bleeding and toxic liver damage).

Acetylsalicylic acid when used in the first trimester of pregnancy has teratogenic effects; in the third trimester it leads to inhibition of labor. It is excreted with breast milk, so the use during lactation is contraindicated.

Contraindications

– Gastrointestinal bleeding (including a history of bleeding;

– Severe liver function abnormalities and/or gout;

– Gastrointestinal bleeding.

– Severe liver and/or kidney function abnormalities, gout;

– Hemorrhagic diathesis, hypocoagulation;

– Surgical interventions accompanied by copious bleeding;

– Pregnancy (I and III trimester), lactation;

– Deficiency of glucose-6-phosphate dehydrogenase;

– Glaucoma;

– Hypersensitivity to the components of the drug, asthma induced by taking acetylsalicylic acid, salicylates and other non-steroidal anti-inflammatory drugs;

– Childhood (before 15 years of age – risk of Reye’s syndrome in children with hyperthermia in the background of viral diseases);

– Excitability, sleep disorders;

– Organic diseases of the cardiovascular system (including.ч. acute myocardial infarction, atherosclerosis;

– Severe arterial hypertension

– Portal hypertension

– Avitaminosis K

– Hypoproteinemia

p> With caution

Mild to moderate renal insufficiency, hepatic insufficiency with elevated transaminases, benign hyperbilirubinemia (including Gilbert syndrome).

Hypatic impairment of the liver in mild to moderate degree, hepatic impairment with elevated transminins, benign hyperbilirubinemia (including Gilbert syndrome and alcoholic liver injury), alcoholism, epilepsy and proneness to seizures, elderly age, gout, arterial hypertension.

Side effects

Overdose

Do not exceed the recommended dose and duration of use!

Symptoms:

– in mild intoxication: nausea, vomiting, stomach pain, dizziness, tinnitus;

– in severe intoxication: lethargy, drowsiness, collapse, seizures, difficulty breathing, anuria, bleeding.

Treatment: gastric lavage with activated charcoal, symptomatic therapy, depending on the state of metabolism – administration of sodium bicarbonate, sodium citrate or sodium lactate, which enhances excretion of acetylsalicylic acid by alkalinization of urine.

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