Grippostad C caps 375.5mg #10

Grippostad C instruction

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Grippostad C - a drug for the symptomatic treatment of acute respiratory diseases.

Release form and composition

Dosage form - capsules: size No. 1, hard gelatin, opaque, with a body of white and yellow cap; contents - powder from white to white with a yellowish tint (10 pcs. each in blister packs, in a cardboard bundle of 1 or 2 packs and instructions for use of Influenza C).
The content of active substances in 1 capsule:
    paracetamol - 200 mg;
    ascorbic acid - 150 mg;
    caffeine - 25 mg;
    chlorphenamine maleate (chlorphenamine) - 2.5 mg.
Additional components:
    excipients: gelatin, glyceryl tristearate, lactose monohydrate;
    capsule composition: case - gelatin, titanium dioxide (E 171), water; cap - gelatin, titanium dioxide (E 171), water, dyes quinoline yellow (E 104) and yellow “Sunny sunset” (E 110).

Pharmacodynamics

Grippostad C is a preparation of combined composition, the components of which determine its symptomatic effect against signs of colds.
Properties of the active substances of the capsules:
    paracetamol - has an antipyretic and analgesic effect;
    ascorbic acid - improves the tolerance of paracetamol and lengthens its effect (slowing down excretion), increases the body's resistance to infections. Participates in tissue regeneration, blood coagulation and carbohydrate metabolism, the regulation of redox processes, the synthesis of steroid hormones. Reduces the need for pantothenic and folic acids, vitamins A, B1, B2, E. Reduces vascular permeability;
    caffeine - has a general tonic effect on the body, stimulates the heart, tones the blood vessels of the brain, dilates the bronchi, has an antispasmodic effect;
    chlorphenamine - is a blocker of histamine H1 receptors, that is, it has an anti-allergic effect, which reduces nasal congestion, reduces lacrimation, sneezing and nasal discharge.
In combination, the active substances of Grippostad C reduce the symptoms of fever and malaise in acute respiratory viral infections and other colds.

Pharmacokinetics

    paracetamol: getting into the gastrointestinal tract, is rapidly and completely absorbed. The maximum concentration in the blood (Cmax) reaches within 30-60 minutes. It is quickly distributed over most body tissues, penetrates the placenta and into breast milk. When used in therapeutic concentrations, plasma proteins bind slightly, with increasing concentration, binding increases. It undergoes primary metabolism in the liver. It is excreted mainly in the urine in the form of sulfate and glucuronide compounds. The half-life (T½) is 1-3 hours. Under the influence of mixed oxidases, a small amount of hydroxylated metabolite is formed in the liver, which is usually neutralized by binding to glutathione, however, with an overdose it can accumulate and cause liver damage;
    ascorbic acid: after oral administration, it is absorbed in the proximal small intestine. It binds to plasma proteins by 25%. It easily penetrates into platelets and white blood cells, as well as into all tissues. It reaches the highest concentration in the liver, white blood cells, and the lens of the eye. It crosses the placenta and into breast milk. Metabolization is mainly carried out in the liver, where it is first converted to deoxy-ascorbic acid, then to oxalacetic acid and ascorbate-2-sulfate. It is excreted unchanged and in the form of metabolites by the kidneys, through the intestines and with sweat;
    caffeine: after oral administration, it is rapidly and completely absorbed. Cmax reaches between 5 and 90 minutes after fasting. In adults, it is excreted almost completely by hepatic metabolism. Individual elimination values ​​in adults can vary greatly. The average T½ of blood plasma is 4.9 hours (may vary from 1.9 to 12.2 hours). It is distributed in all body fluids. It binds to plasma proteins by 35%. Almost completely metabolized by acetylation, oxidation and demethylation. The main metabolites are 1-methylxanthine, 7-methylxanthine and 1,7-dimethylxanthine. It is excreted by the kidneys;
    chlorphenamine: after oral administration, Cmax reaches within 1–2 hours. It acts for 3–6 hours. It is metabolized mainly in the liver by conjugation, hydroxylation, demethylation and the formation of N- and S-oxides. It undergoes the effect of the first passage through the liver (the effect decreases with impaired liver function), therefore, the bioavailability varies between 25-50%. It binds to plasma proteins by 69–72%. The apparent volume of distribution is relatively high and amounts to 3–7 l / kg body weight. T½ in adults - 15–36 hours, in children - 10–13 hours, with renal failure, this period increases. Depending on the pH level (acidic or alkaline medium), from 0 to 34% of chlorphenamine is excreted unchanged in the urine. With prolonged use, the drug may accumulate in the body.

Indications for use

Grippostad C is used for symptomatic treatment of colds, accompanied by chills, fever, body aches, headache, dry cough and runny nose.

Contraindications

Absolute:
    portal hypertension;
    angle-closure glaucoma;
    severe hepatic and / or renal failure;
    prostatic hyperplasia;
    alcoholism;
    glucose-galactose malabsorption, lack of lactase, lactose intolerance;
    children under 12 years old;
    pregnancy and lactation;
    hypersensitivity to any component of the drug.
Grippostad C capsules are used with caution in the following cases:
    stomach ulcer and duodenal ulcer;
    pyloroduodenal stenosis and infravesical obstruction;
    diseases accompanied by the accumulation of iron in the body (thalassemia, hemochromatosis, sideroblastic anemia);
    urolithiasis (oxalate stones);
    congenital hyperbilirubinemia (including Gilbert syndrome);
    impaired liver / kidney function;
    diabetes;
    chronic bronchitis or bronchial asthma;
    viral hepatitis;
    hyperoxalaturia;
    Anxiety Disorders
    arrhythmias;
    hyperthyroidism;
    progressive malignant diseases;
    glucose-6-phosphate dehydrogenase deficiency;
    elderly age;
    simultaneous use of tricyclic antidepressants, potentially hepatotoxic substances, inducers of microsomal oxidation in the liver;
    combined use of monoamine oxidase inhibitors (MAOs) or their use in the previous 2 weeks before taking Grippostad C.

Grippostad C, instructions for use: method and dosage

Grippostad C capsules are taken orally with a sufficient amount of liquid.
Adults and children from 12 years of age are prescribed 2 capsules 3 times a day.
Patients with impaired renal / hepatic function and patients with Gilbert's syndrome require a decrease in the dose of the drug or an increase in the intervals between doses.
Without a doctor’s prescription, you should not take Flupostad C in high doses and / or for a long time.

Side effects

The incidence of side effects is classified according to the following gradation: very often - ≥ 1/10, often - from ≥ 1/100 to <1/10, infrequently - from ≥ 1/1000 to <1/100, rarely - from ≥ 1/10 000 up to <1/1000, very rarely - <1/10 000; unknown frequency - the available data do not allow to accurately assess the frequency of adverse reactions.
Possible side effects of Grippostad C:
    from the gastrointestinal tract: often - dry mouth; very rarely - complaints from the digestive system;
    from the nervous system and psyche: very rarely - dyskinesia, psychotic reactions; unknown frequency - drowsiness, sedation, insomnia, anxiety;
    on the part of the heart: an unknown frequency - arrhythmia (for example, tachycardia);
    on the part of the liver and biliary tract: rarely - increased activity of hepatic transaminases; very rarely with prolonged use of the drug in high doses and with an overdose - liver dysfunction, hepatotoxic effect;
    on the part of the blood and lymphatic system: very rarely - thrombocytopenia, agranulocytosis, neutropenia, pancytopenia, leukopenia, thrombocytopenic purpura, methemoglobinemia, aplastic anemia;
    on the part of the kidneys and urinary tract: very rarely - urination disorders; with prolonged use of Grippostad C in high doses - nephrotoxicity, kidney damage;
    from the immune system: very rarely due to the action of paracetamol - severe hypersensitivity reactions, such as increased sweating, shortness of breath, nausea, anaphylactic shock, arterial hypotension, angioedema; unknown frequency - bullous skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome;
    on the part of metabolism and nutrition: very rarely - increased appetite;
    from the respiratory system: very rarely - respiratory hypersensitivity, bronchospasm in patients sensitive to aspirin and other non-steroidal anti-inflammatory drugs (aspirin asthma);
    on the part of the skin and subcutaneous tissues: infrequently - allergic skin reactions (erythematous rash, urticaria), sometimes accompanied by fever (drug fever) and damage to the mucous membranes; very rarely - serious skin reactions (for example, acute generalized exanthematous pustulosis);
    on the part of the organ of vision: very rarely - visual disturbances, angle-closure glaucoma; unknown frequency - mydriasis;
    laboratory and instrumental data: an unknown frequency - a decrease in the results of skin allergy tests (under the action of chlorphenamine), a distortion of laboratory tests, including quantitative determination of glucose and uric acid in plasma (under the action of paracetamol), determination of glucose, creatinine, urinary in blood and urine acid and inorganic phosphates, false-negative results in the analysis of feces for occult blood (when taking ascorbic acid in doses of more than 1000 mg).

Overdose

With an overdose of Grippostad C, the symptoms are a complex of signs of an overdose of the individual components of the drug.

Paracetamol

Symptoms: lack of appetite, nausea, vomiting, abdominal pain, pallor of the skin (appear within 24 hours from the moment of overdose). Subjective improvement usually follows, but moderate abdominal pain remains, indicating liver damage.
After taking a high dose, an increase in the level of hepatic transaminases, bilirubin and lactate dehydrogenase is observed, as well as an increase in thromboplastin time (12–48 hours after administration). With a single dose of more than 6000 mg in adults and a dose of 140 mg / kg in children, liver necrosis develops, which can lead to irreversible total necrosis, later to encephalopathy, metabolic acidosis (including lactic acidosis), and hepatocellular insufficiency. Subsequently, these violations can cause coma and death.
Clinical symptoms of liver damage appear after 3 days, peak reach after 4-6 days.
Even in the absence of severe liver damage, acute renal failure with acute tubular necrosis may develop.
Symptoms not related to liver function: pancreatitis, myocardial disorders.
The risk of overdose is especially high in the following cases:
    elderly age;
    the presence of liver disease;
    chronic alcoholism;
    chronic eating disorder;
    the use of inducers of microsomal liver enzymes.
In these categories of patients, an overdose is fraught with the development of a fatal outcome.
An overdose threshold can be reduced in children and patients with malnutrition.

Vitamin C

After a single dose, 3000 mg can develop, and after taking 10,000 mg, transient osmotic diarrhea almost always develops, accompanied by abdominal symptoms.
In predisposed patients, an increase in the formation of oxalate stones in the kidneys is possible.
In patients with a deficiency of glucose-6-phosphate dehydrogenase, high doses of ascorbic acid (more than 4000 mg) can cause hemolysis.

Caffeine

A dose of more than 1000 mg taken over a short period of time causes intoxication symptoms such as tremors, disorders of the cardiovascular system (myocardial damage, tachycardia) and reactions from the central nervous system.

Chlorphenamine

In case of an overdose, an anticholinergic syndrome develops, accompanied by dry mouth, fever, dilated pupils, facial flushing, constipation, hallucinations, anxiety, ataxia, muscle tremor, and convulsions.
In the future, the development of symptoms from the central nervous system is possible: impaired coordination, hallucinations, convulsions.
In severe cases, coma occurs, respiratory arrest occurs, and cardiovascular collapse develops.
In the case of a significant excess of the dose of Grippostad C prescribe treatment aimed at eliminating the developed violations.

special instructions

With prolonged use of Grippostad C, a headache may occur that can not be stopped by an increase in the dose of the drug.
In excess of the recommended doses, paracetamol can cause serious liver damage. To avoid the likelihood of an overdose, you should not take other drugs at the same time, in which paracetamol is present. For patients weighing more than 43 kg, the maximum daily dose of paracetamol should not exceed 4000 mg.
You should also refrain from additional intake of ascorbic acid. At high doses in susceptible patients, it can increase the formation of oxalate kidney stones. With a deficiency of glucose-6-phosphate dehydrogenase, ascorbic acid in a daily dose of 4000 mg in some cases leads to the development of hemolysis.
During treatment, you should not drink alcoholic beverages, since the combination of Grippostad C and ethanol can cause toxic liver damage.

Influence on the ability to drive vehicles and complex mechanisms

Against the background of drug therapy, dizziness and drowsiness may develop, therefore it is recommended not to perform potentially dangerous work during this period, including driving a car.

Pregnancy and lactation

Epidemiological studies have found that the use of chlorphenamine during pregnancy increases the risk of developing abnormalities in the fetus from the central nervous system, as well as tumors and cranial anomalies in childhood. The results of another study show that there is an increased risk of forming retrolental fibroplasia in premature babies whose mothers took antihistamines in the last 2 weeks before birth. In this regard, pregnant women are not allowed to take Grippostad C.
If treatment is required during lactation, women should temporarily stop breastfeeding.

Use in childhood

Grippostad C is contraindicated in children under 12 years of age.

With impaired renal function

    severe renal failure: the use of the drug is contraindicated;
    impaired renal function: Flupostad C should be used with caution.

With impaired liver function

    severe liver failure: the use of the drug is contraindicated;
    impaired liver function: Flupostad C should be used with caution.

Use in old age

Elderly patients should be taken with caution.

Drug interaction

Paracetamol

    drugs that slow down gastric emptying (for example, propantheline): it is possible to reduce the rate of absorption of paracetamol and, as a result, slow its action;
    means that accelerate the emptying of the stomach (for example, metoclopramide): it is possible to accelerate the absorption of paracetamol and, as a result, an earlier onset of its action;
    zidovudine: the risk of neutropenia increases (the use of this combination requires careful medical supervision);
    salicylamides: the elimination half-life of paracetamol increases;
    colestyramine: reduced absorption of paracetamol;
    probenecid: the clearance of paracetamol is reduced by about 2 times (if you need to use this combination, the dose of paracetamol should be reduced);
    anticoagulants: with irregular use of paracetamol, there are no reactions, with prolonged use of paracetamol (for several weeks), the effect of anticoagulants is enhanced.

Caffeine

    antihistamines, barbiturates: their sedative effect is reduced;
    theophylline: its excretion is reduced;
    barbiturates, nicotine: caffeine metabolism is accelerated;
    quinolone DNA gyrase inhibitors: possibly slowing down the excretion of caffeine and its metabolite paraxanthin;
    disulfiram, cimetidine, oral contraceptives: decreased caffeine metabolism in the liver;
    thyroxine, sympathomimetics: tachycardia may be enhanced;
    broad-spectrum drugs (for example, benzodiazepines): the development of unpredictable drug interactions is possible.

Chlorphenamine

With the simultaneous use of antidepressants or ethanol with chlorphenamine, a sedative effect is potentiated.

Vitamin C

There is no data on the drug interaction of ascorbic acid.

Terms and conditions of storage

Store at temperatures up to 25 ° C out of the reach of children.
Shelf life is 5 years.

Reviews of Grippostad C

Reviews of Grippostad C are mostly positive. Patients note the effectiveness of the drug with the onset of the first symptoms of colds, its rapid effect and good tolerance.
In isolated messages of a negative nature, there are complaints about the complete absence of the effect of taking the Grippostad C.

Terms of sell

You can buy Grippostad C without a prescription.