Groprinosin-Richter syrup 50mg / ml, 150ml

• flu and acute respiratory viral infections;

• infections caused by the herpes simplex virus types 1, 2, 3 and 4 (genital and labial herpes, herpetic keratitis, herpes zoster, chickenpox, infectious mononucleosis caused by the Epstein-Barr virus);

• cytomegalovirus infection;

• severe measles;

• papillomavirus infection (papillomas of the larynx and vocal cords / fibrous type /, genital papillomavirus infections in men and women, warts);

• subacute sclerosing panencephalitis;

• molluscum contagiosum.

The drug is taken orally after meals. A measuring syringe is included for correct dosing. The dose of the drug depends on the patient's body weight and disease. The daily dose is divided into several parts (3-4), which should be taken at regular intervals throughout the day.

The duration of treatment is usually 5-14 days. The drug should be continued for 1-2 days after the symptoms disappear. The recommended daily dose for adults and elderly patients, as well as children 3 years of age and older (body weight over 15-20 kg) is 50 mg / kg body weight in 3-4 divided doses. 1 ml of GroprinosinЃ-Richter contains 50 mg of inosine pranobex. For the treatment of severe infections, the dose can be individually increased to 100 mg / kg of body weight 4-6 times / day.

The maximum daily dose for adults is 3-4 g / day (60-80 ml / day) The maximum daily dose for children 3 years and older is 50 mg / kg / day.

Duration of treatment

Acute infections: The duration of treatment in adults and children is usually 5 to 14 days. Treatment should be continued until the disappearance of clinical symptoms and for another 1-2 days after the disappearance of symptoms. If necessary, the duration of treatment can be increased individually under the supervision of a physician.

Chronic recurrent infections: in adults and children, treatment should be continued in several courses of 5-10 days with an interval of 8 days. When carrying out maintenance therapy, the dose can be reduced to 500-1000 mg / day (10-20 ml / day) for 30 days.

Herpetic infections: treatment continues for 5-10 days until the symptoms of the disease disappear.

To reduce the number of relapses during the asymptomatic period, the drug is prescribed 500 mg 2 times / day (20 ml / day) for 30 days.

Human papillomavirus infections: as monotherapy, the drug is prescribed for 14-28 days for adults at a dose of 1000 mg 3 times / day (60 ml / day), for children - 250 mg per 5 kg of body weight (1 ml / kg / day) 3-4 times / day

Recurrent genital warts: as monotherapy or in combination with surgical treatment, the drug is prescribed for adults at a dose of 1000 mg 3 times / day (60 ml / day), for children - at a dose of 250 mg per 5 kg of body weight (1 ml / kg / day) in 3-4 receptions. 3 courses are carried out for 14-28 days with an interval of 1 month.

Cervical dysplasia associated with human papillomavirus: 2-3 courses of 1000 mg 3 times / day (60 ml / day) for 10 days with an interval of 10-14 days. In elderly patients, there is no need for dose adjustment; the drug is used in the same way as in middle-aged patients. It should be borne in mind that in elderly patients, an increase in the concentration of uric acid in serum and in urine occurs more often than in middle-aged patients. In patients with renal and hepatic insufficiency during treatment with GroprinosinЃ-Richter, the uric acid content in blood serum and urine should be monitored every 2 weeks. It is recommended to monitor the activity of liver enzymes every 4 weeks with long courses of drug treatment.

The syrup is in the form of a clear yellowish liquid.

1 ml inosine pranobex 50 mg

Excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, sucrose, sodium hydroxide, citric acid, water.

• hypersensitivity to inosine pranobex and other components of the drug;

• gout; urolithiasis disease;

• arrhythmias;

• chronic renal failure;

• children under 3 years of age (body weight up to 15-20 kg);

• pregnancy;

• breastfeeding period;

• deficiency of sucrase / isomaltase, fructose intolerance, glucose-galactose malabsorption.

• With caution: with simultaneous administration with xanthine oxidase inhibitors, diuretics, zidovudine, in acute liver failure.

pharmachologic effect

Inosine pranobex, a synthetic purine derivative, is a complex containing inosine and N, N-dimethylamino-2-propanol in a molar ratio of 1: 3. Possesses immunostimulating activity and nonspecific antiviral action. The effectiveness of the complex is determined by the presence of inosine, the second component increases its availability for lymphocytes. Restores the function of lymphocytes under conditions of immunosuppression, increases blastogenesis in the monocyte population, stimulates the expression of membrane receptors on the surface of T-helpers, prevents a decrease in lymphocyte activity under the influence of GCS, normalizes the inclusion of thymidine in them. Inosine pranobex stimulates the activity of T-lymphocytes and natural killer cells, the function of T-suppressors and T-helpers, increases the production of immunoglobulin G (IgG), interferon-gamma, interleukins IL-1 and IL-2,reduces the formation of anti-inflammatory cytokines - IL-4 and IL-10, potentiates the chemotaxis of neutrophils, monocytes and macrophages. The drug exhibits antiviral activity in vivo against herpes simplex virus, cytomegalovirus, measles virus, human T-cell lymphoma virus (type III), polioviruses, influenza A and B viruses, ECHO virus (enterocytopathogenic human virus), encephalomyocarditis and equine encephalitis viruses ... The mechanism of the antiviral action of inosine pranobex is associated with the inhibition of viral RNA and dihydropteroate synthetase, which is involved in the replication of some viruses, enhances the synthesis of mRNA of lymphocytes suppressed by viruses, which is accompanied by a decrease in the synthesis of viral RNA and translation of viral proteins, increases the production of interferons alpha and gamma by lymphocytes with antiviral properties.When administered in combination, it enhances the effect of interferon-alpha, acyclovir and zidovudine.

Pharmacokinetics

Absorption and distribution

After oral administration, it is well absorbed from the gastrointestinal tract. Cmax in blood plasma is determined after 1-2 hours. No accumulation of the drug in the body was found.

Metabolism and excretion

It is rapidly metabolized and excreted through the kidneys. It is metabolized similarly to endogenous purine nucleotides with the formation of uric acid. N, N-dimethylamino-2-propanol is metabolized to N-oxide, and 4-acetamidobenzoate is metabolized to o-acylglucuronide. T1 / 2 is 3.5 hours for N, N-dimethylamino-2-propanol and 50 minutes for 4-acetamidobenzoate. Inosine pranobex and its metabolites are excreted by the kidneys within 24-48 hours.

Side effect

The incidence of adverse drug reactions (ADR) after the use of the drug is classified according to the WHO recommendations: often (> 1% and <10%), infrequently (> 0.1% and <1%). From the nervous system: often - headache, dizziness, fatigue, feeling unwell, weakness; infrequently - nervousness, drowsiness, insomnia. From the gastrointestinal tract: often - decreased appetite, nausea, vomiting, epigastric pain; infrequently - diarrhea, constipation. From the liver and biliary tract: often - a temporary increase in the activity of transaminases and alkaline phosphatase in the blood plasma, an increase in the concentration of urea in the blood plasma. Skin and subcutaneous tissue disorders: often - itching, rash; infrequently - maculopapular rash, urticaria, angioedema. From the urinary system: infrequently - polyuria. General disorders and disorders at the injection site:often - joint pain, exacerbation of gout. Laboratory and instrumental data: often - an increase in the concentration of blood urea nitrogen.

Application during pregnancy and lactation

The use of the drug GroprinosinЃ-Richter during pregnancy and during breastfeeding is contraindicated, because the safety of use has not been established.

Application for violations of liver function

With caution: in acute liver failure.

Application for impaired renal function

Contraindicated in chronic renal failure. In patients with renal insufficiency during treatment with GroprinosinЃ-Richter, the uric acid content in blood serum and urine should be monitored every 2 weeks.

Application in children

Use is contraindicated in children under 3 years of age (body weight up to 15-20 kg).

Use in elderly patients

In elderly patients, there is no need for dose adjustment.

special instructions

Inosine pranobex, like other antiviral agents, is most effective in acute viral infections if treatment is started at an early stage of the disease (the first day). After 2 weeks of using inosine pranobex, the concentration of uric acid in serum and urine should be monitored. Also, with prolonged use, it is recommended to periodically monitor the concentration of uric acid in serum and urine. Patients with a significantly increased concentration of uric acid in the body can simultaneously take drugs that lower its concentration. It is necessary to control the concentration of uric acid in the blood serum when prescribing the drug simultaneously with drugs that increase the concentration of uric acid or drugs that impair renal function.With prolonged use (after 4 weeks of use), it is advisable to monitor the function of the liver and kidneys every month (transaminase activity, concentration of creatinine, uric acid in blood serum). Inosine pranobex should be used with caution in patients with acute hepatic failure, since the drug is metabolized in the liver. Influence on the ability to drive vehicles and control mechanisms The effect of inosine pranobex on the psychomotor functions of the body and the ability to drive vehicles and moving mechanisms has not been studied. When using the drug, you should take into account the possibility of dizziness and drowsiness.Inosine pranobex should be used with caution in patients with acute hepatic failure, since the drug is metabolized in the liver. Influence on the ability to drive vehicles and control mechanisms The effect of inosine pranobex on the psychomotor functions of the body and the ability to drive vehicles and moving mechanisms has not been studied. When using the drug, you should take into account the possibility of dizziness and drowsiness.Inosine pranobex should be used with caution in patients with acute hepatic failure, since the drug is metabolized in the liver. Influence on the ability to drive vehicles and control mechanisms The effect of inosine pranobex on the psychomotor functions of the body and the ability to drive vehicles and moving mechanisms has not been studied. When using the drug, you should take into account the possibility of dizziness and drowsiness.When using the drug, you should take into account the possibility of dizziness and drowsiness.When using the drug, you should take into account the possibility of dizziness and drowsiness.

Overdose

Treatment: in case of an overdose, gastric lavage and symptomatic therapy are indicated.

Drug interactions

Immunosuppressants weaken the immunostimulating effect of inosine pranobex. Inosine pranobex should be used with caution in patients taking simultaneously xanthine oxidase inhibitors (allopurinol) or drugs that can block the tubular secretion of uric acid, for example, loop diuretics (furosemide, torasemide, ethacrynic acid), because this can lead to an increase in the concentration of uric acid in the blood serum. The combined use of inosine pranobex with zidovudine leads to an increase in the concentration of zidovudine in the blood plasma and lengthens its half-life. Thus, when inosine pranobex is used together with zidovudine, a dose adjustment of zidovudine may be required.