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Blue round pills. Tablets for potency sv black. Application during pregnancy and lactation

Toothache and headache, discomfort in the back - this is a completely incomplete list of problems that people may experience. Pain relievers can help relieve the discomfort.

List of popular pain pills

The use of the drugs described below must be careful. It is necessary to select the appropriate tablets as these medicines may not be suitable for some people. Moreover, this applies to the diagnosis, since the use of an analgesic for pain in the abdomen, heart and other organs can significantly complicate the definition of the disease. In addition, pain is considered only a signal from the body about existing problems, getting rid of a painful symptom does not mean getting rid of the disease, it is necessary to eliminate the cause of the problem.

Aspirin

Aspirin has a pronounced analgesic effect. In addition to relieving high fever, this drug can be used for many diseases, since the pill has an anti-inflammatory effect. It is effectively used to relieve pain in joints, muscles, perfectly eliminates high body temperature and headache.

Aspirin is a fairly strong pain reliever, because the use of these pills implies compliance with certain rules. The medicine should not be used by children under 16 years of age. The situation is the same with pregnant women and nursing mothers. The presence of kidney and liver diseases need great care when using. The drug can be used for no more than a week, the dose must be checked with a doctor.

The drug has side effects, which are nausea, vomiting and pain in the abdomen. Sometimes the drug causes dizziness. During an overdose, the risk of bleeding and tinnitus increases.

Analgin

Analgin is used to relieve unpleasant symptoms in many cases. Joint pain, headache and toothache, the presence of bruises, injuries and related discomfort - the tablets can effectively help in these cases.

Today, analgin is found in many pain pills. This substance relieves pain by suppressing the activity of the centers responsible for this symptom. The impact is partial, but allows the person to receive noticeable relief.

As in the above-described drug, Analgin has other actions in the arsenal. The drug increases heat transfer, and the presence of an anti-inflammatory effect allows you to eliminate diseases. Also, the medicine is suitable during fever, colds and fevers.

Analgin is not used to treat pregnant and lactating women. It is also prohibited to use pills for children under six months. It is advisable to use the drug for the treatment of adults. Long-term alcohol consumption and kidney disease are also considered contraindications.

Side effects are expressed in the form of a decrease in blood pressure, the development of allergic reactions and impaired renal function. This is possible in cases where the medicine is not suitable for a person or the possible dosage is exceeded.

Paracetamol and No-shpa

No-shpa is an antispasmodic drug. It is used for pain in the stomach, intestines and head. Tablets are also used in situations where the symptom appeared as a result of menstruation in women or with diseases of the urinary system.

It is undesirable to use the drug for children under the age of 7 years, as well as for women during lactation. A factor requiring careful admission is the presence of heart, hepatic, renal failure, as well as pregnancy. The appearance of side effects occurs in rare cases. As a rule, they are associated with the development of allergies and nausea, a decrease in blood pressure, and an increased heart rate. When used correctly, tablets will provide a high degree of safety and efficacy.

The effectiveness of paracetamol is also quite high. The medicine is used as an analgesic and antipyretic agent, it is quite safe to use. An anesthetic drug is required for neuralgia, during muscle and articular pain syndromes, for toothaches and headaches.

Tablets are prohibited for use in cases where there is an inflammation of the gastrointestinal tract, as well as severe kidney disorders. Pregnant women in the 3rd trimester and children under one month old also cannot use this medication.

The remedy is completely incompatible with alcohol. The duration of use should not be more than a week. A side effect is associated with the risk of acute liver failure and the development of allergies.

Ketanov and Nurofen

Nurofen contains an active substance - ibuprofen. The preparation is made in the form of tablets, suspensions, gels and suppositories. Nurofen has anti-inflammatory and antipyretic effects, relieves pain in case of colds and fevers. The tool allows you to get rid of headache, joint, muscle, toothache and other types of pain.

You should not resort to using the medicine at the same time as Aspirin, Analgin and Paracetamol. You can not use the drug to treat pregnant women who are in the 3rd trimester and children under 7 years of age. For women during lactation, the drug is not prescribed.

Nurofen has many contraindications, including the following conditions and diseases:

• Renal failure
• Lesion of the gastrointestinal tract of the ulcerative type.
• Disruptions in the functioning of the liver.

The dosage of the drug must be observed, the product requires careful handling. With prolonged use of the drug and overdose, there may be side effects. These include diarrhea, weakness, vomiting, headache, nausea, and decreased blood pressure.

Painkillers are also represented by such a powerful drug as Ketanov. Often it is used after operations, with the development of pain of osteochondrosis and oncological nature. The drug is also effective for colic, unpleasant sensations that appeared in the process of muscle injury. Ketanov is used for a short time. The dose must be strictly observed. It is undesirable to use the medicine for more than 2 days.

The drug is not devoid of side effects... In the process of consuming funds, the following phenomena may appear:

• Nervous state.
• Frequent palpitations.
• Pallor of the integument of the skin.
• Nausea.
• Pain in the abdomen.

It is understood that an overdose of the drug can cause the above symptoms. In addition, the patient experiences drowsiness and shortness of breath. Signs of an overdose require immediate medical attention.

It is forbidden to resort to the help of the drug when a person has a blood clotting disorder, stomach ulcer and renal failure. Pregnant and lactating women, children under 15 years of age are also required to refrain from using the medication.

Diclofenac and Mig 400

Diclofenac is produced in pain relief gels and suspensions, which are required for injections, but there is also a tablet form of the drug. The tool makes it possible to get rid of muscle and joint pain, is used for injuries and associated painful symptoms.

The list of positive effects of the tablets includes anti-inflammatory and anti-edema effects. It is used in the treatment of children who have reached the age of 7 years and more. As in the above cases, it is forbidden to give the drug to women who are in the 3rd semester and during lactation.

Side effects are associated with the appearance of allergies, but it is very rare. The drug is highly safe, and its effectiveness in eliminating pain in articular and muscular localization has an excellent indicator.

The Mig 400 contains ibuprofen. Eliminating pain with this remedy is effective during painful inflammatory syndrome. The drug also helps in such cases:

• Toothaches.
• Pain during menstruation.
• Development of migraines and headaches.
• The presence of a symptom in a febrile state.
• Pain syndrome in joints and muscles.

Like other painkillers, Mig 400 is not used for painful sensations in young children, lactating and pregnant women, diseases of the gastrointestinal tract, stomach ulcers. Care must be taken to use the medication if a person has the following features:

• Diseases of the blood.
• Liver dysfunction.
• Heart failure.
• Kidney disease.

Elderly people also need to accurately and correctly determine the dose of the medicine. This must be done without fail with the participation of a doctor. An overdose of the drug can lead to weakness, anxiety, the development of an allergic reaction and an increase in blood pressure. Dizziness and shortness of breath sometimes appear. The presence of these symptoms indicates the need to stop using the pills and visit a doctor.

Pain relievers must be used after consulting a doctor. It is necessary to carefully consider the presence of side effects and taking medications. Compliance with the dosage makes it possible to achieve effective and positive treatment.

Specific pain medications

This group of drugs is indirectly analgesics, and people who are far from pharmacology and medicine are unlikely to be able to draw an analogy between painkillers and these drugs. Specific analgesics are officially classified as anticonvulsants. And even the instructions for use indicate "Anticonvulsants" or "Antiepileptic".

But against the background of a certain anticonvulsant effect, drugs of this group effectively reduce postoperative and other types of pain. In addition, they reduce sensitivity in severe wounds, for example, after breast surgery and other invasive significant interventions that are characterized by damage to peripheral nerves.

Gabapentin

This drug effectively blocks the release of neurotransmitters that have arousal effects. Clinical studies have determined the role of gabapentin in the treatment of neuropathic and chronic pain, which is associated with the ability of the drug to reduce the sensitivity of the spinal cord, including after traumatic or surgical tissue deformation.

Gabapentin is advised to be prescribed to patients after surgery, including to reduce the dosage of narcotic analgesics. Gabapentin has been proven to be excellent for pain relief during severe headaches and pain associated with cerebral vasospasm. In pharmacies, gabapentin can be found under the names Gapentek, Gabagamma, Neurontin, Katena, Egipentin, Tebantin, etc.

Pregabalin

A pain reliever that has properties similar to gabapentin. The main difference is the longer half-life, which makes it the drug of choice for the relief of acute pain, especially for the elderly. Indications include postoperative pain, fibromyalgia, and neuropathic pain. The original pregabalin is made by Pfizer, USA, called Lyrica. In addition, there are generics on the market: Prabegin, Algerica, Pregabalin Canon, Pregabalin-Richter and Pregabalin Zentiva.

So, as you can see, pain pills are represented by a huge assortment of different drugs. It is necessary to select a drug on an individual basis, since the characteristics of a person's condition and health require attention to them. Failure to follow the rules for the use of pain medications can create side effects or more significant consequences. In this case, the agent must be stopped and immediately consulted a doctor.

Pain relievers. A list of effective pain medications of varying intensity and localization. Complete overview.

Fyodor Mikhailovich Dostoevsky, a connoisseur of human souls, once said that pain is obligatory for "a broad consciousness and a deep heart." Do not take the words of a classic literally. Untreated pain is a severe blow to health and psyche. Moreover, doctors have learned to cope with it: there are dozens of different anesthetic drugs in their arsenal.

Acute pain comes on suddenly and lasts for a limited amount of time. It is caused by tissue damage - bone fractures, sprains, injuries internal organs, caries and many other diseases. Usually, analgesics successfully cope with acute attacks, and this is undoubtedly a positive phenomenon that gives hope for relief.

Chronic pain lasts longer than 6 months and is probably associated with a chronic illness. Osteoarthritis, rheumatism, gout, malignant tumors make themselves felt with severe, debilitating attacks, resistant to treatment. Long-term pain is not only the result of damaged tissues, but also often a consequence of damaged nerves.

Both acute and chronic pain can be so severe that the person experiencing it sometimes becomes deeply depressed. Sadly, chronic pain affects up to 80% of the world's population - this figure was obtained as a result of large epidemiological studies. And therefore, doctors do not get tired of studying this phenomenon and looking for new ways to combat it. So, what are they, pain relievers?

The diverse world of analgesics

When you go to the pharmacy for pain relievers, it seems that there is nothing complicated in your request. And only when the pharmacist starts asking a lot of additional questions, it becomes clear: in reality, everything is not so simple.

In pharmacology - the science of medicine - there are many groups of pain relievers, each of which is used for a specific type of pain.

So, all analgesics are conventionally divided into:

• pyrazolones and combinations thereof;
• combined analgesics containing several components at once;
• anti-migraine agents indicated for the treatment of migraine headaches;
• non-steroidal anti-inflammatory drugs (NSAIDs);
• COX-2 inhibitors;
• narcotic analgesics;
• antispasmodics;
• specific analgesics.

Let's take a look at each of these groups separately and find out which pain relievers to choose in this or that case.

Pyrazolones and their combinations: traditional pain relievers

Typical pain relievers are pyrazolones. This group includes the "father" of all analgesics, who has become the "gold standard" in pain management - His Majesty Analgin.

Analgin

Analgin, or metamizole sodium, has more than just an analgesic effect. It also has mild antipyretic and anti-inflammatory effects. Nevertheless, analgin gained wide popularity and even fame as a drug against many types of pain.

The negative side of Analgin is not the highest security. With frequent long-term use, metamizole sodium causes significant changes in the blood picture, therefore it is recommended to take it "rarely, but accurately". On the Russian market, sodium metamizole is produced under the traditional name Analgin. In addition, the Indian drug Baralgin M and Metamizole sodium produced in Macedonia are registered in the Russian Federation.

Analgin-quinine

The complex analgesic drug Analgin-quinine, produced by the Bulgarian company Sopharma, contains two components: sodium metamizole and quinine. The main task that quinine performs in this complex is to reduce elevated body temperature. Due to the combination of powerful antipyretic quinine and analgesic metamizole, Analgin-Quinine is an excellent choice for fever and joint pain of colds. In addition, the drug is also used for toothache, joint pain, periodic and other types of pain.

Baralgetas, Spazmalgon

Both drugs are among the most popular combined analgesics-antispasmodics in our country. They contain the same combination: metamizole sodium, pitofenone, fenpivirinium bromide.

Each of the components enhances the action of each other. Metamizole is a classic analgesic, pitofenone has an antispasmodic effect on smooth muscles, and fenpivirinium bromide additionally relaxes smooth muscles. Thanks to a very successful combination, Baralgetas and Spazmolgon are used for the widest range of indications in adults and children. Let's list the main ones:

• various types of pain caused by vasospasm or smooth muscle organs: headache, intermittent, ureteral spasm, renal, hepatic, biliary colic, colitis;
• fever.

Baralgetas and Spazmolgon in injectable form are an ambulance for very high temperature body when traditional antipyretic drugs are powerless. The drugs are even used to relieve fever in children, including up to one year of age. For each year of life, 0.1 ml of Baralgetas (Spazmolgon) injection solution is used;

high blood pressure.

By relaxing the spasmodic vessels, pain relievers Baralgin and Spazmolgon help with slightly increased pressure (10–20 mm Hg higher than normal);

increased uterine tone during pregnancy.

In recent years, pain relievers Baralgetas (Spazmolgon) have been increasingly used during pregnancy to reduce the increased tone of the uterus. At the same time, they have a certain advantage over another antispasmodic, which has traditionally been used to relax the uterus - drotaverine. Recently, it was found that after 20 weeks of pregnancy, drotaverine can help soften the cervix. This is extremely undesirable, especially for women suffering from isthmic-cervical insufficiency. But it is this category of patients who more than others need antispasmodics that reduce uterine tone.

Unlike drotaverine, Baralgetas (Spazmolgon) does not affect the cervix and can be safely used at any stage of pregnancy.

In addition to Baralgetas and Spazmolgon, their Ukrainian counterpart, Renalgan tablets, is registered on the Russian market.

Tempalgin

The famous spring-green coated tablets have been known since the days of the Soviet Union. The analgesic drug, which has been consistently produced by the Bulgarian company Sopharma for many decades, contains two active ingredients: sodium metamizole (analgin) and triacetonamine-4-toluenesulfonate. The latter has a so-called anxiolytic effect, reducing anxiety, tension, excitement. In addition, it increases the action of analgin.

Tempalgin and its analogue Tempanginol are used for pain syndrome of moderate and mild severity.

Combined pain relievers: difficult but effective

The central component of most combination analgesics is usually paracetamol. A safe drug, which is sometimes mistakenly referred to the group of non-steroidal anti-inflammatory drugs, has several effects at once: moderate analgesic and antipyretic, as well as extremely insignificant anti-inflammatory. Paracetamol in its pure form is quite a strong analgesic, and when additional components are added to it, its qualities are enhanced. As a rule, combined analgesics, which include paracetamol, are used to relieve pain from colds. Let's get down to specifics.

Vicks Active Symptomax and Vicks Active Symptomax Plus

Vicks Active Symptomax contains paracetamol in combination with phenylephrine. The latter has a vasoconstrictor effect, so the drug not only effectively reduces joint and muscle pain typical for colds, but also reduces nasal congestion.

In addition to paracetamol and phenylephrine, Vicks Active Symptomax Plus also contains guaifenesin, a substance that helps to thin the nasal secretions.

Brustan, Ibuklin and Ibuklin Junior

Means with a fairly pronounced analgesic and anti-inflammatory activity. Brustan and Ibuklin contain paracetamol and one of the most powerful antipyretic and analgesic non-steroidal anti-inflammatory drugs, ibuprofen. At the same time, the concentrations of both components are quite high (paracetamol 325 mg, and ibuprofen at a dose of 400 mg). Due to the effective combination and high dosage, Brustan and Ibuklin have a pronounced analgesic and antipyretic effect. Ibuklin Junior is intended to reduce pain and fever in children and is available in dispersible form (in the form of tablets that are soluble in the mouth).

Brustan's analogs also include the widely advertised drug Next, containing 400 mg of ibuprofen and 200 mg of paracetamol, as well as Nurofen MultiSymptom (400 mg + 325 mg).

Gevadal

The Austrian drug, which includes caffeine, paracetamol and propyphenazone, is a drug from the pyrazolone group, which has a moderate analgesic and antipyretic effect. Caffeine in the composition of combined analgesics plays a very significant role - it dilates blood vessels and enhances the effect of the main anesthetic components. Gevadal is recommended to be used for moderate headache, muscular, and recurrent pain.

Dolaren

Dolospa and Trigan

Both the first and second tablets have the same composition, including paracetamol and the myotropic antispasmodic dicycloverin, which relieves spasm of smooth muscle organs. It is due to the content of dicycloverine that Dolospa and Trigan quite effectively relieve pain in renal, biliary and intestinal colic, including urolithiasis. In addition, they can be taken for spastic constipation and spasms of other origins in the gastrointestinal tract.

Ruler Caffetin

The Caffetin line is also very popular among combined analgesics. It includes three drugs that differ in composition and indications:

• Caffetin Cold contains a classic cough combination;
• Caffetin is a true combination pain reliever in pills that includes codeine, caffeine, paracetamol and propyphenazone.

Codeine is a natural narcotic analgesic that blocks opiate receptors. The rest of the components of the drug (with the exception of caffeine, which we have already mentioned) have antispasmodic and general analgesic properties. Due to the rich composition, caffetin relieves toothache and headache, including migraine, muscle pain of various origins, joint pain, and also periodic pain in women. Due to its inclusion in codeine, Caffetin is sold exclusively by prescription;

Kaffetin Light.

A "lightweight" variation of the analgesic containing paracetamol, propyphenazone and caffeine. The pain reliever Caffetin Light can be purchased without a prescription and can be used for different types mild to moderate pain.

Pentalgin

The well-known Russian combined analgesic tablets are added to the list of fairly strong painkillers. The number of components is "hidden" in the name of the drug: "penta" in Greek means "five". So, the composition of Pentalgin includes:

• drotaverine - myotropic antispasmodic;
• caffeine;
• naproxen is a non-steroidal anti-inflammatory drug;
• paracetamol;
• pheniramine maleate - a component that has an anti-allergic effect.

Pentalgin is quite effective for headache, fever, and severe pain accompanying neuralgia.

Migraine: pain that is difficult to relieve

Migraine pain is characterized by a persistent and severe course. Migraine attacks are not easy to stop. The pathological chain that leads to a sudden and significant vasoconstriction is already running, and it is difficult to break. Conventional analgesics are often powerless, and anti-migraine pain relievers that dilate blood vessels come to the rescue.

Sumatriptan

Sumatriptan is an active ingredient (and drug) that relieves migraine pain. It takes effect 30 minutes after application. The standard dosage of sumatriptan is 50 mg, and if it is ineffective, you can take two tablets per day (total 100 mg). The maximum daily dose is 300 mg.

Sumatriptan-containing preparations include Amigrenin, Imigran, Migrepam, Rapimed, Sumamigren, Trimigren.

Zolmitriptan

A drug that acts similarly to sumatriptan. The original preparation of zolmitriptan is produced by the British corporation Astra Zeneca under the name Zomig and Zomig Rapimelt.

Eletriptan

An effective anesthetic drug that is used to treat migraines, including those with severe pain... Eletriptan shows the best results when used at the very beginning of a migraine attack, but the effectiveness remains at any time. Today, only one eletriptan drug is registered in Russia - the original Relpax, which is produced by the American supergiant Pfizer.

Frovatriptan

Another active ingredient that effectively dilates blood vessels and helps with migraines. Presented by a drug made in Germany Frovamigran.

NSAIDs - effective pain relief

Undoubtedly, non-steroidal anti-inflammatory drugs have a special place in the range of pain relievers. And although almost all of them have an analgesic effect, we will mention only those of them that are distinguished by the most pronounced analgesic activity.

Ibuprofen

One of the safest NSAIDs, which has antipyretic and analgesic properties. The safety of Ibuprofen is highlighted by the fact that the drug is approved for pain relief and fever even in newborns and infants. The drug is available in tablets, syrups, suppositories, as well as in local forms (ointments and gels) for pain relief of joints and muscles. The adult dosage for moderate pain relief is 400 mg. The most famous ibuprofen drugs: Dolgit, Ibuprom, Ipren, Nurofen.

Aspirin

Despite a certain analgesic activity, Aspirin is not used as often for pain relief. This is due to the aggressiveness of high doses of acetylsalicylic acid - the active substance of Aspirin - in relation to the mucous membrane of the digestive tract. Nevertheless, Bayer produces an effervescent and tablet form of Aspirin, designed to relieve pain and fever.

Naproxen

A representative of NSAIDs, which, along with ibuprofen, is mainly used as an analgesic. Like all other drugs of the group of non-steroidal anti-inflammatory drugs, naproxen preparations are used with caution in diseases of the digestive tract. Most often, naproxen is prescribed for the relief of toothache, headache, recurrent and rheumatic pain. In addition, naproxen can be used as an effective modern pain reliever for bone fractures or soft tissue injuries.

In Russian pharmacies, naproxen is sold under the trade names: Apranax, Nalgezin and Nalgezin Forte, Naprobene, Pronaxen, Sanaprox.

Ketorolac

Ketorolac is on the list of the most powerful pain relievers. Its analgesic properties are comparable to those of some opioid narcotic analgesics. However, ketorolac preparations should only be used in extreme cases when other remedies do not work. This is due to the side effects that occur with regular or prolonged pain relief. Treatment with ketorolac is accompanied by irritation of the gastric mucosa (in 13% of cases), nausea (in 12% of cases), abdominal pain and even diarrhea (in 12 and 7% of patients, respectively). In addition, ketorolac can cause headache (in 17% of patients), dizziness (7%) and drowsiness (in 6%). There have been cases of severe gastric lesions, including perforation and subsequent bleeding, as well as hepatic and renal failure in patients taking ketorolac for a long time.

Nevertheless, the potent ketorolac can be indispensable for severe pain as a result of fractures and injuries, as well as a drug for pain relief in cancer and after surgery. By the way, it does not have anti-inflammatory and antipyretic effects. There are several trade names on the domestic market, among them Dolak, Dolomin, Ketalgin, Ketanov, Ketorol, Ketofril, Toradol, Torolak and others.

Safe pain relieving COX-2 inhibitors, or coxibs

These drugs are classified as non-steroidal anti-inflammatory drugs. However, the special mechanism of action and the associated special effectiveness and, most importantly, safety, give grounds to distinguish them into a separate subgroup of anesthetic drugs.

COX-2 inhibitors, unlike other NSAIDs, do not block COX-1, which protects the gastric mucosa. Therefore, they are not aggressive towards organs. gastrointestinal tract, and they can be used by people with a history of gastric ulcer. Nevertheless, most experts agree that coxibs should be taken with caution in such cases.

During treatment with COX-2 inhibitors, patients with peptic ulcer disease or gastric bleeding in the past are advised to drink proton pump inhibitors. These agents block the production of hydrochloric acid and thus protect the stomach lining.

We add that the most famous proton pump inhibitors include Omeprazole, Lanzoprazole, Esomeprazole and Pantoprazole.

Celecoxib

The first of the coxib-type painkillers registered in Russia. Perfectly reduces inflammation and relieves pain. It is used for exacerbation of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and other rheumatic diseases, including those with severe pain.

Celecoxib is available under the trade names Dilaxa, Coxib, Celebrex - the original drug produced by Pfizer.

Rofecoxib

Another representative of coxibs, which is prescribed to reduce pain and inflammation in acute and chronic osteoarthritis, pain syndrome of any origin. In Russian pharmacies, it is available under the name Viox in the form of a suspension and tablets. The manufacturer of the drug is the Dutch company Merck.

Parecoxib

This drug occupies a special position in the range of analgesics - it has a parenteral, that is, injection form of release. Parecoxib has a less pronounced anti-inflammatory activity, but this deficiency more than compensates for its high analgesic capabilities. In Russia, parecoxib is sold under the name Dinastat. It is produced by the British company Pharmacia in the form of a lyophilized powder, from which a solution for intramuscular or intravenous injection is prepared immediately before use.

Dinastat is widely used as a powerful injectable pain reliever for severe pain, including after surgery or fairly sensitive diagnostic tests (for example, colonoscopy), as well as pain in fractures and injuries. In addition, Dynastat is sometimes prescribed for the pain relief of cancer patients in order to reduce the dose of narcotic analgesics.

Etoricoxib

One of the most modern coxibs, which organically combines anti-inflammatory and analgesic effects. The drug is used for symptomatic, that is, pain-relieving therapy of osteoarthritis, osteochondrosis, rheumatoid arthritis and other joint diseases. Etoricoxib is marketed by a Pfizer company called Arcoxia.

Reserve drugs - narcotic analgesics

Narcotic analgesics block opioid receptors and thereby inhibit the transmission of pain impulses. In addition, they reduce the emotional assessment of pain and the reaction to it, and also cause euphoria and a sense of mental comfort. In order to avoid the formation of dependence, narcotic analgesics are used only in extreme cases, for example, to relieve acute pain syndrome. In addition, opioid analgesics are used in anesthesiology for the so-called premedication - preparation of the patient before the introduction of epidural and spinal anesthesia.

The narcotic pain relievers registered in the Russian Federation include codeine, fentanyl, morphine and some others.

The well-known drugs Nurofen Plus and Sedalgin Neo also got into the group of opioid narcotic analgesics in combinations due to the content of codeine.

Nurofen Plus

The drug from the Nurofen line, which is produced by the British company Rekkit Healthcare, contains ibuprofen in a dose of 200 mg and 10 mg of codeine. Nurofen Plus tablets effectively relieve headaches and toothaches, migraine pains, recurrent pain in women, pain in the back, muscles and joints, pain in neuralgia and spinal hernias. In addition, the drug is good for fever and pain, characteristic of colds and flu. Nurofen Plus should not be taken by children under 12 years of age.

Sedalgin Neo

The Bulgarian pain reliever produced by Activis Sedalgin Neo, known for a long time, also fell into the group of combined opioid analgesics. Sedalgin Neo contains a combination of five active ingredients, including codeine, caffeine, metamizole sodium, paracetamol and phenobarbital. Due to the latter, the medicine has not only anesthetic, but also a sedative effect. Sedalgin Neo is effective for neuralgia, neuritis, migraine, as well as pain of various origins, including rheumatic, headache, dental, phantom, post-burn, traumatic, postoperative and periodic. In addition, the drug can be used for fever and aches during ARVI and influenza.

Myotropic antispasmodics: both pain and spasm

Myotropic antispasmodics are able to reduce the flow of active calcium into the cells of smooth muscle fibers. As a result, there is an expansion of smooth muscles and blood vessels, a decrease in pressure, which provides the drugs with an antispasmodic and analgesic effect.

Drotaverin

The most popular myotropic antispasmodic is the good old drotaverine. It has a pronounced antispasmodic effect and high safety. Drotaverin is used as an anesthetic for various diseases accompanied by spasm of smooth muscle organs, including:

• chronic gastroduodenitis;
• peptic ulcer of the stomach and duodenum;
• chronic cholecystitis (inflammation of the gallbladder);
• dyskinesia of the biliary tract;
• intestinal dyskinesia;
• intestinal colic;
• colitis;
• proct;
• flatulence;
• renal colic;
• spasm of cerebral vessels.

In addition, drotaverine weakens uterine contractions and is used in obstetrics to reduce tone, as well as reduce cervical spasm during childbirth.

Sometimes drotaverine is used at high body temperature against the background of peripheral vascular spasm. In such cases, the patient has severe fever and contrasting cold extremities.

For effective normalization of body temperature with spasm of peripheral vessels, traditional antipyretic drugs are used - paracetamol or ibuprofen - in combination with drotaverine.

Dozens of drotaverine analogues are sold on the domestic market. We will list the most popular of them: Vero-Drotaverin, Droverin, Drotaverin-Teva, No-shpa, No-shpa forte (80 mg dosage), Spazmol and others.

Dicetel

The drug, which is produced by the French company Abbott, contains pinaverium bromide as an active ingredient. He, like drotaverine, relieves spasm of smooth muscle fibers and blood vessels. Dicetel tablets are used to relieve spastic bowel contractions, including irritable bowel syndrome, biliary dyskinesia.

Duspatalin

The same Abbott company produces another myotropic antispasmodic, Duspatalin. It contains mebeverine, which has an antispasmodic and analgesic effect.

Duspatalin is the original brand drug. There are also its analogues, which differ in a more economical price. These include Mebeverine hydrochloride, Niaspasm, Sparex.

Combined antispasmodics

A small group of drugs, which includes only a few medicinal compositions.

No-shpalgin

The original French drug from Sanofi Aventis contains three active ingredients: drotaverine, codeine and paracetamol. An effective combination provides multiple effects. Paracetamol reduces the severity of pain and lowers fever, drotaverine reduces spasm, and codeine further enhances the analgesic effect.

No-shpalgin is used for headaches of various origins: tension headache, vascular, as well as pain due to fatigue or stress. The Indian analogue of No-shpalgin Unispaz has the same composition and a more favorable price.

Nomigren

A very interesting drug combination is the drug Nomigren, which is produced by Bosnia and Herzegovina. It contains five components: propyphenazone, caffeine, camilofin chloride, mecloxamine citrate and ergotamine tartrate.

The active ingredients of the drug Nomigren, enhancing the action of each other, have a strong analgesic effect for migraines and vascular headaches. The drug shows the best result if it is taken at the very beginning of the attack.

Specific pain medications

This group of drugs refers to analgesics indirectly, and people far from medicine and pharmacology are unlikely to draw an analogy between them and painkillers. Officially, specific analgesics belong to the group of anticonvulsants. And even in the instructions for use in the column "Pharmacological group" it is written in black and white "Antiepileptic" or "Anticonvulsant". However, against the background of some anticonvulsant effect, drugs in this group effectively reduce severe postoperative and other types of pain. In addition, they reduce sensitivity in severe wounds, for example, after breast surgery and other invasive large interventions, which are characterized by damage to the peripheral nerves and the associated hypersensitivity of the postoperative wound.

Gabapentin

Gabapentin effectively blocks the release of excitatory neurotransmitters. Large clinical trials have shown a role for gabapentin in the treatment of chronic and neuropathic pain. It is associated with the ability of the drug to reduce the sensitivity of the spinal cord, including after surgical or traumatic tissue injury.

Gabapentin is recommended to be prescribed to patients after surgery, including with the aim of reducing the dose of narcotic analgesics. The high efficacy of gabapentin preparations for pain relief in severe tension headaches, as well as pain associated with cerebral vasospasm, has been proven.

In domestic pharmacies, gabapentin is sold under the names Gabagamma, Gapentek, Katena, Neurontin, Tebantin, Egipentin and others.

Pregabalin

A drug that has properties similar to gabapentin. The main difference is the longer half-life, which is why pregabalin is considered the drug of choice for the treatment of acute pain, especially in the elderly. Indications for pregabalin include neuropathic pain, fibromyalgia, and postoperative pain. The original pregabalin is produced by the American concern Pfizer under the name Lyrica. In addition, there are generics on the market: Algerica, Prabegin, Pregabalin Zentiva, Pregabalin-Richter and Pregabalin Canon.

As you can see, there is a great variety of painkillers, which include prescription and over-the-counter, pills and injections, strong and not so, modern and time-tested drugs. It is not so easy to choose from this variety the remedy that you need right now, so it is better to rely on the knowledge of a doctor and pharmacist. Rely and live without pain.

The article above and comments written by readers are for informational purposes only and do not call for self-medication. Consult with a specialist regarding your own symptoms and diseases. When treating any drug, always use the instructions that come with it in the package, as well as the advice of your healthcare professional, as a basic guideline.

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Nalorius: instructions for use and reviews

Nalorius is an anti-allergic drug.

Release form and composition

Dosage form Nalorius - film-coated tablets: round biconvex shape, slight surface roughness is allowed; the color of the shell of the tablets is blue, the cores are white with a yellowish tinge or white (in a cardboard box 1–3 or 5 blisters of 7 or 10 tablets).

Composition of 1 tablet:

• active substance: desloratadine - 5 mg;
• auxiliary components: croscarmellose sodium - 1.85 mg; microcrystalline cellulose - 14.8 mg; hypromellose - 3.7 mg; calcium hydrogen phosphate dihydrate - 145.4 mg; pregelatinized starch - 5.55 mg; colloidal silicon dioxide (aerosil) - 1.85 mg; magnesium stearate - 1.85 mg;
• shell: simethicone emulsion - 0.033 mg; Opadry II blue (including brilliant blue - 0.38%; titanium dioxide - 23%; indigo carmine - 2.5%; lactose monohydrate - 36%; hypromellose - 28%; polyethylene glycol - 10%; yellow iron oxide - 0.12%) - 4.967 mg.

Pharmacological properties

Pharmacodynamics

Nalorius is a long-acting antihistamine with antipruritic and antiexudative efficacy.

Desloratadine is the primary active metabolite of loratadine. The substance inhibits the cascade of reactions of allergic inflammation. Thanks to its use, the following reactions are observed:

• release of pro-inflammatory cytokines, including interleukin-4, -6, -8, -13, as well as pro-inflammatory chemokines;
• production of superoxide anions by activated polymorphonuclear neutrophils;
• adhesion and chemotaxis of eosinophils;
• isolation of adhesion molecules, in particular P-selectin;
• IgE-mediated release of histamine, leukotriene C4 and prostaglandin D2.

Thus, desloratadine prevents allergic reactions and facilitates their course, reduces capillary permeability, prevents smooth muscle spasms and tissue edema.

Nalorius on the electrocardiogram does not cause prolongation of the QT interval, does not affect the central nervous system, practically does not lead to drowsiness (does not have a sedative effect) and does not affect the speed of psychomotor reactions.

The effect of the drug after taking a single dose develops within 30 minutes, its duration is 24 hours.

Pharmacokinetics

Being well absorbed in the gastrointestinal tract, desloratadine is determined in blood plasma after 30 minutes. The maximum concentration reaches an average of 3 hours.

Penetrates through the placental barrier and into breast milk; does not penetrate the blood-brain barrier.

The connection of desloratadine with plasma proteins is from 83 to 87%. When used in therapeutic doses for a course of 14 days, clinically significant accumulation of the drug does not occur.

Desloratadine is not an inhibitor of CYP3A4 and CYP2D6 isoenzymes and an inhibitor / substrate of P-glycoprotein. The simultaneous intake of Nalorius in a daily dose of 7.5 mg with food / grapefruit juice has no effect on the distribution of the substance.

An intensive metabolism occurs in the liver, by hydroxylation, followed by the formation of 3-OH-desloratadine combined with glucuronide.

Less than 2% of the taken desloratadine is excreted by the kidneys, and up to 7% (in the form of an unchanged substance) through the intestines. The average elimination half-life is 27 hours.

Indications for use

• allergic rhinitis: Nalorius is prescribed to eliminate / relieve the main symptoms, including itchy palate, watery eyes, sneezing, nasal mucus, nasal congestion, itchy nose, redness / itching of the eyes;
• urticaria: to reduce / eliminate the main symptoms, including pruritus, rash.

Contraindications

• lactose intolerance, glucose-galactose malabsorption syndrome and lactase deficiency;
• pregnancy and lactation;
• age up to 12 years;
• individual intolerance to the components of the drug, as well as loratadine.

According to the instructions, Nalorius in patients with severe renal insufficiency should be prescribed under medical supervision (a relative contraindication).

Instructions for use of Nalorius: method and dosage

Nalorius is taken orally with water, preferably regularly at the same time of the day, regardless of the time of the meal. Do not split / chew the tablet.

Scheme of taking Nalorius: 1 tablet once a day.

Patients with seasonal allergic rhinitis (with symptoms lasting up to 4 days a week or less than 4 weeks a year) should be evaluated for their disease. Reception of Nalorius after the disappearance of symptoms should be discontinued, resumption of therapy is possible when symptoms reappear.

With year-round allergic rhinitis (symptoms occur 4 days a week or longer than 4 weeks a year) Nalorius must be taken throughout the entire period of exposure to the allergen.

Side effects

Possible adverse reactions (> 10% - very common;> 1% and< 10% – часто; >0.1% and< 1% – нечасто; >0.01% and< 0,1% – редко; < 0,01% – очень редко):

• digestive system: infrequently - xerostomia; very rarely - diarrhea, vomiting, abdominal pain, dyspepsia, nausea, increased activity of hepatic transaminases, hepatitis, increased concentration of bilirubin;
• cardiovascular system: very rarely - palpitations, tachycardia;
• nervous system: infrequently - headache; very rarely - drowsiness, dizziness, psychomotor hyperactivity, insomnia, hallucinations, convulsions;
• musculoskeletal system: very rarely - myalgia;
• immune system: very rarely - rash, including urticaria, pruritus, shortness of breath, anaphylactic shock, angioedema;
• other reactions: often - increased fatigue.

Overdose

In clinical and pharmacological studies, when taking doses significantly exceeding the recommended ones, the development of serious adverse reactions was not observed.

Desloratadine is not excreted during hemodialysis, the effectiveness of peritoneal dialysis has not been established.

In cases of taking a large amount of Nalorius, you should immediately consult a doctor. Recommended measures: gastric lavage, intake of activated charcoal, symptomatic treatment.

special instructions

Influence on the ability to drive vehicles and complex mechanisms

The ability to drive vehicles during the period of Nalorius therapy is determined individually, based on the reaction to taking the drug, since it is possible to develop such disorders as dizziness, drowsiness, hallucinations.

Application during pregnancy and lactation

Nalorius is not prescribed during pregnancy / lactation.

Childhood use

Nalorius therapy is contraindicated in patients under 12 years of age.

With impaired renal function

Nalorius therapy for severe renal failure should be carried out under medical supervision.

Drug interactions

There were no changes in the concentration of desloratadine, which are of clinical significance, when used together with cimetidine, erythromycin, ketoconazole, fluoxetine and azithromycin.

Analogs

Nalorius's analogs are Ezlor, Elisey, Lordestin, Blogir-3, Erius, Desloratadin, Alestamin, Desal, etc.

Terms and conditions of storage

Store in a place protected from light at temperatures up to 25 ° C. Keep out of the reach of children.

Shelf life is 4 years.

Hard & Strong Tablets are dietary supplements that help treat erectile dysfunction. One package contains 10 oblong black capsules that are engraved with "SV". In the manufacture of additives, only folk remedies, which do not harm the body, but at the same time contribute to the appearance of a long and strong erection.

Supplements do not have a detrimental effect on the body, unlike most synthetic products, because they include natural ingredients.

What are the names of the pills for the blue potency. Drugs to reduce libido in women treatment

These units are weakened to increase potency within minutes before taking. All the sellers of blue, grayish, federalist ones climbed ... Including blue ones. The bandage will renew you to create blue. Sex does not last very much 3 pills, one at a time.

The bald head will grow over in 2 weeks! At least now I have ceased to feel sorry for myself, remembering myself 20 years ago. Well, I don’t know how all this is bullshit for me ..

Interaction with other medicinal products

Inhibitors of isoenzymes CYP3A4 and CYP2C9 (ketoconazole, erythromycin, cimitidine) reduce metabolism and increase the concentration of sildenafil in the blood. In this case, treatment with sildenafil is started with a dose of 25 mg. Simultaneous use with ritonavir Cmax of sildenafil increases by 300%, AUC by 1000% and remains at a high level even a day after taking sildenafil.

Concomitant use with saquinavir Cmax of sildenafil increases by 140%, AUC by 210%. The pharmacokinetics of ritonavir and saquinavir do not change with sildenafil.

Sildenafil enhances the antiplatelet effect of sodium nitroprusside.

The best pills are still pharmaceutical products. So, you need to take them with the "blessing" of a specialist. To minimize the risk of side effects, consult your doctor before using even effective pills. Of course, any of the described means increases what needs to be increased, but they must be taken, taking into account certain limitations.

5th position - Impaza and Vizarsin

The products are similar. In Vizarsin, the active ingredient is a PDE-5 inhibitor - sildenafil.

Impaza refers to homeopathic remedies based on microscopic concentrations of essential substances. In our case - C200, C30, C12.

Impaza requires a longer application - at least three weeks. Vizarsin does not need so much time to add male potential.

But more time means less health risk. Still, homeopathic products like Impaza are based on natural ingredients.

This means that the risk of side effects is minimized.

4th position - Sildenafil

This drug has a bunch of analogues, including the one described above. Almost the entire list is built around the action of the best drugs, which are based on sildenafil. The tool belongs to a series of inhibitors of the fifth type of phosphodiesterase enzyme (already mentioned PDE-5). How do the best tools of this type work?

Inside the penis, in the blood vessels, the amount of nitric oxide increases, which contributes to an increase in the amount of blood in the penis. The concentration of this substance stimulates the production of cyclic guanosine monophosphate - CGMP.

This is necessary to enhance blood flow to the cavernous bodies of the penis. In addition, CGMP supports smooth muscle relaxation function.

All of this is imperative for the penis to be large and strong - within the genetic constraints.

CGMP is inactivated by PDE-5 - the latter converts guanosine monophosphate into 5-guanosine monophosphate. And inhibitors are just designed to inhibit this transformation, which provides an erection and an increase in the duration of intercourse. The effect of the remedy keeps the potency at the proper level for 5-6 hours. Quite enough to feel yourself the most charming and attractive.

3rd position - Levitra

It is a good, promising and popular remedy for combating impotence. It successfully competes with more eminent analogs. Manufactured in Germany. One of the safest of its kind. This has been confirmed by numerous tests.

The action of Levitra is based on vardenafil. The substance is characterized by rapid absorption - the result is "evident" within 30-40 minutes. The effect lasts 4-6 hours.

Instructions for use

Trade name: Dynamico.

International non-proprietary name: Sildenafil.

Chemical name: 1- ((3- (6,7-Dihydro-1methyl-7-oxo-3-propyl-1H-pyrazolo (4,3-alpha) pyrimidin-5-yl) -4-ethoxyphenyl) sulfonyl) piperazine citrate.

Dosage form: film-coated tablets.

Tablets 25 and 50 mg: round biconvex film-coated tablets of blue color; tablets of 100 mg: oval biconvex film-coated tablets of blue color, with a line on both sides.

Pharmacotherapeutic group: erectile dysfunction treatment agent, PDE-5 inhibitor.

Hard and Strong capsules are used to treat erectile dysfunction. They are intended for men who are not less than 18 years old, but not more than 70 years old.

The tool has a number of indications for use, the most basic are:

• sluggish penis with erection;
• premature and rapid ejaculation;
• violation hormonal background;
• low level of sperm motility;
• poor level of genital musculature;
• problems with erection, which were caused by chronic fatigue or overwork, as well as frequent being in a stressful situation or depression;
• lack of erection due to a sedentary lifestyle and poor nutrition;
• age changes reproductive system, as well as for disorders caused by age;
• past diseases of the small pelvis.

Important! The tablets are also intended to prevent the appearance of a disease such as prostatitis. Often used in the treatment of infertility.

Contraindications

"Solid and strong" has a number of contraindications, including they are prohibited for admission to minors and women.

The main contraindications:

• individual intolerance to the funds that make up the capsules;
• serious diseases of the cardiovascular system;
• high pressure;
• atherosclerosis;
• diseases of the nervous system, including nervous irritability and insomnia.

Important! If the penis was injured or inflamed, then before using the pills, you should consult a urologist.

Interaction with other medications

"Hard and strong" is combined with all medications. The exception is drugs and dietary supplements that are used to increase libido.

Does not affect the effectiveness of drugs, and also does not increase their concentration in the blood.

The drug is taken once a day. It can be washed down with plain water or other non-alcoholic drinks. Reception is carried out half an hour before the intended sexual intercourse.

To complete the full treatment course, the tablets are taken within three months. With prophylaxis, the reception is carried out 1 time in 3 days.

Important! For prevention, it is allowed to take small doses of alcoholic beverages. During treatment, you should limit or completely abandon fatty and high-calorie foods.

Ideal for older men. No dosage reduction is required.

Overdose

With an increase in the indicated dosage, side effects may appear, which manifest themselves in the form of:

• nausea and vomiting;
• elevated temperature;
• headaches;
• allergic reactions.

If the symptoms do not go away within a few hours after taking the medicine, then you should immediately contact a medical institution.

Catad_pgroup Antipsychotics (neuroleptics)

Thiodazine - instructions for use

INSTRUCTIONS
(information for specialists)
on the medical use of the drug

Registration number P No. 014622 / 01-2002

Tradename: Thiodazine

International non-proprietary name:

Thioridazine

Chemical name:
10-2- (methylthio) -10H-phenothiazine (as hydrochloride or tartrate)

Dosage form:

film-coated tablets.

Composition of the preparation:
1 film-coated tablet contains:
active substances: Thioridazine hydrochloride 10, 25, 50 or 100 mg
inactive substances: lactose, starch, microcrystalline cellulose, magnesium stearate, colloidal silicon dioxide, talc, eudragit E 100, sodium lauryl sulfate, polyethylene glycol.
Dyes: sunset yellow, indigo carmine, titanium dioxide.

Description:
10 mg tablets: Round, film-coated tablets from light orange to light orange with a pink tinge, scored on one side.
Tablets 25 mg: Round, blue film-coated tablets, scored on one side.
50 mg tablets: Round, yellow film-coated tablets, scored on one side.
100 mg tablets: Round, film-coated tablets of blue color, without dividing lines.

Pharmacotherapeutic group:

antipsychotic agent (neuroleptic).

PBX code .

Pharmachologic effect:
Thioridazine - the active substance of the drug THIODAZIN - belongs to the group of piperidine derivatives of phenothiazine.
The main pharmacological properties of thioridazine are similar to those of other phenothiazines, but its clinical spectrum differs significantly from the spectrum of other drugs in this class. The distinctive features of Thiodazine are its low ability to cause extrapyramidal disorders, its rather pronounced sedative and anxiolytic activity. Has a moderate alpha-adrenergic blocking and M-anticholinergic action. Causes antihypertensive and antiemetic effects. When applying in low doses Thiodazine has an anxiolytic effect. Relieves feelings of tension and anxiety; also effective in mild depressive disorders. With the use of Thiodazin, there is an improvement in the adaptation of patients to the surrounding reality.
When applying in high doses Thiodazine has an antipsychotic effect. Thiodazine has a wide therapeutic range. When used in the recommended dose range, the drug is well tolerated.

Pharmacokinetics:
Suction ... Thiodazine is rapidly absorbed from the gastrointestinal tract. Maximum plasma concentrations are reached 2-4 hours after ingestion. Bioavailability averages about 60%. Significant interindividual variability of this indicator was noted. Protein binding is high (over 95%).
Thiodazine crosses the placenta and is excreted in breast milk. Thiodazine and its main metabolites (sulforidazine and mesoridazine) cross the blood-brain barrier and are found in the cerebrospinal fluid. The ratio of the concentration of metabolites in the cerebrospinal fluid to their plasma concentration is higher than the same ratio for the unchanged drug, which indicates the significant role of metabolites in the implementation of the antipsychotic effect of the drug.
Excretion. Excretion is carried out mainly with feces (50%), as well as through the kidneys (less than 4% in the form of an unchanged drug, about 30% in the form of metabolites). The plasma half-life is approximately 10 hours.

Indications for use:

A) Schizophrenia and other psychoses

Treatment of exacerbations of schizophrenia.

Treatment of chronic schizophrenia. Thiodazine is also indicated for long-term treatment inpatients and long-term maintenance treatment of outpatients with schizophrenia.
B) Anxiety and Depression Syndromes

In psychiatric practice - as monotherapy or as part of combination therapy for patients with agitated depression.

In general medical practice - as a sedative and anxiolytic - the treatment of a variety of syndromes characterized by anxiety, a combination of anxiety and depression, tension and agitation, psychosomatic disorders and emotional disorders.

Long-term treatment of mixed anxiety-depressive states or psychotic depression.
B) Indications in geriatric practice

As a neuroleptic and antipsychotic agent - the treatment of severe cognitive and behavioral disorders in geriatric patients with organic brain damage of varying severity.

As an anxiolytic or sedative - treatment of anxiety, mixed anxiety-depressive states, senile agitation and insomnia.
G) Indications in pediatric practice

As a neuroleptic - treatment of childhood schizophrenia, as well as severe behavioral disorders against the background of mental retardation and organic brain damage.

As an anxiolytic or sedative - treatment of states of anxiety, tension, agitation; treatment of concentration disorders in children with severe behavioral abnormalities; treatment of cases of hyperactivity, resistant to stimulant drugs; treatment of sleep disorders.
D) Other indications

Treatment of severe behavioral disorders in mentally retarded adults and patients with symptomatic deficits.

To reduce the severity of such mental manifestations as anxiety, agitation, hostility and hallucinations in alcohol withdrawal syndrome.

Vomiting of central genesis.

Contraindications:

Hypersensitivity to thioridazine hydrochloride, thioridazine base or any other component of the drug. Comatose states or states of severe depression of the central nervous system, anamnestic information about serious hematological diseases, in particular, inhibition of bone marrow hematopoiesis.
Anamnestic information about hypersensitivity reactions, such as severe photosensitivity or hypersensitivity to other phenothiazines.
Severe heart disease, especially clinically significant arrhythmias (in particular, ventricular tachycardia). Pregnancy, breastfeeding period.
Thiodazine should not be given to children under 2 years of age.

Method of administration and dosage:

The dose and time of taking the drug should be selected individually, depending on the disease and the severity of symptoms. It is recommended to start treatment with doses at the lower end of the specified range. Then, in the course of treatment, the dose is gradually increased until the maximum effective dose is reached. Upon reaching the maximum therapeutic effect the dose is gradually reduced to a maintenance dose. The daily dose is usually divided into 2-4 doses.
Schizophrenia and other psychoses
Exacerbations of schizophrenia in adult hospitalized patients: 100-600 mg / day - up to a maximum dose of 800 mg / day.
Chronic schizophrenia: 100-600 mg / day. in hospitalized patients; 50-300 mg / day - in outpatients.
Anxiety and Depression Syndromes
In psychiatric practice, patients with agitated depression: 25-200 mg / day.
In general medical practice, as a sedative and anxiolytic: 10-75 mg / day.
In geriatric practice
As a neuroleptic / antipsychotic agent: 25-200 mg / day. As anxiolytic / sedative: 10-75 mg / day.
In pediatric practice
As a neuroleptic for the treatment of severe mental and emotional disorders in children over the age of 2 years: 1-3 mg / kg / day.
As an anxiolytic / sedative in children over 2 years of age: 0.5-2 mg / kg / day.
Other indications
Treatment of severe behavioral disorders in mentally retarded adult patients and patients with symptomatic deficiency: 100-600 mg / day; the maximum dose is 800 mg / day. To reduce the severity of mental disorders in alcohol withdrawal syndrome: 100-200 mg / day.
Treatment of patients with underweight, impaired renal and / or liver function, as well as elderly patients and children is recommended to be carried out under close supervision and to start with especially small doses and increase them very slowly.
In patients with schizophrenia who are in hospital, a clear positive effect is usually achieved after 2-3 weeks or more from the start of treatment. In patients with chronic psychosis, it may take 6 weeks to 6 months to achieve the maximum effect. In contrast, in patients with acute psychosis, improvement in condition can be noted within 24-48 hours.
In the case of cancellation of long-term therapy with Thiodazine, it is recommended to reduce its dose gradually, over several weeks, since sudden cancellation in patients who received the drug for a long time or in high doses can in some cases lead to such phenomena as nausea, vomiting, tremors, dizziness, anxiety, agitation, insomnia, transient dyskinesia. These phenomena can create the erroneous impression of a depressive or psychotic state in the patient.

Side effect:

Side effects of Thiodazine, like other phenothiazines, depend on the dose and, as a rule, are due to the pronounced pharmacological effects of the drug. When using the drug in the recommended dose range, adverse events in most cases are mild and transient. Severe events are noted with the use of high doses of Thiodazine.
From the side of the central nervous system: sedation, drowsiness; dizziness; sometimes - impaired consciousness, psychomotor agitation, hallucinations, increased irritability, headache; rarely - convulsions, extrapyramidal symptoms (tremor, muscle rigidity, akathisia, dyskinesia, dystonia), tardive dyskinesia; very rarely - depression, insomnia, neuroleptic malignant syndrome.
From the autonomic nervous system / anticholinergic effects: often - dry mouth, blurred vision, paresis of accommodation, nasal congestion; sometimes nausea, vomiting, diarrhea, constipation, loss of appetite, retention or urinary incontinence; rarely - pallor, tremor; very rarely - paralytic intestinal obstruction.
On the part of the cardiovascular system: often - orthostatic hypotension; sometimes ECG changes (lengthening of the QT interval), tachycardia; rarely - arrhythmias; very rarely - atrial fibrillation, ventricular fibrillation, sudden death.
From the side endocrine system: often, with prolonged use - hyperprolactinemia, galactorrhea; sometimes - amenorrhea, menstrual irregularities, changes in body weight, erectile dysfunction and ejaculation; rarely priapism; very rarely - engorgement of the mammary glands, gynecomastia, peripheral edema.
From the peripheral blood: rarely - leukopenia, agranulocytosis, thrombocytopenia; very rarely - anemia, leukocytosis.
From the liver: sometimes - deviations from the normal activity of liver enzymes; rarely hepatitis.
From the side of the skin: rarely - dermatitis, skin rash (including allergic), urticaria, increased photosensitivity, angioedema.
Others: rarely - edema in the parotid gland, hyperthermia, respiratory depression. With long-term therapy with Thiodazine, there are reports of rare cases of retinopathy pigmentosa that developed in patients who received the drug in a dose exceeding the recommended maximum dose of 800 mg per day. Drug interactions:
Cytochrome-mediated metabolism P450 2B6. THIODAZINE is metabolized by the enzyme cytochrome P450 2B6, and, in addition, itself is an inhibitor of this metabolic pathway. In this regard, drugs that inhibit this isoenzyme (for example, cimetidine, fluoxetine, paroxetine, moclobemide) can enhance and lengthen the effects of Thiodazine.
Tricyclic antidepressants... The simultaneous use of tricyclic antidepressants and phenothiazine derivatives can lead to an increase in the plasma concentration of these drugs and / or a phenothiazine derivative, which can lead to cardiac arrhythmias.
Anticonvulsants. Thiodazine, like other phenothiazines, can lower the seizure threshold. With simultaneous use with Thiodazine, an increase or decrease in the serum concentration of phenytoin is possible, in connection with which a correction of its dose may be required. With the combined use of Thiodazine and carbamazepine, the concentrations of these drugs in serum do not change.
Antihypertensive drugs and beta-blockers. Due to the suppression of metabolism, the combined use of these drugs with Thiodazine can lead to an increase in plasma concentrations of each of the drugs, which probably can lead to severe hypotension, cardiac arrhythmias or side effects from the central nervous system.
Indirect anticoagulants. Combined use with Thiodazine can cause an increase in the hypoprothrombinemic effect, which is mainly associated with competitive interaction at the enzyme level. In this case, careful monitoring of the concentration of prothrombin in plasma is necessary.
Drugs with a depressing effect on the central nervous system. Thiodazine can enhance the effects of alcohol and other drugs that have a depressing effect on the central nervous system, benzodiazepines, narcotic analgesics, barbiturates, antidepressants and anesthetics.
MAO inhibitors... The simultaneous use of an MAO inhibitor and Thiodazine can lengthen and enhance the sedative and antimuscarinic effect of each of the drugs.
Lithium preparations... It is possible that severe neurotoxic complications, extrapyramidal disturbances and somnambulism may occur in patients who received concomitantly a lithium drug and a phenothiazine derivative, including Thiodazine.
Anticholinergic drugs... With simultaneous use with Thiodazine, it is possible to increase the anticholinergic effects of M-anticholinergics (atropine-like drugs), antihistamines and tricyclic antidepressants, up to such manifestations as "atropine psychosis", severe constipation, paralytic intestinal obstruction, hyperpyrexia with possible heat stroke. In these cases, careful monitoring of the patient and dose adjustments are indicated.
Antiparkinsonian drugs. With the simultaneous use of Thiodazine and levodopa, the effects of each of the drugs may be weakened.
Vasoconstrictor drugs. Due to its β-adrenergic blocking properties, Thiodazine can weaken the pressor effect of vasoconstrictors (epinephrine, dopamine, ephedrine, phenylephrine).
Quinidine... With the simultaneous use of quinidine and thiodazine, it is possible to increase the inhibitory effect of quinidine on the myocardium.
Antiarrhythmics / QT interval prolongation... Considering that phenothiazines, including Thiodazine, can cause such ECG changes as prolongation of the QT interval, caution should be exercised when they are used simultaneously with drugs that have similar properties.
Thiazide diuretics.... The simultaneous use of Thiodazine and a thiazide diuretic can lead to severe arterial hypotension. In addition, diuretic-induced hypokalemia may enhance the cardiotoxic effects of Thiodazine.
Antidiabetic drugs. Thiodazine affects carbohydrate metabolism, and therefore, when used, the patient's stable condition, achieved during treatment with antidiabetic agents, can be disturbed.
Antacids and antidiarrheals may reduce the absorption of Thiodazine from the gastrointestinal tract. Warnings
Use with extreme caution in patients with glaucoma (especially the closed-angle form), with cardiovascular diseases, severe respiratory diseases, renal failure, Parkinson's disease, epilepsy, prostatic hypertrophy, myasthenia gravis, pheochromocytoma.
During the period of treatment with Thiodazine, alcohol is prohibited, as well as driving vehicles, working with mechanisms and other activities that require a quick reaction. Overdose.
Strengthening side effects, the appearance of acute neuroleptic reactions. An increase in body temperature, which may be one of the symptoms of neuroleptic malignant syndrome, should be especially alarming. In severe cases of overdose, various forms of impairment of consciousness, up to coma, can be observed.
Aid measures: discontinuation of therapy with Thiodazine and any other antipsychotic drugs (neuroleptics), prescription of correctors (central anticholinergics), administration of high doses of activated charcoal, gastric lavage, with convulsions, intravenous diazepam, glucose solution, nootropic drugs, vitamins B and C, careful monitoring of the functions of the cardiovascular, respiratory and central nervous systems, symptomatic therapy.
In case of seizures, barbiturates should be avoided, as they can increase respiratory depression caused by phenothiazine derivatives.

Release form:

10 tablets in aluminum strips, 10 strips in a cardboard box.

Terms of dispensing from pharmacies:

List B.
Dispensed by prescription.

Storage conditions:

At a temperature not higher than + 25 ° C, in a dry, dark place, out of the reach of children.

Shelf life:

4 years.
Do not use after the expiration date.

Manufacturer:

San Pharmaceutical Industries Ltd., India. 117420, st. Profsoyuznaya, house 57, office 722

Iruzid: instructions for use and reviews

Iruzid is a combined drug with an antihypertensive, diuretic effect.

Release form and composition

Iruzid dosage form - tablets: biconvex; 10 + 12.5 mg - of blue color, hexagonal; 20 + 12.5 mg - yellow, hexagonal; 20 + 25 mg - light pink, round (30 pcs. In blisters, in a cardboard box 1 blister).

Active ingredients in 1 tablet:

• lisinopril dihydrate (in terms of anhydrous lisinopril) - 10/20/20 mg;
• hydrochlorothiazide - 12.5 / 12.5 / 25 mg.

Additional components: indigo carmine, mannitol, calcium phosphate dihydrate, pregelatinized and corn starch, magnesium stearate.

Pharmacological properties

Pharmacodynamics

Iruzid is a combined antihypertensive drug. It has a diuretic and antihypertensive effect.

When combined, the active ingredients have an additive antihypertensive effect.

Lisinopril

Lisinopril is one of the ACE inhibitors (angiotensin converting enzyme), helps to reduce the formation of angiotensin II from angiotensin I. A decrease in the content of angiotensin II leads to a direct decrease in the release of aldosterone.

Other effects of lisinopril:

• a decrease in the degradation of bradykinin and an increase in the synthesis of prostaglandins;
• decrease in total peripheral vascular resistance, blood pressure (blood pressure), preload, pressure in the pulmonary capillaries;
• increased exercise tolerance and increased minute blood volume in patients with chronic heart failure;
• vasodilation (arteries more than veins);
• a decrease in the severity of myocardial hypertrophy and the walls of resistive arteries (with prolonged therapy);
• improving the blood supply to the ischemic myocardium;
• prolongation of life expectancy in patients with chronic heart failure;
• slowing the progression of left ventricular dysfunction in patients who have had myocardial infarction without clinical manifestations of heart failure.

Some of the effects are attributed to the effect on tissue renin-angiotensin systems.

The antihypertensive effect begins to develop after about 6 hours, the effect lasts for 24 hours. The duration of the effect also depends on the size of the dose. The effect in arterial hypertension is observed in the first days after the start of therapy, a stable effect develops after 1–2 months.

In the case of abrupt withdrawal of Iruzid, a pronounced increase in blood pressure is not observed.

In addition to lowering blood pressure, lisinopril also reduces albuminuria. With hyperglycemia, taking Iruzid helps to normalize the function of the damaged glomerular endothelium.

Lisinopril does not affect the concentration of glucose in the blood in diabetic patients. Also, therapy does not cause an increase in the incidence of hypoglycemia.

Hydrochlorothiazide

Hydrochlorothiazide is a thiazide diuretic. Its diuretic effect is associated with impaired reabsorption of magnesium, potassium, sodium, chlorine, and water ions in the distal nephron. The development of hypotensive action is provided by the expansion of arterioles. It has antihypertensive properties, delays the excretion of uric acid and calcium ions.

It practically does not affect normal blood pressure.

The development of diuretic action is observed after 1–2 hours, reaching a maximum after 4 hours. The duration of the effect is from 6 to 12 hours.

The antihypertensive effect develops after 3-4 days, but it may take 3 to 4 weeks for the optimal therapeutic effect to be achieved.

Pharmacokinetics

Lisinopril

It is absorbed from the gastrointestinal tract quickly, absorption does not depend on food intake and is 30%. C max is observed after 6-8 hours from the moment of taking the drug. The connection with blood proteins is weak, bioavailability is 29%. It penetrates through the blood-brain barrier in insignificant quantities. It is excreted unchanged by the kidneys, without biotransformation in the body, the half-life is 12 hours.

Hydrochlorothiazide

Absorption of hydrochlorothiazide - 60-80%, does not depend on food intake. The maximum concentration in the blood is observed after 3 hours from the moment of taking the drug. It binds to blood proteins by 40–70%, accumulates in erythrocytes, and is poorly metabolized.

Excretion from the body occurs in two phases, mainly with urine.

Indications for use

According to the instructions, Iruzid is prescribed for the treatment of arterial hypertension if there are indications for combination therapy.

Contraindications

Absolute:

• anuria;
• severe renal failure (with creatinine clearance< 30 мл/мин);
• angioedema (including a burdened history of this condition associated with the use of ACE inhibitors);
• hemodialysis using high-flow membranes;
• hypercalcemia;
• hyponatremia;
• porphyria;
• precom;
• hepatic coma;
• diabetes mellitus in severe forms;
• age under 18;
• pregnancy and breastfeeding period;
• individual intolerance to the components of the drug, as well as other ACE inhibitors and sulfonamide derivatives.

Relative (diseases / conditions in the presence of which the appointment of Iruzid requires caution):

• primary hyperaldosteronism;
• hypertrophic cardiomyopathy / aortic stenosis;
• stenosis of the artery of a single kidney, proceeding with progressive azotemia;
• bilateral renal artery stenosis;
• renal failure (with creatinine clearance> 30 ml / min);
• conditions after kidney transplantation;
• bone marrow hypoplasia;
• arterial hypotension;
• hypovolemic conditions (including diarrhea, vomiting);
• hyponatremia (in patients on a low-salt or salt-free diet, there is an increased risk of developing arterial hypotension);
• diabetes;
• connective tissue diseases (scleroderma, systemic lupus erythematosus);
• oppression of bone marrow hematopoiesis;
• gout;
• hyperkalemia;
• hyperuricemia;
• cerebrovascular diseases (including cerebrovascular insufficiency);
• cardiac ischemia;
• liver failure;
• severe chronic heart failure;
• elderly age.

Instructions for the use of Iruzid: method and dosage

The drug is taken orally.

Usually, 1 tablet is prescribed (10 + 12.5 mg or 20 + 12.5 mg, in some cases 20 + 25 mg) once a day.

The use of Iruzid in renal failure:

• uncomplicated renal failure: initial dose - 5-10 mg of lisinopril;
• creatinine clearance 30–80 ml / min: the drug can be prescribed only after selecting the dose of individual components.

Symptomatic hypotension may develop after taking the initial dose of Iruzid. Most often, such cases are observed in patients who have had a loss of electrolytes and fluid due to the previous use of diuretics. In this regard, before taking the drug for 2-3 days, diuretic therapy is canceled.

Side effects

Disorders that most often develop during therapy are headache, dizziness.

Other adverse reactions:

• digestive system: taste changes, dry mouth, nausea, vomiting, abdominal pain, dyspepsia, diarrhea, anorexia, jaundice, pancreatitis, cholestatic / hepatocellular hepatitis;
• cardiovascular system: chest pain, marked decrease in blood pressure; rarely - tachycardia, orthostatic hypotension, bradycardia, violation of atrioventricular conduction, the appearance of symptoms of heart failure, myocardial infarction;
• skin: pruritus, urticaria, photosensitivity, increased sweating, hair loss;
• respiratory system: bronchospasm, dyspnea, apnea;
• nervous system: convulsive twitching of the muscles of the limbs and lips, drowsiness, impaired concentration, mood lability, paresthesia, increased fatigue; rarely - confusion, asthenic syndrome;
• genitourinary system: oliguria / anuria, uremia, impaired renal function, decreased potency, acute renal failure;
• hematopoietic system: anemia (erythrocytopenia, decreased hematocrit, hemoglobin content), leukopenia, thrombocytopenia, agranulocytosis, neutropenia;
• laboratory parameters: hypochloremia, hyperglycemia, hyperuricemia, hypokalemia / hyperkalemia, hypomagnesemia, hyponatremia, hyperbilirubinemia, hypertriglyceridemia, hypercholesterolemia, hypercalcemia, increased plasma levels of creatinine and urea in the blood, decreased tolerance of liver glucose tolerance, increased liver transmissibility kidney disease, renovascular hypertension and diabetes mellitus;
• allergic reactions: angioedema of the face, extremities, tongue, lips, larynx and / or epiglottis, eosinophilia, skin rashes, increased ESR, pruritus, vasculitis, fever, positive reactions to antinuclear antibodies;
• others: exacerbation of gout, impaired fetal development, dry cough, arthritis, arthralgia, fever, myalgia.

Overdose

The main symptoms are: dry mouth, marked decrease in blood pressure, drowsiness, anxiety, urinary retention, constipation, irritability.

Therapy: symptomatic; intravenous fluid administration, control of blood pressure, urea, electrolytes and serum creatinine, as well as diuresis; measures aimed at correcting violations of the water-salt balance and dehydration.

special instructions

Most often, a pronounced decrease in blood pressure is observed with a decrease in fluid volume, which is caused by the use of diuretics, a decrease in the amount of salt in food, dialysis, vomiting, or diarrhea.

In chronic heart failure with / without renal failure, a marked decrease in blood pressure is also possible. This is most often seen in patients with severe heart failure as a result of high-dose diuretic therapy, impaired renal function, or hyponatremia. In such cases, it is necessary to start taking Iruzid under strict medical supervision. The same rules must be followed when prescribing the drug for ischemic heart disease, cerebrovascular insufficiency, since a sharp drop in blood pressure can cause a stroke or myocardial infarction.

A transient hypotensive reaction is not a contraindication for further administration of Iruzid.

Before starting therapy, if possible, it is necessary to normalize the sodium concentration indicators and / or replenish the lost volume of fluid; after taking the initial dose, the patient's condition should be closely monitored.

In chronic heart failure, a pronounced decrease in blood pressure after initiation of therapy may cause further deterioration in renal function. There is information about the development of acute renal failure. In patients with stenosis of the artery of a solitary kidney or bilateral stenosis of the renal arteries, who received Iruzid, there was an increase in the level of creatinine and urea in the blood serum (as a rule, it is reversible).

In cases of the development of angioedema of the face, extremities, tongue, lips, larynx, epiglottis, the drug is immediately canceled, after which the patient's condition is monitored. If the swelling occurs only on the lips and face, additional therapy is often not required, but antihistamines may be prescribed. Angioedema with laryngeal edema can be fatal. When covering the tongue, larynx or epiglottis, airway obstruction is possible, therefore, immediate treatment (subcutaneously 0.3-0.5 ml of epinephrine solution 1: 1000) and / or measures to ensure airway patency is required.

In patients with a history of angioedema not associated with previous use of ACE inhibitors, an increased risk of its development is usually observed during the period of use of Iruzid.

During treatment, there may be a prolonged, dry cough, which passes after discontinuation of the drug (must be taken into account when making a differential diagnosis).

Anaphylactic reactions can also occur in patients who are on hemodialysis using dialysis membranes with high permeability. In such cases, it is recommended to consider the use of another drug with an antihypertensive effect or a different type of dialysis membrane.

It should be borne in mind that the use of Iruzid during major surgery or during general anesthesia can block the formation of angiotensin II. A pronounced decrease in blood pressure, which is considered a consequence of this mechanism, can be eliminated by increasing the volume of circulating blood. Before surgery (including dentistry), the surgeon / anesthesiologist should be warned about taking the drug.

In some cases, taking Iruzid is accompanied by hyperkalemia. Risk factors include diabetes mellitus, renal failure, combined use with potassium preparations or drugs that increase the concentration of potassium in the blood, especially against the background of impaired renal function. In patients who have the likelihood of symptomatic hypotension (following a low-salt / salt-free diet) with / without hyponatremia, as well as in patients receiving high doses of diuretics, the conditions listed above should be compensated for before starting therapy.

Thiazide diuretics can affect glucose tolerance, and therefore the dose of antidiabetic drugs must be adjusted.

Thiazide diuretics can cause hypercalcemia and decrease urinary calcium excretion. Severe hypercalcemia may be a symptom of latent hyperparathyroidism. It is not recommended to use the drug before the test to assess the function of the parathyroid glands.

During the period of therapy, it is necessary to regularly monitor blood plasma glucose, potassium, urea, fats and lipids.

The use of alcoholic beverages during the use of Iruzid must be abandoned, since ethanol leads to a significant decrease in blood pressure.

Care must be taken when exercising and during hot weather, as there is the possibility of dehydration and an excessive drop in blood pressure, which is associated with a decrease in circulating blood volume.

Influence on the ability to drive vehicles and complex mechanisms

Due to the likelihood of dizziness, care must be taken when driving vehicles, especially at the beginning of the use of the drug.

Application during pregnancy and lactation

Pregnancy and lactation are contraindications for taking Iruzid.

The use of the drug in the II – III trimesters of pregnancy adversely affects the fetus. Possible consequences: hyperkalemia, renal failure, cranial hypoplasia, marked decrease in blood pressure, intrauterine death. For the condition of newborns / infants who have been exposed to intrauterine exposure to the drug, it is recommended to establish observation.

Childhood use

Patients under 18 years of age are not prescribed Iruzid (the safety and effectiveness of its use have not been established).

With impaired renal function

With severe renal failure (with creatinine clearance< 30 мл/мин) применять препарат противопоказано, при клиренсе креатинина >30 ml / min Iruzid should be used with caution.

For violations of liver function

In case of liver failure, the drug should be used with caution.

Use in the elderly

Elderly patients should take Iruzid with caution.

Drug interactions

Possible interactions:

• vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, ethanol: increased hypotensive effect of Iruzid;
• potassium-sparing diuretics (triamterene, spironolactone, amiloride), potassium preparations, salt substitutes with potassium content: an increase in the likelihood of hyperkalemia, especially against the background of impaired renal function (before prescribing this combination, the doctor must assess the benefit-risk ratio; regular monitoring of serum potassium levels is required and renal function);
• lithium preparations: slowing down the elimination of lithium from the body (increasing its neurotoxic / cardiotoxic effect);
• non-steroidal anti-inflammatory drugs, estrogens: reducing the antihypertensive effect of lisinopril;
• salicylates: increased neurotoxicity;
• antacids, cholestyramine: decreased absorption of the drug in the gastrointestinal tract;
• cardiac glycosides: enhancing their effects (including side effects);
• oral hyperglycemic drugs, norepinephrine, epinephrine, drugs with an anti-gout effect: weakening their action;
• quinidine: a decrease in its excretion;
• peripheral muscle relaxants: enhancing their action;
• ethanol: enhancement of the hypotensive effect of Iruzid;
• oral contraceptives: decrease in their effectiveness;
• methyldopa: an increase in the likelihood of hemolysis.

Analogs

Iruzid's analogues are: Ko-Diroton, Lisinopril ND-Krka, Lisinopril NL 20-Krka, Lisinopril NL-Krka, Listril Plus, Liten N, Lizoretik, Rileis-Sanovel plus.

Terms and conditions of storage

Store at temperatures up to 25 ° C. Keep out of the reach of children.

Shelf life is 3 years.