Acetylsalicylic acid, Caffeine, Paracetamol | Citramon Ultra tablets coated. 10 pieces.

Latin name

Citramon-Ultra

sachet release form

coated tablets



packaging 10 pcs

Indications

Pain of mild to moderate severity (of various origins):

Headache of various origins

Migraine

Toothache

Myalgia

Arthralgia

Neuralgia sorelp.

Contraindications

Hypersensitivity to the drug's components complete or incomplete combination of bronchial asthma, nasal polyposis and intolerance to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs (NSAIDs) erosive and ulcerative lesions of the gastrointestinal tract, ulcerative ulcer disease ), gastrointestinal bleeding hypocoagulation, hemophilia, hemorrhagic diathesis, hypoprothrombinemia surgical interventions, bleeding accompanied by portal hypertension, severe course of coronary heart disease, severe arterial hypertension, vitamin deficiency K renal failure pregnancy (I and III trimesters), lactation, glucose-6-phosphate dehydrogenase deficiency, lactase, lactose intolerance, glucose-galactose malabsorption, glaucoma, disorders), increased irritability, sleep disturbances for children under 15 years of age (risk of developing Reye syndrome in children with hyperthermia due to viral disease vany).

Precautions: Gout, liver disease, renal and hepatic insufficiency, benign hyperbilirubinemia (including Gilbert syndrome), alcoholic liver damage, alcoholism, pregnancy, lactation, old age.

Pregnancy and lactation

Acetylsalicylic acid has a teratogenic effect when used in the first trimester leads to malformation - splitting of the upper palate in the third trimester - to inhibition of labor (inhibition of prostaglandin synthesis), to the closure of the arterial duct in the fetus, which causes pulmonary hyperplasia and hypertension in the vessels of the pulmonary circulation.

Is excreted in breast milk, which increases the risk of bleeding in a child due to impaired platelet function.

Composition of

per 1 tablet

active substances:

acetylsalicylic acid - 0.2400 g,

paracetamol -0.1800 g,

caffeine-0. 0273 g in terms of caffeine monohydrate 0.0300 g

excipients:

hydroxypropylmethyl cellulose (hypromellose),

potato starch,

silicon dioxide colloid (aerosil),

citric acid monohydro lycdolp 6000),

microcrystalline cellulose,

stearic acid

film coating aids:

Opadry II (85 series),

polyvinyl alcohol,

macrogol,

talc,

titanium dioxide black iron,

black oxide, srd for oxide yellow,

iron oxide red.

Dosage and administration

Adults and children over 15 years of age take orally (during or after meals) 1-2 tablets 3-4 times a day with an interval between doses of 4-8 hours. The maximum daily dose is 8 tablets.

Duration of taking the drug is not more than 5 days as an analgesic drug and not more than 3 days as an antipyretic (without prescribing and monitoring a doctor).

An increase in the daily dose of the drug or the duration of treatment is possible only after consulting a doctor.

Side effects

From the gastrointestinal tract: gastralgia, nausea, vomiting, hepatotoxicity, erosive and ulcerative lesions of the gastrointestinal tract.

From the cardiovascular system: tachycardia, increased blood pressure.

Allergic reactions: skin rash, itching, angioedema, hyperemia of the skin, Stevens-Johnson syndrome, Lyell, bronchospasm.

From the central nervous system: dizziness, headache.

From the urinary system: nephrotoxicity, kidney damage with papillary necrosis.

From the blood coagulation system: anemia, methemoglobinemia, decreased platelet aggregation, thrombocytopenia, hypocoagulation, hemorrhagic syndrome (nosebleeds, bleeding gums, purpura, etc.).

On the part of the sensory organs: visual impairment, tinnitus, deafness.

Reye's syndrome in children (hyperpyrexia, metabolic acidosis, disorders of the nervous system and psyche, vomiting, impaired liver function).

Paracetamol. Possible nausea, pain in the epigastrium (the area of ​​the abdomen located immediately below the convergence of the costal arches and sternum) allergic reactions in the form of skin rash, itching, urticaria, Quincke's edema. Rarely, anemia (a decrease in hemoglobin in the blood), thrombocytopenia (a decrease in the number of platelets in the blood), methemoglobinemia (high blood levels of methemoglobin, a derivative of hemoglobin that is not able to carry oxygen). With prolonged use in high doses, a hepatotoxic (liver damaging) effect is possible.

With prolonged use, especially in large doses, paracetamol may have a nephrotoxic (kidney damage) effect.

Acetylsalicylic acid. Dyspeptic symptoms (nausea, stomach pain). With prolonged use, gastritis, peptic ulcer of the stomach and duodenum can occur, gastric bleeding is possible. Allergic reactions sometimes occur: bronchospasm, Quincke's edema, skin reactions.

Caffeine. Sometimes when using caffeine, insomnia, palpitations, trembling of the extremities, tinnitus, shortness of breath and vomiting occur. In addition, drug abuse may lead to drug dependence.

Drug Interaction

Increases the effects of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic drugs. Co-administration with other NSAIDs, methotrexate increases the risk of side effects. Prolonged use of paracetamol and other NSAIDs increases the risk of analgesic nephropathy and renal papillary necrosis, as well as the onset of end-stage renal failure.

Concurrent long-term administration of high-dose paracetamol and salicylates increases the risk of kidney or bladder cancer.

Reduces the effectiveness of spironolactone, furosemide, antihypertensives, and uricosuric agents that promote uric acid. Inductors of liver microsomal enzymes (phenytoin, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol, and hepatotoxic drugs (LS) increase the production of hydroxylated active metabolites, which causes the possibility of severe intoxications.

Prolonged use of barbiturates reduces the effectiveness of paracetamol. Inductors of liver microsomal enzymes (including cimetidine) reduce the risk of hepatotoxic action of paracetamol.

Metoclopramide accelerates the absorption of paracetamol. Under the influence of paracetamol T1 / 2, chloramphenicol increases 5-fold. With repeated administration, paracetamol may enhance the action of anticoagulants (coumarin derivatives) by reducing the synthesis of procoagulant factors in the liver. Concomitant administration of paracetamol and ethanol increases the risk of acute pancreatitis.

Diflunisal increases the plasma concentration of paracetamol by 50%, which causes the risk of hepatotoxicity.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

Caffeine accelerates the absorption of ergotamine.

Overdose

Symptoms: mild intoxication - pallor of the skin, nausea, vomiting, gastralgia, dizziness, ringing in the

severe intoxication - inhibition, drowsiness, collapse, convulsion, convulsions shortness of breath, anuria, bleeding, anorexia, impaired glucose metabolism, metabolic acidosis.

Symptoms of liver dysfunction can occur 12-48 hours after overdose. In severe overdose - hepatic failure with progressive encephalopathy, coma, death acute renal failure with tubular necrosis (including in the absence of severe liver damage) arrhythmia, pancreatitis.

Initially, central pulmonary hyperventilation leads to respiratory alkalosis (shortness of breath, asphyxiation, cyanosis, excessive sweating). As the intoxication intensifies, progressive respiratory depression and uncoupling of oxidative phosphorylation cause respiratory acidosis.

Treatment: constant control of acid-base and electrolyte balance depending on the state of metabolism - the introduction of sodium bicarbonate, sodium citrate or sodium lactate. Increasing reserve alkalinity enhances the excretion of acetylsalicylic acid by alkaline urination.

Introduction of SH-group donors and precursors for glutathione-methionine synthesis within 8-9 h after overdose and acetylcysteine ​​- for 8 h. paracetamol in the blood, as well as the time elapsed after its administration.

Storage conditions

In a dry, dark place at a temperature of no higher than 25 РC.

Keep out of the reach of children.

Terms and conditions

without prescription

dosage form

tablets

Possible product names

Citramon Ultra tablets coated film 10 pieces.