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Zaldiar - instructions for use, analogs, reviews and release forms (tablets) of a narcotic analgesic drug for the treatment of pain of various etiologies in adults, children and pregnancy. Composition and alcohol

Zaldiar - instructions for use, analogs, reviews and release forms (tablets) of a narcotic analgesic drug for the treatment of pain of various etiologies in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Zaldiar. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of narcotic opioid analgesic Zaldiar 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 Zaldiara in the presence of existing structural analogs.Use to treat pain of various etiologies in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

 

Zaldiar - combined preparation with analgesic action.

 

Tramadol (active ingredient of Zaldiar) is a synthetic opioid analgesic, an opioid receptor agonist. Activates opioid receptors (mu, delta, kappa) on the pre- and postsynaptic membranes of the afferent fibers of the nociceptive system in the brain and GI tract. Has an effect on the brain and spinal cord: promotes the discovery of K + - and Ca2 + -channels, causes hyperpolarization of membranes and inhibits pain impulses. Strengthens the action of sedatives.

 

Paracetamol is an analgetic-antipyretic. It blocks cyclooxygenase in the central nervous system, affecting the centers of pain and thermoregulation. Does not cause irritation of the mucous membrane of the stomach and intestines, does not affect the water-salt metabolism, since it does not affect the synthesis of prostaglandins in peripheral tissues.

 

Paracetamol provides a rapid onset of analgesic effect, while Tramadol - prolongation of analgesia.The synergism of the analgesic effect of the two components reduces the risk of side effects.

 

Composition

 

Tramadol hydrochloride + Paracetamol + excipients.

 

Pharmacokinetics

 

After ingestion, the active components are quickly and almost completely absorbed from the digestive tract. The absorption of tramadol is slower than paracetamol. The bioavailability of tramadol is approximately 75%, with repeated application increases to 90%. Tramadol is metabolized in the liver by N- and O-demethylation, followed by conjugation with glucuronic acid. There were 11 metabolites, of which mono-O-desmethyltramadol (M1) has pharmacological activity. Paracetamol is metabolized predominantly in the liver. Tramadol (about 30%) and its metabolites (about 60%) are excreted mainly with urine. Paracetamol and its conjugates are also excreted in the urine.

 

Indications

  • pain syndrome of medium and strong intensity of various etiology (including inflammatory, traumatic, vascular origin);
  • anesthesia for painful diagnostic or therapeutic procedures.

 

Forms of release

 

The tablets covered with a cover.

 

Instructions for use and dosage

 

The dosage regimen and duration of treatment are set individually, depending on the severity of the pain syndrome and the sensitivity of the patient. Do not prescribe the drug over a time-justified from a therapeutic point of view.

 

For adults and children older than 14 years, the initial single dose is 1-2 tablets, the interval between doses of single doses is not less than 6 hours. The maximum daily dose is 8 tablets (300 mg of tramadol and 2.6 g of paracetamol).

 

Tablets should be taken regardless of food intake, swallowing whole, not breaking and not chewing, squeezed with liquid. If the patient forgot to take another pill, then the next dose should not be doubled.

 

In elderly patients (aged 75 years and older), there is no need to correct a single dose. However, in connection with the possibility of delayed induction, the interval between single-dose doses may be increased.

 

With a moderate violation of liver function, the interval between doses should be increased. With severe violations of liver function, the drug should not be used.

 

Side effect

  • hives;
  • itching;
  • angioedema;
  • dizziness;
  • headache;
  • weakness;
  • increased fatigue;
  • retardation;
  • paradoxical stimulation of the central nervous system (nervousness, agitation, anxiety, tremor, muscle spasms, euphoria, emotional lability, hallucinations);
  • drowsiness;
  • sleep disturbance;
  • confusion of consciousness;
  • violation of coordination of movement;
  • convulsions of the central genesis (with the simultaneous appointment of antipsychotic drugs);
  • depression;
  • amnesia;
  • unsteadiness of gait;
  • impaired vision, taste;
  • dry mouth;
  • nausea, vomiting;
  • flatulence;
  • stomach ache;
  • constipation, diarrhea;
  • difficulty in swallowing;
  • tachycardia;
  • orthostatic hypotension;
  • fainting;
  • difficulty urinating;
  • retention of urine;
  • nephrotoxicity (interstitial nephritis, papillary necrosis);
  • exanthema;
  • bullous rash;
  • erythema multiforme (including Stevens-Johnson syndrome);
  • toxic epidermal necrolysis (Lyell's syndrome);
  • sulfemoglobinemia;
  • aplastic anemia, pancytopenia, agranulocytosis;
  • increased sweating;
  • violation of the menstrual cycle.

 

Contraindications

  • acute intoxication with alcohol or drugs depressing the central nervous system (hypnotics, opioid analgesics and psychotropic drugs);
  • simultaneous application of MAO inhibitors and a period of 2 weeks after their withdrawal;
  • severe hepatic and / or renal failure (CC less than 10 ml / min);
  • epilepsy, uncontrolled therapy;
  • withdrawal syndrome;
  • children's age till 14 years;
  • hypersensitivity to the components of the drug.

 

Application in pregnancy and lactation

 

Do not use Zaldiar during pregnancy and lactation (breastfeeding).

 

Use in children

 

Contraindicated in children under the age of 14 years.

 

special instructions

 

Patients should be informed of the need for strict adherence to the dosing regimen. During the period of Zaldiar's admission, do not use other drugs containing tramadol or paracetamol, without the appointment of a doctor.

 

With prolonged uncontrolled use of Zaldiar, symptoms of drug dependence may appear (irritability, phobias, nervousness, sleep disturbances, psychomotor activity, tremor, gastrointestinal discomfort). With a sharp withdrawal of the drug may appear signs of withdrawal syndrome.

 

In patients who are addicted to abuse or addiction,treatment should be carried out under close medical supervision for a short period of time.

 

During the period of treatment, Zaldiar is not allowed to drink alcohol. The risk of liver function disorders increases in patients with alcoholic hepatosis.

 

During a prolonged use of Zaldiar, a picture of the peripheral blood and the functional state of the liver is needed.

 

The drug is released by prescription. A strict accounting group due to the presence of a narcotic opioid component in the composition - Tramadol hydrochloride.

 

Impact on the ability to drive vehicles and manage mechanisms

 

During treatment Zaldiar should refrain from driving motor vehicles and activities potentially hazardous activities that require high concentration and psychomotor speed reactions.

 

Drug Interactions

 

analgesic effect is reduced by the competing actions on the receptors and the risk of withdrawal, so the use of this combination is not suitable for a joint application with Zaldiar opioid agonist-antagonists (buprenorphine, nalbuphine, pentazocine).

 

When Zaldiar therapy together with other drugs that exert a depressing effect on the central nervous system (for example, hypnotics or tranquilizers), and with the simultaneous administration of ethanol, the side effects characteristic of tramadol may be more pronounced.

 

Naloxone, being an antagonist of opioid receptors, activates respiration, eliminating the cause of Zaldiar's analgesia.

 

Inductors of microsomal oxidation (including carbamazepine, phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) reduce the analgesic effect of Zaldiar and its duration.

 

Inhibitors of microsomal oxidation (including cimetidine) with simultaneous application reduce the risk of hepatotoxic action Zaldiara.

 

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

 

Prolonged sharing of paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of developing nephropathy and renal papillary necrosis, the onset of the terminal stage of renal failure. Simultaneous long-term administration of paracetamol in high doses and salicylates increases the risk of developing kidney or bladder cancer.

 

The concomitant use of Zaldiar with drugs that lower the threshold of convulsive readiness (for example, with selective serotonin reuptake inhibitors, tricyclic antidepressants, neuroleptics) may increase the risk of seizures.

 

Zal'diar with simultaneous application for a long time enhances the effect of indirect anticoagulants (warfarin and other coumarins), which increases the risk of bleeding.

 

Preparations that inhibit the isoenzyme CYP3A4, such as Ketoconazole and erythromycin, can slow the metabolism of tramadol (N-demethylation) and the active O-demethylated metabolite.

 

Diflunisal increases the concentration of paracetamol in the blood plasma by 50%, and the risk of developing hepatotoxicity increases.

 

Quinidine increases the concentration in the blood plasma of tramadol and reduces the concentration of M1 metabolite due to competitive inhibition of the CYP2D6 isoenzyme.

 

The rate of absorption of paracetamol can be increased with simultaneous administration of Metoclopramide or Domperidone and reduced with simultaneous administration of colestyramine.

 

Analogues of the drug Zaldiar

 

Structural analogs for the active substance:

  • Ramlepsa;
  • Tramacet;
  • Vessodol.

 

Analogues on the pharmacological group (means for relief of pain):

  • Amitriptyline;
  • Analgin;
  • Antigrippin;
  • Aertal;
  • I took it;
  • Bralangin;
  • Brustan;
  • Voltaren;
  • Dexalgin;
  • Diclofenac;
  • Ibuklin;
  • Carbamazepine;
  • Ketanov;
  • Ketonal;
  • Ketoprofen;
  • Ketorol;
  • Ketorolac;
  • Xsefokam;
  • Lapal;
  • Maxigan;
  • Movalis;
  • Nyz;
  • Naklofen;
  • Nalgezin;
  • Nemux;
  • Nurofen;
  • Pipolphen;
  • Piroxicam;
  • Rapten Duo;
  • Revalgine;
  • Spasgan;
  • Spazmalgon;
  • Tempalgin;
  • Tramadol;
  • Finlepsin;
  • Finlepsin retard;
  • Flamax;
  • Hyrumat;
  • Celebrex;
  • Efilipt;
  • Yunispaz.

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Reviews (2):
Guests
Mayan
I accept only when I have a severe headache (I have a diagnosis: a chronic tension headache), and in side effects of Zaldiar's reception, a headache is written, but the doctor prescribed these pills for headache, it turns out a paradox, explain, please?
Administrators
admin
Mayan, And Suprastin has side effects allergy. One does not cancel the other. Side effects indicate any changes that were observed in the subjects when taking medication during clinical trials or in subsequent use in patients.

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