Diclofenac, Paracetamol | Panoxen tablets, 20 pcs.

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BID462603
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Latin name

PANOXEN
Latin name

PANOXEN

Packaging

20 pcs

Pharmacological action

Orungal is a broad-spectrum antifungal drug derived from triazole. Itraconazole disrupts the synthesis of ergosterol in the cell membrane of fungi, which causes the antifungal effect of the drug.

Itraconazole is active against infections caused by dermatophytes (Trichophyton spp., Microsporum spp., Epidermophyton floccosum) yeast-like and yeast fungi (Candida spp., including Candida albicans, Candida glabrata and Candida krusei ne cryptococococcocococcocmococococcocmocococococcocococcococcococcococci. , Trichosporon spp., Geotrichum spp.) Aspergillus spp. Histoplasma spp. Paracoccidioides brasiliensis Sporothrix schenckii Fonsecaea spp. Cladosporium spp. Blastomyces dermatitidis Pseudoallescheria boydii Penicillium marneffei and others.

Candida glabrata and Candida tropicalis are the least sensitive species of Candida to itraconazole.

The main types of fungi whose development is not inhibited by itraconazole are Zygomycetes (Rhizopus spp., Rhizomucor spp., Mucor spp., Absidia spp.), Fusarium spp., Scedosporium spp., Enterococcus faecalis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Serratia marcescens, Pseudomonas aeruginosa, Acinetobacter, Mycoplasma hominis, Mycoplasma pneumoniae, Mycobacterium tuberculosis, Mycobacterium fortuitum, Ureaplasma urealyticum, Clostridium perfringens, Corynebacterium spp., Helicobacter pylori, Listeria monocytogenes, Gardnerella vaginalis .

In most cases, insensitive: Nocardia asteroides, anaerobic bacteria (e.g. Bacteroides spp., Peptococcus spp., Peptostreptococcus spp., Eubacterium spp., Fusobacterium spp., Clostridium difficile). Not valid for Treponema pallidum.

Pharmacokinetics

After oral administration, it is rapidly and completely absorbed. Bioavailability - over 96%, binding to plasma proteins - 25%. Tmax is 1-2 hours, Cmax after administration at a dose of 100, 300,

Panoxen as a combined preparation has two mechanisms of analgesic action - peripheral and central.

The drug is effective against non-infectious inflammatory diseases.

Indications

Panoxen is prescribed for inflammatory and degenerative diseases: the musculoskeletal system (rheumatism, lumbago, gout, arthritis, spondylitis, osteoarthritis, polyarthritis, osteochondrosis, etc.)

of the nervous system (inflammation of the sciatic nerve) .

The drug Panoxen is effective as an analgesic for headaches and toothaches, sprains and bruises, renal colic, and inflammatory diseases of the ENT organs.

Contraindications

Panoxen is contraindicated in its intended use: with hypersensitivity and intolerance to the components of the

preparation with a combination of bronchial asthma with complicated ENT disease

with hyperkalemia

with hepatic and renal failure

in the rehabilitation period after coronary bypass surgery

with gastric ulcer

in the age of 12 years.

Caution Panoxen should be prescribed to patients with cardiovascular disease, diabetes mellitus, porphyria, cerebrovascular disease, glucose deficiency, as well as while taking oral medications and antiplatelet agents.

Patients working in hazardous industries and driving vehicles should limit their activities during the treatment period.

Use during pregnancy and lactation

The safety of the drug during pregnancy and during breastfeeding has not been established, therefore, the appointment of this category of patients is contraindicated.

Composition

1 tablet contains:

Active ingredients: paracetamol 500 mg, diclofenac sodium 50 mg

Excipients: corn starch - 290 mg, cellacephate (acetylphthalyl cellulose) - 15 mg, diethyl phthalate magnesium - 10 mg, - 10 mg, titanium dioxide - 13 mg, microcrystalline cellulose - 70 mg, povidone K-30 - 18 mg, methyl paraben (methyl parahydroxybenzoate) - 17.5 mg, propyl paraben (propyl parahydroxybenzoate) - 4 mg.

Shell composition: TS 1005 tablet coating (white) - 28.5 mg (hypromellose - 5.5 mg, propylene glycol - 4.3 mg, talc - 10.8 mg, titanium dioxide - 7.98 mg).

Dosage and administration of

Panoxen must be taken orally half an hour before a meal, 1 tablet 2-3 times a day.

The daily dose should not exceed 3 tablets of 50/500 mg.

For children from 12 years of age, Panoxen is prescribed in a dosage taking into account body weight - 2 mg per 1 kg.

Patients with heart failure, kidney and liver diseases should reduce the dosage of the drug and monitor the functioning of the digestive tract.

With a long course of treatment, additional diagnostic procedures should be performed to detect hidden bleeding.

Panoxen in large doses can affect blood glucose and uric acid levels.

Side effects of the

Digestive system: epigastric pain, nausea, vomiting, diarrhea, dyspepsia, flatulence, anorexia, increased activity of hepatic aminotransferases, gastritis, proctitis, bleeding from the gastrointestinal tract (blood vomiting, melena, ulceration of the gastrointestinal mucosa (with or without bleeding or perforation), hepatitis, jaundice, impaired liver function, stomatitis, glossitis, esophagitis, hemorrhagic colitis, exacerbation of ulcerative colitis or Crohn's disease, constipation, pancreatitis, fulminant ge Amum.

On the part of the nervous system: headache, dizziness, drowsiness, impaired sensitivity (including paresthesia), memory disorders, tremors, convulsions, anxiety, cerebrovascular disorders, aseptic meningitis, disorientation, depression, insomnia, nightmares, irritability, mental violations.

From the sensory organs: vertigo, visual impairment (blurred visual perception, diplopia), hearing impairment, tinnitus, taste impairment.

From the urinary system: acute renal failure, hematuria, proteinuria, interstitial nephritis, nephrotic syndrome, papillary necrosis of the kidneys.

From the hemopoietic system: thrombocytopenia, leukopenia, anemia, including hemolytic or aplastic, agranulocytosis, methemoglobinemia.

Allergic reactions: urticaria, anaphylactic / anaphylactoid reactions (including a marked decrease in blood pressure and shock), angioedema (including facial).

From the cardiovascular system: palpitations, chest pain, increased blood pressure, vasculitis, heart failure, myocardial infarction, allergic purpura.

From the respiratory system: bronchial asthma (including shortness of breath), pneumonitis.

On the part of the skin: skin rash (including bullous), erythema, incl. multiform and Stevens-Johnson syndrome, Lyell syndrome, exfoliative dermatitis, pruritus, hair loss, photosensitivity, purpura.

Other: edema.

Drug Interaction

Diclofenac

Increases plasma concentration of digoxin, lithium drugs reduces the effect of diuretics, against the background of potassium-sparing diuretics increases the risk of developing hyperkalemia against anticoagulants, antiplatelet agents and thrombolytics (alteplase, streptokinase, urokinase) increase the risk of bleeding (more often from the gastrointestinal tract).

Reduces the effects of hypotensive and sleeping pills.

Increases the likelihood of side effects of other NSAIDs and ACS (gastrointestinal bleeding), methotrexate toxicity, and cyclosporine nephrotoxicity (by increasing their plasma concentration). Acetylsalicylic acid lowers the concentration of diclofenac in the blood.

Reduces the effect of hypoglycemic agents.

Paracetamol increases the risk of nephrotoxic effects of diclofenac.

Cefamandol, cefoperazone, cefotetan, valproic acid and plicamycin increase the incidence of hypoprothrombinemia.

Cyclosporine and gold preparations increase the effect of diclofenac on the synthesis of prostaglandins in the kidneys, which is manifested by an increase in nephrotoxicity.

Selective serotonin reuptake inhibitors increase the risk of gastrointestinal bleeding.

Concomitant use with ethanol, colchicine, corticotropin, and periwinkle hypertension increases the risk of gastrointestinal bleeding.

Photosensitizing agents increase the sensitizing effect of diclofenac on UV radiation.

The tubular secretion-blocking agents increase the plasma concentration of diclofenac, thereby increasing its efficacy and toxicity.

Quinolone antibacterial agents increase the risk of convulsions.

Paracetamol

Reduces the effectiveness of uricosuric agents.

Concomitant use of paracetamol in high doses increases the effect of anticoagulants (reducing the synthesis of coagulation factors in the liver).

Inductors of liver microsomal enzymes (phenytoin, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic agents increase the production of hydroxylated active metabolites, which leads to the possibility of severe intoxications even with overdose.

Prolonged use of barbiturates reduces the effectiveness of paracetamol.

Ethanol contributes to the development of acute pancreatitis while being administered.

Inhibitors of microsomal liver enzymes (including cimetidine) reduce the risk of hepatotoxic action.

Long-term concomitant use of paracetamol and NSAIDs increases the risk of analgesic nephropathy and papillary necrosis of the kidneys, and the onset of terminal renal failure.

Prolonged co-administration of high-dose paracetamol and salicylates increases the risk of kidney or bladder cancer.

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

Myelotoxic agents increase the manifestations of hematotoxicity of paracetamol.

Storage conditions

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

Expiration

2 Year

Deystvuyuschee

substance Diclofenac, Paracetamol

Pharmacy terms

Prescription

Anglo-French Drags & Industries, India

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