Askofen-P tablets, No. 20

• Moderate or mild pain syndrome (headache, toothache, neuralgia, myalgia, chest radicular syndrome, lumbago, arthralgia, algomenorrhea, migraine) in adults;

• decrease in elevated body temperature, with colds and other infectious and inflammatory diseases in adults and children over 15 years old.

Inside, after eating. 1-2 tables. 2-3 times a day. The maximum daily dose is 6 tablets. The break between doses of the drug should be at least 4 hours.

To reduce the irritant effect on the gastrointestinal tract, the drug should be taken after meals with water, milk, alkaline mineral water.

In case of impaired renal or liver function, the interval between doses is at least 6 hours.

The drug should not be taken for more than 5 days when prescribed as an anesthetic and for more than 3 days as an antipyretic. Other dosages and dosage regimens are determined by the doctor

Pills

1 tab.

active substances:

acetylsalicylic acid 200 mg

paracetamol 200 mg

caffeine 40 mg

excipients: potato starch; povidone (low molecular weight medical PVP); stearic acid; talc; calcium stearate; silicone emulsion KE-10-12; Vaseline oil VGM-30M

• Hypersensitivity to acetylsalicylic acid or other NSAIDs or xanthines;

• hypersensitivity to other components of the drug;

• erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase), gastrointestinal bleeding;

• severe abnormalities in liver or kidney function;

• asthma induced by the intake of acetylsalicylic acid, salicylates and other NSAIDs;

• hemorrhagic diathesis (von Willebrand disease, hemophilia, telangiectasia, hypoprothrombinemia, thrombocytopenia, thrombocytopenic purpura);

• dissecting aortic aneurysm;

• deficiency of glucose-6-phosphate dehydrogenase;

• portal hypertension, vitamin K deficiency;

• hyperexcitability, sleep disturbance, anxiety disorders (agoraphobia, panic disorder);

• organic diseases of the CVS (acute myocardial infarction, severe ischemic heart disease, arterial hypertension), paroxysmal tachycardia, frequent ventricular premature beats;

• glaucoma;

• surgical interventions accompanied by bleeding;

• children under 15 years of age.

With care: hyperuricemia, urate nephrolithiasis, gout, gastric ulcer and / or duodenal ulcer (in history), severe heart failure.

pharmachologic effect

Combined drug, the action of which is determined by the components that make up its composition.

Acetylsalicylic acid has an analgesic, antipyretic, anti-inflammatory effect associated with the suppression of COX-1 and COX-2, which regulate the synthesis of prostaglandins; inhibits platelet aggregation.

Paracetamol has antipyretic, analgesic effects.

Caffeine increases the reflex excitability of the spinal cord, stimulates the respiratory and vasomotor centers, dilates the blood vessels of skeletal muscles, brain, heart, kidneys, reduces platelet aggregation; reduces drowsiness, fatigue, increases mental and physical performance.

Side effect

From the digestive system: anorexia, nausea, vomiting, gastralgia, diarrhea, erosive and ulcerative lesions of the gastrointestinal tract, gastrointestinal bleeding, hepatic and / or renal failure.

From the side of the cardiovascular system: increased blood pressure, tachycardia.

Allergic reactions: skin rash, Quincke's edema, bronchospasm.

With prolonged use: dizziness, headache, visual disturbances, tinnitus, decreased platelet aggregation, hypocoagulation, hemorrhagic syndrome (including nosebleeds, bleeding gums, purpura), kidney damage with papillary necrosis; deafness; Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome), Reye's syndrome in children (metabolic acidosis, disorders of the nervous system and psyche, vomiting, liver dysfunction).

Application during pregnancy and lactation

It is contraindicated to use in the first and third trimesters of pregnancy, in the second trimester of pregnancy, a single dose of the drug in recommended doses is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

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

If necessary, the use of the drug during lactation should stop breastfeeding. Acetylsalicylic acid is excreted in breast milk, which increases the risk of bleeding in a child due to dysfunction of platelets.

Application for violations of liver function

The use of the drug is contraindicated in case of severe liver dysfunction, portal hypertension.

Application for impaired renal function

The use of the drug is contraindicated in case of severe renal dysfunction.

The drug should be taken with caution in case of urate nephrolithiasis.

Application in children

The drug is not prescribed as an analgesic agent for children and adolescents under the age of 18 years, as an antipyretic agent - for children under 15 years of age with ARVI due to the risk of developing Reye's syndrome.

special instructions

With prolonged use of the drug, it is necessary to monitor the peripheral blood and the functional state of the liver.

Since acetylsalicylic acid has an antiplatelet effect, the patient, if he is to undergo surgery, must warn the doctor in advance about taking the drug.

Acetylsalicylic acid in low doses reduces the excretion of uric acid. This can in some cases provoke a gout attack.

During treatment, the patient should stop drinking alcohol (increased risk of gastrointestinal bleeding).

Use in pediatrics

The drug is not prescribed as an anesthetic for children and adolescents under the age of 18 years, as an antipyretic agent - for children under 15 years of age with ARVI due to the risk of developing Reye's syndrome (encephalopathy and acute fatty degeneration of the liver with acute development of liver failure).

Overdose

Symptoms: nausea, vomiting, stomach pain, sweating, pallor of the skin, tachycardia. With mild intoxication - ringing in the ears; severe intoxication - drowsiness, collapse, convulsions, bronchospasm, shortness of breath, anuria, bleeding. As intoxication intensifies, progressive respiratory paralysis and uncoupling of oxidative phosphorylation, causing respiratory acidosis.

Treatment: gastric lavage, intake of adsorbents (activated carbon). If you suspect poisoning, the patient should immediately seek medical help.

Drug interactions

The drug enhances the effect of heparin, indirect anticoagulants, reserpine, steroid hormones and hypoglycemic agents.

Reduces the effectiveness of spironolactone, furosemide, antihypertensive drugs, anti-gout drugs that promote the excretion of uric acid.

Enhances the side effects of GCS, sulfonylurea derivatives, methotrexate, non-narcotic analgesics and NSAIDs.

Avoid the combination of the drug with barbiturates, antiepileptic drugs, zidovudine, rifampicin, with drinks containing ethanol (increases the risk of hepatotoxic effect).

Under the influence of paracetamol, the elimination time of chloramphenicol increases by 5 times.

Caffeine accelerates the absorption of ergotamine.

Salicylamide and other stimulants of microsomal oxidation contribute to the formation of toxic metabolites of paracetamol, which affect liver function.

Metoclopramide accelerates the absorption of paracetamol.

When taken again, paracetamol can enhance the effect of anticoagulants (dicoumarin derivatives).