Pentalgin - instructions for use, analogs, reviews and release forms (tablets H, ICN, Plus, green without codeine and without a prescription) drugs for the treatment of headache, dental and other pain and temperature in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Pentalginum. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Pentalgin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Pentalgin with existing structural analogues.Use to treat headache, dental and other pain and temperature in adults, children, as well as during pregnancy and lactation. The composition of the drug and the conditions of over-the-counter and prescription leave, depending on the availability of components that are banned for general sale.

Pentalginum - combined preparation, analgesic, anti-inflammatory, antispasmodic, antipyretic effect.

Paracetamol - an analgesic-antipyretic, has an antipyretic and analgesic effect due to blockade of COX in the central nervous system and exposure to pain centers and thermoregulation.

Naproksen - non-steroidal anti-inflammatory drug, has anti-inflammatory, analgesic and antipyretic effect associated with nonselective suppression of COX activity regulating the synthesis of prostaglandins.

Caffeine - a psychostimulating agent, causes the expansion of blood vessels of skeletal muscles, heart, kidneys; increases mental and physical performance, helps to eliminate fatigue and drowsiness; increases the permeability of histohematological barriers and increases the bioavailability of non-narcotic analgesics, thereby contributing to the enhancement of the therapeutic effect.Has a tonic effect on the vessels of the brain.

Drotaverin - has a myotropic antispasmodic effect caused by inhibition of PDE 4, acts on the smooth muscles of the gastrointestinal tract, bile ducts, urogenital system, vessels.

Phenyramin is a blocker of histamine H1 receptors. Has spasmolytic and mild sedative effect, reduces the phenomenon of exudation, and also enhances the analgesic effect of Paracetamol and naproxen.

Codeine has an analgesic effect due to the excitation of opioid receptors in various departments of the central nervous system, leading to stimulation of the antinociceptive system and a change in the emotional perception of pain.

Phenobarbital - barbiturate, increases the analgesic efficiency of metamizole sodium and paracetamol.

Phenobarbital and codeine increase the analgesic effect of metamizole sodium and naproxen.

Composition

Paracetamol + Naproxen + Caffeine + Drotaverina hydrochloride + Pheniramine maleate + excipients (tablets are green, do not contain codeine and are sold without a prescription).

Metamizole sodium + Naproxen + Caffeine + Phenobarbital + Codeine (in the form of phosphate) + auxiliary substances (Pentalgin H).

Paracetamol + Metamizole sodium + Caffeine + Phenobarbital + Codeine phosphate + excipients (Pentalgin ICN).

Paracetamol + Propyphenazone + Caffeine + Codeine Phosphate + Phenobarbital + excipients (Pentalgin Plus).

Pharmacokinetics

The components of the drug are well absorbed into the digestive tract.

Metamizol sodium

In the intestinal wall, it hydrolyses to form an active metabolite, 4-methyl-amino-antipyrine, which in turn is metabolized to 4-formyl-amino-antipyrine and other metabolites. The binding of the active metabolite with proteins is 50-60%. Metabolites are excreted by the kidneys and excreted in breast milk.

Naproxen

Bioavailability is 95%. It binds to blood proteins. It is excreted in the urine mainly in the form of a metabolite (dimethylnaproxen), in small amounts - with bile.

Caffeine

Well absorbed in the intestines. It is excreted mainly by kidneys in the form of metabolites, about 10% - in unchanged form.

Codeine

Slightly binds to plasma proteins. Undergoes biotransformation in the liver (10% by demethylation passes into morphine). It is excreted by the kidneys (5-15% - unchanged).

Phenobarbital

Well penetrates the placental barrier.Biotransformatsya in the liver. The main metabolite does not have pharmacological activity. It is excreted by the kidneys, incl. 20-25% - unchanged.

Indications

• pain syndrome of various genesis, including pain in the joints, muscles, sciatica, algodismenorea, neuralgia, toothache, headache (including caused by spasm of cerebral vessels);
• Pain syndrome associated with spasm of smooth muscles, incl. with chronic cholecystitis, cholelithiasis, postcholecystectomy syndrome, renal colic;
• Post-traumatic and postoperative pain syndrome, incl. accompanied by inflammation;
• catarrhal diseases accompanied by febrile syndrome (as symptomatic therapy).

Forms of release

Tablets (green color of OTC).

Tablets (H, ICN, Plus).

Instructions for use and dosage

The drug is prescribed for 1 tablet 1-3 times a day. The maximum daily dose is 4 tablets.

The drug should not be taken more than 5 days as an anesthetic and more than 3 days as an antipyretic agent without prescribing a doctor.

Do not exceed the indicated doses of the drug.

Side effect

• skin rash;
• itching;
• hives;
• angioedema;
• Thrombocytopenia, leukopenia, agranulocytosis, anemia;
• excitation;
• anxiety;
• amplification of reflexes;
• tremor;
• headache;
• sleep disorders;
• dizziness;
• decreased concentration of attention;
• palpitation;
• arrhythmias;
• increased blood pressure;
• erosive and ulcerative lesions of the gastrointestinal tract;
• nausea, vomiting;
• discomfort in epigastrium;
• stomach ache;
• constipation;
• impaired renal function;
• hearing loss;
• noise in ears;
• increased intraocular pressure in patients with closed-angle glaucoma;
• dermatitis;
• quickening of breathing.

Contraindications

• erosive and ulcerative lesions of the gastrointestinal tract (in the phase of exacerbation);
• gastrointestinal bleeding;
• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including in anamnesis);
• severe hepatic impairment;
• severe renal failure;
• anemia, leukopenia;
• oppression of bone marrow hematopoiesis;
• condition after aortocoronary bypass surgery;
• severe organic diseases of the cardiovascular system (including acute myocardial infarction);
• paroxysmal tachycardia;
• frequent ventricular extrasystole;
• severe arterial hypertension;
• alcoholic intoxication;
• glaucoma;
• hyperkalemia;
• deficiency of glucose-6-phosphate dehydrogenase;
• pregnancy;
• lactation period (breastfeeding);
• children and adolescents under 18;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

Contraindicated use of the drug during pregnancy and lactation (breastfeeding).

Application in elderly patients

With caution should be used in elderly patients.

special instructions

It is necessary to avoid simultaneous use of the preparation Pentalgin with other products containing paracetamol and / or NSAIDs, as well as with funds to relieve the symptoms of colds, flu and nasal congestion.

When using the drug Pentalgin for more than 5-7 days should monitor the peripheral blood and the functional state of the liver.

Paracetamol distorts the results of laboratory studies of glucose and uric acid in the blood plasma.

If it is necessary to determine 17-ketosteroids, pentalgin should be discontinued 48 hours before the test. It should be borne in mind that naproxen increases the time of bleeding.

The effect of caffeine on the CNS depends on the type of nervous system and can be manifested both by excitation and inhibition of higher nervous activity.

During treatment, the patient should avoid drinking alcohol.

Impact on the ability to drive vehicles and manage mechanisms

In some cases, the concentration of attention and the speed of psychomotor reactions may be reduced, so during the treatment the patient should be careful when driving vehicles and taking other potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

With the simultaneous administration of Pentalgin with barbiturates, tricyclic antidepressants, rifampicin, ethanol (alcohol), the risk of hepatotoxic effects increases (these combinations should be avoided).

Paracetamol increases the effect of anticoagulants of indirect action and reduces the effectiveness of uricosuric drugs.

Long-term use of barbiturates reduces the effectiveness of paracetamol.

With the simultaneous use of paracetamol with ethanol (alcohol) increases the risk of acute pancreatitis.

Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxic effects of paracetamol.

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

Naproxen is able to cause a decrease in the diuretic effect of furosemide, enhance the effect of indirect anticoagulants, increase the toxicity of sulfonamides and methotrexate, reduce lithium excretion and increase its concentration in blood plasma.

With the joint use of caffeine and barbiturates, primidon, anticonvulsants (hydantoin derivatives, especially phenytoin), it is possible to increase metabolism and increase caffeine clearance; with the simultaneous administration of caffeine and cimetidine, oral contraceptives, disulfiram, ciprofloxacin, Norfloxacin - a decrease in the metabolism of caffeine in the liver (slowing its elimination and increasing blood concentrations).

Simultaneous use of caffeine-containing beverages and other CNS stimulating agents may lead to excessive stimulation of the CNS.

With the simultaneous use of drotaverine can weaken the antiparkinsonian effect of levodopa.

With the simultaneous use of phenyramine with tranquilizers, hypnotics, MAO inhibitors, ethanol (alcohol), it is possible to increase the oppressive effect on the central nervous system.

Analogues of the drug Pentalginum

Structural analogs for the active substance:

• Pentalgin Plus.
• Pliwalgin.

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