Migrenium, 65 mg+500 mg 20 pcs.

Mygrenium is a combined preparation, the effect of which is determined by the components in its composition.

Caffeine has psychostimulant (it stimulates psychomotor centers of the brain), analeptic effect, enhances the effect of analgesics, eliminates sleepiness and fatigue, increases physical and mental performance. It affects the cardiovascular system: it increases the heart rate and heart rate (HR), increases blood pressure (BP) in hypotension (it does not change the normal blood pressure). Dilates bronchi, biliary tracts, blood vessels of skeletal muscles, heart, kidneys, narrows vessels of abdominal organs. Reduces platelet aggregation. It stimulates secretion of gastric glands, increases basic metabolism, has a moderate diuretic effect.

Paracetamol has antipyretic and analgesic effect (due to inhibition of cyclooxygenase (COX) and inhibition of prostaglandin synthesis (Pg), it affects the thermoregulation center in hypothalamus and conduction of pain impulses in the central nervous system (CNS). The drug blocks cyclooxygenase I and II mainly in the CNS, affecting the centers of pain and thermoregulation. In inflamed tissues cellular peroxidases neutralize the effect of paracetamol on cyclooxygenase, which explains its almost complete lack of anti-inflammatory effect.

The drug has no negative effect on water-salt metabolism (sodium and water retention) and gastrointestinal (GI) mucosa due to no effect on prostaglandin synthesis in peripheral tissues. The possibility of formation of methemoglobin is unlikely.

Pharmacokinetics

Caffeine and its water-soluble salts are well absorbed in intestine (including large intestine). Period of semi-elimination of the drug (T1/2) is about 5 hours, in some patients – up to 10 hours. The main part is demethylated and oxidized. About 10% is excreted unchanged by the kidneys.

Paracetamol is quickly and almost completely absorbed from the gastrointestinal tract. Plasma concentrations reach a peak after 30-60 minutes. Plasma T1/2 is 1-4 hours. It is metabolized in the liver. It is excreted in the urine, mainly as esters with glucuronic and sulfuric acids; less than 5% is excreted unchanged.

Indications

Active ingredient

Composition

active ingredients:

Paracetamol – 0.500 g,

caffeine – 0.065 g.

Auxiliary substances:

Potato starch,

Cellulose microcrystalline,

croscarmellose sodium,

hyprolose (oxypropyl cellulose),

colloidal silicon dioxide,

magnesium stearate,

copovidone,

talk,

titanium dioxide,

silicone emulsion (50% solution)

How to take, the dosage

At the mouth, adults and children after 12 years of age – 2 tablets 4 times a day with an interval of at least 4 hours. Maximum daily dose is 8 tablets.

The duration of preparation is not more than 3 days (as antipyretic) and not more than 5 days (as analgesic).

Interaction

It enhances the effect of monoamine oxidase inhibitors (MAOIs). Reduces the effectiveness of uricosuric drugs.

Caffeine accelerates absorption of ergotamine.

Paracetamol increases the elimination time of chloramphenicol by 5 times. With prolonged use, paracetamol may increase the effect of anticoagulants (dicumarin derivatives).

The simultaneous use 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 production of hydroxylated active metabolites, causing the possibility of severe intoxication in small overdoses.

Microsomal oxidation inhibitors (cimetidine) reduce the risk of hepatotoxic effects. Metoclopramide and domperidone increase and colestyramine decreases absorption.

Special Instructions

The excessive use of caffeine-containing products (coffee, tea) during treatment may cause symptoms of overdose.

In long-term (more than 1 week) treatment it is necessary to monitor the peripheral blood picture and the functional state of the liver.

Without physician’s consultation, it is taken not more than 3 days for febrile syndrome and not more than 5 days for pain syndrome.

May change the results of doping control tests on athletes. Makes it difficult to establish a diagnosis in acute “acute abdomen. Patients with atopic bronchial asthma and pollinosis have an increased risk of allergic reactions. During treatment the use of ethanol should be avoided (increased risk of hepatotoxicity).

Contraindications

Hypersensitivity, severe hepatic and/or renal failure, epilepsy, glucose-6-phosphate dehydrogenase deficiency, old age, childhood (under 12 years)

Side effects

Allergic reactions (skin rash, angioneurotic edema, urticaria), dyspeptic disorders (including nausea, epigastric pain).

In rare cases – hemolytic anemia, thrombocytopenia, methemoglobinemia.

In long-term use in high doses – hepatotoxicity, pancytopenia, nephrotoxicity (renal colic, pyuria, interstitial nephritis, papillary necrosis)

Overdose

Symptoms: Pallor of the skin, decreased appetite, nausea, vomiting, sometimes with blood; hepatonecrosis (severity of necrosis due to intoxication directly depends on the degree of overdose), gastralgia, agitation, anxiety, agitation, motor restlessness, confusion, delirium, dehydration, tachycardia, arrhythmia, hyperthermia, rapid urination, headache, increased tactile or pain sensitivity, tremor or muscle twitching; tinnitus, epileptic seizures (in acute overdose – tonic-clonic), increased activity of “hepatic” transaminases, increased prothrombin time; the full clinical picture of liver damage becomes apparent in 1-6 days.

Treatment: administration of donators of SH-groups and precursors of glutathione synthesis – methionine in 8-9 hours after overdose and N-acetylcysteine – in 12 hours. Gastric lavage is performed to prevent late hepatotoxic effects.

Similarities