TeraFlu for flu and cold, 4 pcs.

Combined drug, the action of which is due to its constituent components.

Indications

Inflammation in the mouth, runny nose (rhinitis), Laryngitis, Pain, Angina, Gum inflammation, sore throat, Chills, HeadacheSymptomatic treatment of inflammatory diseases (SARS, including the flu), accompanied by a high fever, chills, body aches, headache and muscle pain, runny nose, stuffy nose, sneezing.

Active ingredient

Paracetamol, Phenylephrine, Pheniramine, Ascorbic acid

Composition

Paracetamol;

How to take, the dosage

Inside. The contents of one sachet dissolved in one cup of hot, but not boiling water. Take in hot water. The second dose may be taken every 4-6 hours (no more than 3-4 doses within 24 hours).

TeraFlu® for flu and colds can be used at any time of the day, but the best effect is achieved by taking the drug before going to bed at night. If the relief of symptoms is not observed within 3 days after the beginning of the preparation it is necessary to consult a physician.
It is not necessary to use TeraFlu® from the flu and cold for more than 5 days.

In patients with liver dysfunction or Gilbert syndrome it is necessary to decrease the dose or increase interval between the doses.
In severe renal failure (CK< 10 ml/min) the interval between doses should be at least 8 h.

In elderly patients dosage adjustment is not required.

Interaction

Paracetamol
Increases the effects of MAO inhibitors, sedatives, ethanol.

The risk of hepatotoxic effects of paracetamol increases with the simultaneous use of barbiturates, phenytoin, phenobarbital, carbamazepine, rifampicin, isoniazid, zidovudine and other inducers of microsomal liver enzymes.

Long-term regular use of paracetamol may increase anticoagulant effect of warfarin and other coumarins, with increased risk of bleeding. Single use of paracetamol has no significant effect.

Metoclopramide increases the rate of absorption of paracetamol and reduces the time to reach its Cmax in plasma.

Paracetamol may increase the T1/2 of chloramphenicol.

Paracetamol may decrease the bioavailability of lamotrigine and the efficiency of lamotrigine may decrease due to induction of its metabolism in the liver.

Absorption of paracetamol may be decreased when used concomitantly with colestyramine, but the decrease in absorption is insignificant if colestyramine is taken one hour later.

Regular use of paracetamol concomitantly with zidovudine may cause neutropenia and increase the risk of liver damage.
Probenecid affects the metabolism of paracetamol. In patients concomitantly using probenecid, the dose of paracetamol should be reduced.
Hepatotoxicity of paracetamol is enhanced with prolonged excessive use of ethanol (alcohol).

Paracetamol may affect uric acid test results using a precipitating reagent phospho-tungstate.

Pheniramine
The effects of other substances on the CNS (e.g., MAO inhibitors, tricyclic antidepressants, alcohol, anti-Parkinsonian drugs, barbiturates, tranquilizers and narcotics) may be enhanced. Pheniramine may inhibit the effect of anticoagulants.

Phenylephrine
Teraflu® for flu and cold is contraindicated in patients who receive or have received MAO inhibitors during the last 2 weeks. Phenylephrine may potentiate the effects of MAO inhibitors and cause a hypertensive crisis.

Concomitant use of phenylephrine with other sympathomimetic drugs or tricyclic antidepressants (such as amitriptyline) may lead to an increased risk of adverse cardiovascular reactions.

Phenylephrine may decrease the effectiveness of beta-adrenal blockers and other antihypertensive drugs (e.g., debrisochine, guanethidine, reserpine, methyldopa). There may be an increased risk of arterial hypertension and other cardiovascular side effects.

Concomitant use of phenylephrine with digoxin and cardiac glycosides may increase the risk of cardiac rhythm disturbances or myocardial infarction.

Concomitant use of phenylephrine with ergot alkaloids (ergotamine and methysergide) may increase the risk of ergotism

Special Instructions

In order to avoid toxic liver damage the drug should not be combined with the use of alcoholic beverages.

Patients should consult a physician if:

– Bronchial asthma, emphysema or chronic bronchitis are present;
-Symptoms do not resolve within 5 days or are accompanied by severe fever lasting for 3 days, rash or persistent headache.
These may be signs of more serious disorders.
Teraflu® for flu and cold contains:
-saccharose 20 g per bag. This should be taken into account in patients with diabetes mellitus. Patients with such rare hereditary problems as fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase deficiency should not take Teraflu® for flu and cold;
-dye sunset yellow (E110). May cause allergic reactions;
-Sodium 28.3 mg per bag. It should be taken into account in patients on a sodium-restricted diet.

Do not use the drug from damaged sachets.

Effect on the ability to drive vehicles and mechanisms

Teraflu® for flu and cold may cause drowsiness, so during the treatment it is not recommended to drive vehicles or engage in other activities that require concentration and high speed of psychomotor reactions.

Synopsis

Powder for oral solution (lemon) is white with yellow flecks, loose, granular, without foreign particles, citrus-scented; soft lumps are allowed.

Contraindications

Hypersensitivity to the drug components;
– Severe cardiovascular disease;
– Arterial hypertension;
– Portal hypertension;
– Diabetes mellitus;
– Hyperthyroidism;
– Close angle glaucoma. – portal hypertension;
– diabetes mellitus;
– hyperthyroidism;
– closed-angle glaucoma;
– pheochromocytoma;
– alcoholism;
– Sucrose/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;
– concurrent or during the preceding 2 weeks taking MAO inhibitors;
– Simultaneous use of tricyclic antidepressants, beta-adrenoblockers, other sympathomimetics;
– Pregnancy;
– Breast-feeding period;
– Children under 12 years of age.

With caution:

In cases of severe coronary atherosclerosis, cardiovascular diseases, acute hepatitis, hemolytic anemia, bronchial asthma, severe liver or kidney diseases, prostatic hyperplasia, difficulty in urination due to prostatic hypertrophy, blood diseases, glucose-6-phosphate dehydrogenase deficiency, congenital hyperbilirubinemia (Gilbert, Dubin-Johnson, and Rotor syndromes), in emaciation, dehydration, pyloroduodenal obstruction, stenotic gastric and/or duodenal ulcer, epilepsy, in concurrent administration of drugs that may negatively affect the liver (such as inducers of microsomal liver enzymes); In patients with recurrent formation of urate kidney stones.

Side effects

Determination of the frequency of side effects: very frequently (≥1/10), frequently (≥1/100 and < 1/10), infrequently (≥1/1000 and < 1/100), rarely (≥1/10 000 and < 1/1000), very rarely (< 1/10 000), including individual reports, frequency is unknown (according to available data the frequency cannot be determined).

Blood system: very rare – thrombocytopenia, agranulocytosis, leukopenia, pancytopenia.
Allergic reactions: rare – hypersensitivity (rash, shortness of breath, anaphylactic shock), urticaria, angioedema; frequency is unknown – anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis.

Nervous system: often – drowsiness, rarely – dizziness, headache.
Mental disorders: rarely – increased excitability, sleep disturbance.

Visually: rare – mydriasis, accommodation paresis, increased intraocular pressure.

Cardiovascular system: rare – tachycardia, palpitations, arterial hypertension.

The digestive system: frequently – nausea, vomiting, rarely – constipation, dry mouth, abdominal pain and diarrhea.

The liver and biliary tract: rare – increased liver transaminase activity.

Skin and subcutaneous tissue: rare – skin rash, itching, erythema.

The urinary system: rare – difficulty urinating.

General reactions: rarely – malaise.

If any of the above side effects worsen and any other side effects appear, the patient should consult a physician.

Overdose

Symptoms of overdose are mainly caused by paracetamol.

Paracetamol
Symptoms: mainly occur after taking 10-15 g of paracetamol. In severe cases of overdose, paracetamol has hepatotoxic effects, including can cause liver necrosis. Also overdose can cause irreversible nephropathy and irreversible liver damage. The severity of overdose depends on the dose, therefore patients should be warned against concomitant use of paracetamol-containing drugs. The risk of poisoning is especially high in elderly patients, children, patients with liver diseases, in cases of chronic alcoholism, in patients with emaciation and in patients taking inducers of liver microsomal enzymes.
Paracetamol overdose can lead to liver failure, encephalopathy, coma, and death.

Symptoms of paracetamol overdose in the first 24 h: pale skin, nausea, vomiting, anorexia, seizures. Abdominal pain may be the first sign of liver damage and is usually not apparent for 24-48 hours and may sometimes appear later, after 4-6 days. Damage to the liver is at its maximum extent after 72-96 hours of taking the drug. Impaired glucose metabolism and metabolic acidosis may also occur. Even in the absence of liver damage, acute renal failure and acute tubular necrosis may develop. Cases of cardiac arrhythmias and development of pancreatitis have been reported.

Treatment: administration of acetylcysteine v/v or orally as an antidote, gastric lavage, oral methionine administration may have a positive effect for at least 48 h after overdose. Administration of activated charcoal and monitoring of respiration and circulation are recommended. Diazepam may be administered if convulsions develop.

Pheniramine and phenylephrine (overdose symptoms are combined due to the risk of mutual potentiation of the parasympatholytic effect of pheniramine and the sympathomimetic effect of phenylephrine in case of drug overdose)

Symptoms: Drowsiness, which is further joined by restlessness (especially in children), visual disturbances, rash, nausea, vomiting, headache, increased excitability. Dizziness, insomnia, circulatory disorders, coma, seizures, behavioral changes, increased BP and bradycardia. Cases of atropine-like “psychosis” have been reported in pheniramine overdose.

Treatment: there is no specific antidote. Routine relief measures are necessary, including administration of activated charcoal, saline laxatives, and measures to support cardiac and respiratory function. Psychostimulants (methylphenidate) should not be administered because of the risk of seizures. In case of arterial hypotension vasopressor drugs may be used.

In case of BP increase IV administration of alpha-adrenoblockers is possible since phenylephrine is a selective agonist of α1-adrenoreceptors, hence the hypotensive effect in overdose should be treated by blocking α1-adrenoreceptors. If seizures develop, diazepam should be administered.

Pregnancy use

It is not recommended to use TeraFlu® for flu and cold during pregnancy and lactation (breastfeeding).

Similarities

TeraFlu, Maxicold Rhino, Asterisk Flu, For colds and flu, Asterisk for colds