Rinza tablets, # 10

Symptomatic treatment of colds, ARVI, incl. flu (febrile syndrome, pain syndrome, rhinorrhea).

Inside. Children over 15 years old and adults - 1 tablet 3-4 times a day. The maximum daily dose is 4 tablets. The course of treatment is not more than 5 days.

The tablets are round, flat, pink in color with dark pink and white blotches, with beveled edges and a dividing line on one side.

1 tab.

paracetamol 500 mg

caffeine 30 mg

phenylephrine hydrochloride 10 mg

chlorphenamine maleate 2 mg

Excipients: colloidal silicon dioxide - 7 mg, corn starch - 62.5 mg, corn starch (for 20% paste) - 20 mg, povidone (K30) - 4 mg, sodium methyl parahydroxybenzoate - 1 mg, magnesium stearate - 6 mg, talc - 7 mg, sodium carboxymethyl starch (type A) - 10 mg, crimson dye (Ponso 4R) - 0.5 mg.

• Severe atherosclerosis of the coronary arteries;

• arterial hypertension;

• portal hypertension;

• diabetes;

• simultaneous administration of tricyclic antidepressants, monoamine oxidase (MAO) inhibitors, beta-blockers, including within 2 weeks after the withdrawal of MAO inhibitors;

• hypersensitivity to caffeine, chlorpheniramine, paracetamol, phenylephrine or other components of the drug;

• taking other drugs containing substances that make up the RinzaЃ drug;

• pregnancy, lactation period;

• children's age (up to 15 years old);

• alcoholism.

Carefully

With hyperthyroidism, pheochromocytoma, bronchial asthma, chronic obstructive pulmonary disease, emphysema, chronic bronchitis, glucose-6-phosphate dehydrogenase deficiency, hemolytic anemia, blood diseases, acute hepatitis, congenital hyperbilirubinemia (Gilbert's syndrome, Dubin-Johnson syndrome), Pechin and Rhoven's syndrome or renal failure, concomitant use of drugs that can adversely affect the liver (barbiturates, phenytoin, phenobarbital, carbamazepine, rifampicin, isoniazid, zidovudine and other inducers of microsomal liver fermenters), pyloroduodenal obstruction, stenotic ulcer of the stomach and / or duodenal ulcer , epilepsy, prostatic hyperplasia, as well as persons with a deficit in calories from food,RinzaЃ can be used with caution after consulting a doctor.

Pharmacological properties

Combined drug.

Paracetamol has an antipyretic and analgesic effect: it reduces the pain syndrome observed in colds - sore throat, headache, muscle and joint pain, reduces high temperature.

Phenylephrine has a vasoconstrictor effect - it reduces edema and hyperemia of the mucous membranes of the upper respiratory tract and paranasal sinuses.

Chlorphenamine has an anti-allergic effect: it eliminates itching of the eyes, nose and throat, swelling and hyperemia of the mucous membranes of the nasal cavity, nasopharynx and paranasal sinuses, reduces exudative manifestations. Caffeine has a stimulating effect on the central nervous system, which leads to a decrease in fatigue and drowsiness, and to an increase in mental and physical performance.

Application during pregnancy and during breastfeeding

Due to the lack of clinical data, the safety of using the drug during pregnancy and during breastfeeding has not been established, therefore, the appointment of the drug in this category of patients is contraindicated.

Side effect

Allergic reactions: skin rash, itching, urticaria, angioedema, anaphylactic shock.

From the nervous system: headache, dizziness, drowsiness, sleep disturbance, irritability.

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

From the digestive system: nausea, vomiting, pain in the epigastric region, dyspepsia, diarrhea, hepatotoxic effect.

From the senses: mydriasis, accommodation paresis, increased intraocular pressure.

From the side of hematopoietic organs: anemia, thrombocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia, leukopenia.

From the urinary system: nephrotoxicity (renal colic, glucosuria, interstitial nephritis, papillary necrosis), difficulty urinating.

Others: dryness of the mucous membrane of the mouth and nose, pharyngitis, bronchospasm.

Serious skin reactions:

Rarely:

- Acute generalized exanthematous pustulosis (OGEP). Acute condition with the development of pustular eruptions. It is characterized by fever and diffuse erythema, accompanied by burning and itching. Swelling of the face, hands and mucous membranes may occur;

- Stevens-Johnson syndrome (SJS) (malignant exudative erythema).

From the immune system.

Very rare: anaphylactic reactions, hypersensitivity. Allergic reactions. Very rare: skin rash, itching, urticaria.

From the nervous system.

Very rare: insomnia, anxiety, headache.

On the part of the cardiovascular system.

Very rare: palpitations, tachycardia.

From the digestive system.

Very rare: abdominal pain, diarrhea, vomiting, increased transaminase levels *.

* a low rise in the level of transaminases can be observed in some patients using paracetamol at the doses indicated in the instructions; this rise is not accompanied by liver failure and usually resolves with continued treatment or discontinuation of paracetamol. If you notice one of the side effects described above, you should stop taking the drug and consult a doctor immediately!

Overdose

In case of overdose, you should immediately consult a doctor. Prompt medical attention is critical, even if you don't see any signs or symptoms.

Caffeine

Symptoms of acute overdose: abdominal pain, vomiting, flushing, fever, chills, agitation, insomnia, irritability, loss of appetite, weakness, tremor, increased muscle tone, altered consciousness, delirium, hallucinations, increased blood pressure followed by hypotension, tachycardia, tachypnea, increased urine output, hypokalemia, hyponatremia, hyperglycemia, metabolic acidosis, convulsions, myoclonus and rhabdomyolysis, supraventricular and ventricular arrhythmias. Symptoms of chronic intoxication with caffeine 'caffeinism': irritability, insomnia, anxiety, emotional lability, chronic abdominal pain.

Chlorphenamine

Symptoms: depression of the central nervous system, hyperthermia, anticholinergic syndrome (mydriasis, flushing of the face, fever, dry mouth, urinary retention, intestinal paresis), tachycardia, hypotension, hypertension, nausea, vomiting, agitation, disorientation, hallucinations, psycrhythmias, ... Rarely, patients with agitation, seizures, or coma develop rhabdomyolysis and renal failure.

Phenylephrine

Symptoms: nausea, vomiting, irritability, agitation, insomnia, psychosis, convulsions, palpitations, tachycardia, increased blood pressure, reflex bradycardia.

Paracetamol

Symptoms appear after ingestion of more than 7.5 - 10 g: during the first 24 hours after ingestion - pallor of the skin, nausea, vomiting; anorexia, abdominal pain; increased prothrombin time, impaired glucose metabolism, metabolic acidosis (including lactic acidosis).

Symptoms of liver dysfunction may appear 12 to 48 hours after an overdose: increased activity of 'hepatic' transaminases, hepatonecrosis. In severe cases - liver failure with progressive encephalopathy, coma. Rarely, liver failure develops lightning fast and can be complicated by renal failure (tubular necrosis). The overdose threshold can be lowered in elderly patients and children, in patients taking certain medications (for example, inducers of liver microsomal enzymes), alcohol, or wasting.

Treatment: gastric lavage, the appointment of activated carbon in the first 6 hours after the overdose, the introduction of SH-group donors and precursors of the synthesis of glutathione - methionine 8-9 hours after the overdose and acetylcysteine ??after 12 hours. The need for additional therapeutic measures (further administration of methionine and acetylcysteine) is determined by the concentration of paracetamol in the blood, as well as the time elapsed after taking it. Symptomatic therapy. From the side of the hematopoietic system: an overdose of paracetamol in people with a deficiency of glucose-6-phosphate dehydrogenase can cause hemolytic anemia.

Interaction with other medicinal products

Enhances the effects of monoamine oxidase (MAO) inhibitors, sedatives, ethanol. Antidepressants, antiparkinsonian drugs, antipsychotics, phenothiazine derivatives - increase the risk of urinary retention, dry mouth, constipation.

Glucocorticosteroids increase the risk of developing glaucoma.

Inhibitors of microsomal oxidation (cimetidine) reduce the risk of hepatotoxic effects. Metoclopramide and domperidone increase, and cholestyramine reduces the rate of absorption of paracetamol. Paracetamol reduces the effectiveness of uricosuric drugs.

When administered simultaneously with barbiturates, diphenin, carbamazepine, rifampicin, isoniazid, zidovudine and other inducers of liver microsomal enzymes, the risk of developing the hepatotoxic effect of paracetamol increases.

With the combined use of chloramphenicol and paracetamol, the half-life of chloramphenicol may increase. In most patients on long-term warfarin, infrequent use of paracetamol usually has little or no effect on the International Normalized Ratio (INR). However, with prolonged regular use, paracetamol enhances the effect of indirect anticoagulants (warfarin and other coumarin derivatives), which increases the risk of bleeding. A single high dose of caffeine can increase the excretion of lithium by the kidneys. Abrupt cessation of caffeine intake can lead to an increase in serum lithium concentration.

Chlorphenamine simultaneously with monoamine oxidase (MAO) inhibitors, furazolidone can lead to hypertensive crisis, agitation, hyperpyrexia.

The simultaneous use of phenylephrine with digoxin and other cardiac glycosides may increase the risk of developing arrhythmias and myocardial infarction.

Phenylephrine when taken with MAO inhibitors can increase blood pressure. Phenylephrine reduces the effectiveness of beta-blockers and antihypertensive drugs.

Tricyclic antidepressants enhance the adrenomimetic effect of phenylephrine, the simultaneous administration of halothane increases the risk of ventricular arrhythmia.

Reduces the hypotensive effect of guanethidine, which, in turn, enhances the alpha-adrenomimetic activity of phenylephrine.

special instructions

During the period of treatment, one should refrain from taking alcohol, sleeping pills and anxiolytic (tranquilizers) drugs. Do not take with other medicines containing paracetamol. If the symptoms of the disease worsen or persist after 5 days of using the drug, you should stop taking it and consult your doctor. The drug may cause drowsiness. Patients with heart disease and thyroid disease should not take the drug without consulting a doctor. The drug contains components that can cause allergic reactions (sodium methyl parahydroxybenzoate and crimson dye [Ponso 4R]), including delayed ones. If a medicinal product has become unusable or the expiration date has expired, do not throw it into wastewater or outside!Place the medicine in a bag and put it in the trash can. These measures will help protect the environment!

Influence on the ability to drive vehicles and other mechanisms

The drug may cause drowsiness. During the period of treatment, it is necessary to refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.