Rinzasip with vit. C powder for oral administration, lemon 5g, No. 5

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

Inside. Pour the contents of 1 sachet (sachet) into a glass, add hot water, stir until completely dissolved and drink (sugar or honey can be added if desired). Taking the drug is recommended 1-2 hours after a meal. Adults and children over 15 years old: take one sachet 3-4 times a day with intervals between doses 4-6 hours. The maximum daily dose is 4 sachets. The course of treatment without consulting a doctor is not more than 5 days.

Active substances

Ascorbic acid (Vitamin C) 200 mg

Caffeine 30 mg

Paracetamol 750 mg

Phenylephrine hydrochloride 10 mg

Pheniramine maleate 20 mg

Excipients: - orange: citric acid 200.0 mg, sodium saccharinate 40.0 mg, sodium citrate 500.0 mg, sucrose 3062.5 mg, sunset yellow dye (E110) 7.5 mg, orange flavor 150.0 mg; - citric: citric acid 200.0 mg, sodium saccharinate 40.0 mg, sodium citrate 500.0 mg, sucrose 3136.0 mg, quinoline yellow dye (E104) 1.0 mg, lemon flavoring 83.0 mg; - blackcurrant: citric acid 200.0 mg, sodium saccharinate 40.0 mg, sodium citrate 500.0 mg, sucrose 2915.0 mg, dye azorubin (E122) 4.0 mg, fruit flavor (Tutti Frutti) 166.7 mg , raspberry flavoring 66.7 mg, blackcurrant flavoring 66.7 mg.

• Severe atherosclerosis of the coronary arteries,

• portal hypertension,

• conditions associated with the accumulation of iron in the body, such as hemochromatosis;

• severe renal failure or hemodialysis,

• concomitant use of tricyclic antidepressants, beta-blockers, monoamine oxidase (MAO) inhibitors and discontinuation of their intake less than 2 weeks ago;

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

• hypersensitivity to individual components of the drug, as well as to sympathomimetic drugs;

• simultaneous administration of medicinal products containing substances that make up the drug;

• pregnancy, lactation period,

• children under 15 years old,

• alcoholism.

pharmachologic effect

The combined drug, has antipyretic, analgesic, alpha-adrenostimulating, vasoconstrictor and antihistamine effects, eliminates the symptoms of a cold.

Paracetamol is a non-narcotic analgesic; blocks cyclooxygenase, mainly in the central nervous system, affecting the centers of pain and thermoregulation; has an analgesic and antipyretic effect.

Phenylephrine is an alpha-adrenergic agonist with a moderate vasoconstrictor effect. Reduces edema and hyperemia of the mucous membranes of the upper respiratory tract and paranasal sinuses.

Pheniramine is a blocker of H1-histamine receptors. It has an anti-allergic effect: 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, enhances the effect of analgesics, eliminates drowsiness and fatigue, increases physical and mental performance, reduces fatigue and drowsiness.

Ascorbic acid (vitamin C) is involved in the regulation of redox processes, carbohydrate metabolism, blood clotting, tissue regeneration, in the synthesis of steroid hormones; reduces vascular permeability and increases the body's resistance to the effects of various adverse environmental factors.

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.

On the part of the skin: serious skin reactions very rarely - acute generalized exanthematous pustulosis (OGE; acute condition with the development of pustular rashes; characterized by fever and diffuse erythema, accompanied by burning sensation and itching; swelling of the face, hands and mucous membranes may occur), Stevens-Johnson syndrome (SS; malignant exudative erythema; severe erythema multiforme, in which blisters appear on the mucous membrane of the mouth, throat, eyes, genitals, other areas of the skin and mucous membranes), toxic epidermal necrolysis (TEN, Lyell's syndrome; the syndrome is a consequence of extensive apoptosis of keratinocytes, which leads to the detachment of large areas of the skin in the places of the dermoepidermal junction; the affected skin looks like scalded with boiling water).

From the immune system: very rarely - anaphylactic reactions, hypersensitivity.

Allergic reactions: very rarely - skin rash, itching, urticaria.

From the nervous system: very rarely - insomnia, anxiety, headache.

From the side of the cardiovascular system: very rarely - palpitations, tachycardia.

On the part of the digestive system: very rarely - an increase in the level of transaminases *.

* A slight rise in the level of transaminases can be observed in some patients using paracetamol in recommended doses; this rise is not accompanied by liver failure and usually resolves with continued treatment or discontinuation of paracetamol.

If one of the side effects described above develops, the patient should stop taking the drug and immediately consult a doctor.

Application during pregnancy and lactation

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.

Application for violations of liver function

The drug should be used with caution in liver failure.

Application for impaired renal function

The drug should be used with caution in case of renal failure.

Application in children

Contraindicated in children under 15 years of age.

special instructions

During the period of treatment, you should refrain from drinking alcohol.

If the symptoms of the disease worsen or persist for 5 days, or if new symptoms appear, you should consult your doctor.

The drug may cause drowsiness.

The drug contains sucrose, which must be taken into account by patients with diabetes mellitus, as well as those on a low-calorie diet. 1 single dose of the drug contains from 2915 to 3136 mg of sucrose, which corresponds to 0.24-0.26 XE.

Keep out of the reach of children. If the drug is swallowed by a child, seek immediate medical attention.

If a medicinal product has become unusable or the expiration date has expired, it should not be thrown into the 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 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.

Overdose

In case of overdose, consult a doctor immediately. Prompt medical attention is critical without even showing any signs or symptoms.

Vitamin C

Symptoms of acute overdose: diarrhea and other gastrointestinal disorders.

Symptoms of chronic intoxication with ascorbic acid: impaired renal excretory function, formation of kidney stones, decreased capillary permeability (possible deterioration of tissue trophism, increased blood pressure, hypercoagulation, development of microangiopathies, impaired iron metabolism), erosion of tooth enamel.

Caffeine

Symptoms of acute overdose: abdominal pain, nausea, vomiting, fever, chills, headache, agitation, insomnia, irritability, loss of appetite, weakness, tremor, anxiety, altered consciousness, delirium, hallucinations, increased blood pressure followed by hypotension, tachycardia, tachypnea , hypokalemia, hyponatremia, hyperglycemia, metabolic acidosis, epileptic seizures, seizures, myoclonus and rhabdomyolysis, supraventricular and ventricular arrhythmias.

Symptoms of chronic intoxication with caffeine ('caffeinism'): irritability, insomnia, anxiety, emotional lability, chronic abdominal pain.

Pheniramine

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, psychomotor agitation, disorientation, hallucinations, convulsions , arrhythmias. Rarely, patients with agitation, seizures, or coma develop rhabdomyolysis and renal failure.

Phenylephrine

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

Paracetamol

Symptoms appear after taking 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, hypokalemia, metabolic acidosis (including lactic acidosis ). Symptoms of liver dysfunction may appear 12-48 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 suffering from wasting.

From the circulatory system: an overdose of paracetamol in people with a deficiency of glucose-6-phosphate dehydrogenase can cause hemolytic anemia.

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) depends on the concentration of paracetamol in the blood, as well as on the time elapsed after taking it. Symptomatic therapy.

Drug interactions

Oral contraceptives and hormone replacement therapy. Ascorbic acid acts as a competitive inhibitor for sulfated ethinylestradiol. It was noted that ascorbic acid at a dose of 1 g increases the bioavailability of ethinylestradiol by 60-70% in women who received a single oral dose, by 47% with long-term use of contraceptives and by 21% in postmenopausal women who received transdermal estradiol.

Iron. The use of ascorbic acid can increase the absorption of iron. Ascorbic acid enhances iron absorption by chelating with oxidized iron at acidic pH, which remains soluble at alkaline duodenal pH.

Deferoxamine. The combined use of ascorbic acid and deferoxamine in severe chronic iron intoxication can lead to cardiac dysfunction. The effect is thought to be a result of deferoxamine increasing the amount of iron available for chelation with ascorbic acid.

MAO inhibitors. Enhances the effects of MAO inhibitors, sedatives, ethanol.

When taken with digoxin or other cardiac glycosides, the risk of arrhythmias and myocardial infarction may increase.

Antidepressants, antiparkinsonian drugs, antipsychotics, phenothiazine derivatives increase the risk of urinary retention, dry mouth, and constipation.

GCS 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 diuretic and uricosuric drugs.

With simultaneous administration with barbiturates, diphenin, carbamazepine, rifampicin and other inducers of microsomal liver enzymes, the risk of developing the hepatotoxic effect of paracetamol increases.

In most patients on long-term warfarin, infrequent use of paracetamol usually has little or no effect on 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.

When taken simultaneously with MAO inhibitors, furazolidone, pheniramine can lead to hypertensive crisis, agitation, hyperpyrexia. When taken with MAO inhibitors, phenylephrine can lead to an increase in blood pressure.

Phenylephrine reduces the effectiveness of beta-blockers and antihypertensive drugs, and also reduces the hypotensive effect of guanethidine, which, in turn, enhances the alpha-adrenomimetic activity of phenylephrine.

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