Analgin-quinine tablets, No. 20

• Pain syndrome of various etiologies (including headache, neuralgia, arthralgia, myalgia, myositis, algomenorrhea, postoperative pain);

• renal and biliary colic (in combination with antispasmodics);

• feverish conditions in infectious and inflammatory diseases.

Inside, without chewing, after eating, drinking plenty of fluids.

Adults and children over 14 years old: 1-2 tables. 1-3 times a day, depending on the severity of clinical symptoms.

Children 12-14 years old: 1 table. 3 times a day, depending on the severity of the clinical symptoms.

The duration of taking the drug (without consulting a doctor) as an antipyretic agent - no more than 3 days, as an analgesic agent - no more than 5 days.

Special patient groups

Patients over 65 years of age. No dose reduction is usually required. In patients with age-related impairment of kidney and liver function, treatment should be carried out using 1/2 of the recommended adult dose for a short period of time.

Liver dysfunction. In patients with impaired liver functions, an increase in T1 / 2 of metamizole sodium metabolites is possible. In patients with moderate or severe liver damage, treatment with 1/2 of the recommended adult dose is recommended.

Renal dysfunction. Metamizole sodium and its metabolites are excreted by the kidneys. In patients with impaired renal function, treatment should be carried out using 1/2 the recommended adult dose.

Film-coated tablets

1 tab.

active substances:

metamizole sodium (as 100%) 200 mg

quinine hydrochloride 50 mg

excipients: MCC (Avicel RN101) - 75 mg; sodium carboxymethyl starch (primogel) - 26 mg; kollidone 25 (povidone) - 3 mg; talc - 5 mg; magnesium stearate - 1 mg film shell: talc - 4.1 mg; titanium dioxide - 1.3005 mg; eudragid L12.5P (methacrylic acid and methyl methacrylate copolymer) - 1.6832 mg; macrogol 400 - 1.1 mg; glycerol - 0.28 mg; castor oil - 0.036 mg; pigment green dye (quinoline yellow dye E104 + blue patented VE131) - 0.0001 mg

• Severe liver dysfunction;

• severe renal dysfunction;

• bronchial asthma;

• asthma caused by taking salicylates or other NSAIDs;

• diseases accompanied by bronchospasm;

• hereditary hemolytic anemia caused by a deficiency of glucose-6-phosphate dehydrogenase;

• oppression of hematopoiesis (agranulocytosis, neutropenia, leukopenia);

• severe myasthenia gravis;

• diseases of the middle and inner ear, hearing loss;

• optic neuritis;

• children under 12 years of age;

• hypersensitivity to the components of the drug, as well as to other pyrazolone derivatives.

• The drug should be prescribed with caution in case of hypersensitivity to other NSAIDs, food, drug or other forms of allergy (including hay fever, bronchial asthma), granulocytopenia (control of hematological parameters is necessary.)

pharmachologic effect

Combined drug. Metamizole sodium is a pyrazolone derivative and has an analgesic, antipyretic and weak anti-inflammatory effect, the mechanism of which is associated with inhibition of prostaglandin synthesis by inhibiting COX.

Quinine inhibits the center of thermoregulation, in high doses - the auditory and visual zones of the cerebral hemispheres. Also, quinine inhibits the development of erythrocytic forms of schizonts and malaria gamonts, suppressing DNA replication, and has a local irritating and local anesthetic effect.

The pharmacological action develops 20-40 minutes after taking the drug and reaches a maximum after 2 hours.

Side effect

From the digestive system: nausea, vomiting, pain and discomfort in the epigastric and abdominal regions, diarrhea; rarely - ulceration of the gastrointestinal tract mucosa, bleeding from the gastrointestinal tract.

From the side of the central nervous system and peripheral nervous system: headache, dizziness, fatigue, insomnia, tremors of the extremities.

From the senses: tinnitus and hearing impairment, visual impairment (blurred vision, scotoma, photophobia, diplopia, decreased visual fields, impaired color vision).

From the side of the cardiovascular system: angina pectoris, palpitations, fainting.

From the hematopoietic system: leukopenia, agranulocytosis, hypoprothrombinemia.

From the urinary system: impaired renal function (including oliguria, anuria, proteinuria), water and electrolyte retention.

Allergic reactions: sometimes - itching, eczema, enanthema, urticaria, angioedema; rarely - anaphylactic shock; in some cases - malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), bronchospastic syndrome.

Others: increased body temperature.

Application during pregnancy and lactation

The drug is contraindicated during pregnancy and lactation (breastfeeding).

If necessary, the appointment during lactation should decide on the termination of breastfeeding.

Application for violations of liver function

The drug should be prescribed with caution to patients with impaired liver function. Contraindicated in severe liver dysfunction.

Application for impaired renal function

The drug should be prescribed with caution to patients with impaired renal function. Contraindicated in severe renal impairment.

Application in children

Contraindication: children under 12 years of age.

special instructions

While taking the drug, you should not use X-ray contrast agents, colloidal blood substitutes and penicillin.

With prolonged (more than 7 days) use of the drug, it is necessary to control the picture of peripheral blood.

Do not use the drug for acute abdominal pain (until the cause is clarified).

In the event of side effects (including those not mentioned above), the patient should stop taking the drug and consult a doctor.

Analgin-Quinine can be used concomitantly with antibiotics, chemotherapeutic agents, and vitamins.

In patients suffering from bronchial asthma and pollinosis, hypersensitivity reactions may develop.

Influence on the ability to drive vehicles and use mechanisms

During the period of taking the drug, you should not drive vehicles and work with mechanisms, because there is a risk of decreased ability to concentrate and speed of psychomotor reactions.

Overdose

Symptoms: nausea, vomiting (including bloody), melena, epigastric pain, agranulocytosis, aplastic anemia, hemorrhagic diathesis, dizziness, tinnitus, clonic and tonic convulsions, cardiotoxic effect, skin rash (bullous, petechial, bark - or typhoid), anaphylactic shock, coma is possible.

Treatment: gastric lavage, prescription of laxatives and gastroprotective drugs, forced diuresis, respiratory restoration, anti-shock measures, restoration of the BCC; if necessary - symptomatic therapy, with the development of seizures - IV barbiturates and diazepam. There is no specific antidote.

Drug interactions

The simultaneous use of metamizole sodium with other analgesics-antipyretics can lead to mutual intensification of toxic effects.

Tricyclic antidepressants, oral contraceptives, allopurinol disrupt the metabolism of metamizole sodium in the liver and increase its toxicity.

Barbiturates and phenylbutazone weaken the effect of sodium metamizole.

Sedatives and tranquilizers enhance the analgesic effect of metamizole sodium.

Metamizole sodium enhances the effect of ethanol-containing drinks.

Metamizole sodium, displacing oral hypoglycemic drugs, indirect anticoagulants, GCS and indomethacin from the connection with protein, enhances their effect.

Quinine can potentiate the action of drugs that block neuromuscular transmission.

Quinine increases the concentration of digoxin in the blood plasma and enhances its effect.

Cimetidine decreases clearance and increases T1 / 2 of quinine.

The simultaneous use of Analgin-Quinine with cyclosporine reduces the level of the latter in the blood.

Microsomal oxidation inducers accelerate metabolism and reduce the effectiveness of the drug; microsomal oxidation inhibitors increase the effectiveness and the risk of side effects.

With simultaneous use with thiamazole and sarcolysin, the risk of developing leukopenia increases.

Codeine, propranolol enhance the action of Analgin-Quinine.