Pentalgin side effects. What does Pentalgin help with: instructions for use. Additional information on the drug Pentalgin®

Some facts about the product:

Instructions for use

Price in online pharmacy website: from 67

Some facts

The drug Pentalgin was created to lower elevated body temperature and combat pain in certain areas of the body caused by inflammation, spasm or other reasons.

Detailed composition and dosage form

The positive effect on thermoregulatory processes and the ability to eliminate pain and discomfort is ensured by the combination of the effects of the active components contained in the medicine.

The active core of Pentalgin is represented by:

Paracetamol - 0.325 g;
Naproxen - 0.1 g;
Caffeine - 0.05 g;
Drotaverine hydrochloride - 0.04 g;
Pheniramine maleate - 0.01 g.

In addition to active substances, when creating a medicine, auxiliary components are used that do not have clinical significance, but give the drug the necessary physical properties.

The product is produced in tablet form. Each pill is protected by a shell consisting of its own components, which allow the delivery of medicinal substances to the required part of the intestine in an intact form.

The tablets have a light green or green color, oblong capsule-like biconvex shape and beveled edges. One side is divided by a line, and the other side is embossed with the name of the medicine in Latin letters. At the break, the pill has a greenish tint with whitish inclusions.

The medicine is packaged in PVC bags with individual contour cells of 2, 4, 6, 10 or 12 pills. A cardboard box may contain 1 or 2 identical blisters with medication and official instructions for use.

The drug is dispensed from the pharmacy without a prescription. Before using the product, you should obtain recommendations for use from your treating specialist.

Pharmacological possibilities

The medicinal effect of the drug is explained by the complex influence of the active substances, each of which has its own properties aimed at eliminating hyperthermia, inflammation, pain and improving the general condition.

Paracetamol has the ability to reduce fever and reduce pain due to the formation of interactions that selectively block cyclooxygenase-3, which is active in the central nervous system. This action allows you to influence areas of the brain responsible for pain sensitivity and temperature regulation in the body.

Naproxen is a representative of nonsteroidal anti-inflammatory drugs derived from propion. The substance is able to suppress inflammatory processes and eliminate local or general hyperthermia associated with them. The drug does not selectively bind to prostaglandin endoperoxide synthases (cyclooxygenases), inhibiting the synthesis of prostaglandins.

The effect of caffeine is to temporarily improve the general condition of the body due to stimulation of nervous activity. The substance helps eliminate signs of fatigue, drowsiness, and increases endurance in relation to mental and physical stress. An additional effect that makes it possible to achieve a more pronounced effect from taking the drug is the ability of the substance to increase the permeability of the histiocytic barrier, which increases the bioavailability of analgesic components.

Drotaverine belongs to the category of myotropic antispasmodics. The substance blocks the action of phosphodiesterase-4, which leads to relaxation of smooth muscle tissue in the digestive tract, biliary tract, genitourinary system and vascular walls. Eliminating spasm allows you to get rid of pain.

The use of pheniramine allows one to achieve antihistamine activity, manifested in a decrease in the production of inflammatory fluid, increased effectiveness of analgesic components and a weak sedative effect.

Pharmacokinetic parameters differ for each of the active components.

The concentration of paracetamol reaches its maximum in the bloodstream 30-120 minutes after administration, and the half-life ranges from 50 to 240 minutes. The substance is biotransformed in the liver and excreted by the urinary system.

The highest levels of naproxen in the blood are observed 60-240 minutes after administration, and elimination of half the dose takes up to 13 hours. It is poorly metabolized, up to 95% is excreted through the renal system and about 5% through the intestines.

Caffeine is quickly and completely absorbed from the gastrointestinal tract, and the half-life lasts from 5 to 10 hours.

The maximum content of drotaverine in the blood is observed 2 hours after administration, and the half-life takes 120-240 minutes. The substance is excreted through the kidneys and bile.

Pheniramine reaches maximum plasma levels after 60-150 minutes, and the elimination time of half the dose is 16-19 hours (final phase). Up to 80% of the substance is excreted by the urinary system.

Indications for use

It is recommended to use Pentalgin to combat fever and cold symptoms, and pain (including headache, muscle, joint, dental, neuralgia, etc.) of weak and moderate intensity caused by inflammation, spasm of smooth muscle structures (cholecystitis, renal colic, etc.).

In the International Classification of Diseases (ICD-10), these conditions are coded: J06.9, K08.8, K80, K81.1, K91.5, M25.5, M54.1, M54.3, M54.4, M79 .1, M79.2, N23, N94.4, N94.5, R50, R51, R52.0, R52.2, T14.3.

Directions for use and dosage

The pills are taken whole and washed down with a sufficient volume of liquid. A single dose of the medicine is represented by one tablet. It is recommended to take 1 to 3 pills per day. It is not recommended to use the drug more than four times a day (1 tablet).

In order to combat thermoregulation disorders (fever, hyperthermia), it is not recommended to use the medication for more than three days. To reduce pain, the permissible duration of therapy is 5 days.

If symptoms persist or reoccur, it is recommended to consult a doctor to change the dosage regimen or replace therapy.

The product is not used in pediatric practice (under 18 years of age).

The use of the drug is prohibited in case of severe functional liver and/or kidney pathologies.

Use by patients over 65 years of age requires additional monitoring.

Contraindications

Medical contraindications for the use of the medication are the following conditions:

Individual intolerance to components;
Severe pathologies in the functioning of the kidneys (creatinine clearance less than 30 ml per minute) and liver;
Hematopoietic diseases;
Glucose-6-phosphate dehydrogenase deficiency;
Gastrointestinal bleeding, peptic ulcer in the acute period;
A combination of bronchial asthma, nasal polyposis (paranasal sinuses) with a recurrent course, hypersensitivity to non-steroidal anti-inflammatory drugs;
The period after installation of a coronary artery bypass graft;
Paroxysmal tachycardia;
Frequent ventricular tachycardia;
A pronounced persistent increase in blood pressure;
Severe pathologies of the circulatory system;
Hyperkalemia;
Under 18 years of age.

The drug requires careful use by patients with:

Pathologies of cerebral circulation;
Glucose metabolism disorders (diabetes mellitus);
Diseases of the peripheral arteries;
Past peptic ulcer disease;
Benign hyperbilirubinemia;
Mild to moderate functional abnormalities of the kidneys and liver;
Viral hepatitis;
Epilepsy and predisposition to seizures;
Alcoholic hepatosis;
Glucose-6-phosphate dehydrogenase deficiency.

If one or more factors from the list presented are present, the treating specialist should be notified.

Side effects

In most patients, the use of Pentalgin does not cause complications if medical instructions are followed. During clinical trials, it was found that the medicine can cause the following side effects:

Pancyto-, leuko-, neutro-, thrombocytopenia, agranulocytosis, methemoglobinemia, anemia;
Increased excitability, anxiety, increased reflexes, tremor, cephalalgia, dizziness, decreased ability to concentrate, insomnia, drowsiness;
Palpitations, heart rhythm disturbances, arterial hypertension;
Constipation, nausea, vomiting, abdominal pain, liver dysfunction, ulcerative lesions of the digestive tract mucosa, a feeling of heaviness in the epigastric region;
Pathologies of renal functions;
Tinnitus, hearing impairment, increased intraocular pressure in a patient with angle-closure glaucoma;
Increased breathing rate;
Rash, itching, angioedema, urticaria, anaphylaxis.

If side effects occur, you should consult a specialist for further recommendations on changing the dosage regimen or replacing therapy with another drug.

Overdose

The drug, when used in doses exceeding the permissible limits, can cause toxic damage to the liver structures with the concomitant occurrence of:

Drowsiness;
Paleness of the skin and mucous membranes;
Nausea, vomiting;
Loss of appetite;
Hyperhidrosis;
Epigastric pain.

In addition, as a result of acute poisoning with the drug, the following symptoms may appear:

Anxiety, confusion;
Heart rhythm disturbances;
Increased body temperature;
Pollakiuria;
Cephalgia;
Trembling fingers or involuntary muscle twitching;
Convulsive seizures;
Increased activity of liver enzymes.

A severe overdose can lead to:

Failure of liver functions;
Encephalopathy;
Coma;
Acute kidney failure;
Lethal outcome.

The appearance of these signs indicates the need for urgent hospitalization for medical care. The following are prescribed as treatment: N-acetylcysteine, antacids, symptomatic drugs, enterosorbents and other detoxification medications.

Pregnancy and lactation period

Treatment with the drug during gestation and breastfeeding is prohibited.

The components of the drug are able to pass into breast milk in small quantities, which makes it necessary to stop lactation during therapy with Pentalgin.

Drug interactions

Taking barbiturates, tricyclic antidepressants, rifampicin, ethanol (alcohol) in parallel with Petalgin increases the negative effect on the liver, which makes combining drugs from these groups undesirable.

The likelihood of liver toxicity is reduced with concurrent therapy with cimetidine or other microsomal oxidation inhibitors.

Diflunisal increases the plasma level of paracetamol by 50%, which increases the likelihood of negative effects on the liver.

Primidone and anticonvulsants accelerate the excretion of caffeine, and cimetidine, oral contraceptives, disulfiram, ciprofloxacin, norfloxacin slow it down.

Tranquilizers, hypnotics, monoamine oxidase inhibitors increase the sedative effect of pheniramine.

Drotaverine reduces the effectiveness of levodopa in reducing signs of parkinsonism.

Storage conditions

Analogs

Analogues of Pentalgin in terms of the effect produced are: Rinza, Plivalgin, etc.

In addition to obvious contraindications, there are also conditions in which Pentalgin is dangerous to use. These include:

circulatory disorders;
a history of ulcerative lesions of the gastrointestinal tract;
high blood sugar;
age after 65 years;
epilepsy.

During long-term use of Pentalgin, more than 3 days, patients may experience the following side effects:

the digestive tract may react to long-term use of Pentalgin with nausea, stomach pain, vomiting, loss of appetite, exacerbation of chronic diseases;
the circulatory system reacts with a decrease in the number of leukocytes, platelets, and anemia;
the nervous system reacts with tremor, dizziness, insomnia, increased blood pressure, and headache;
the heart may react with arrhythmia, increased blood pressure, and tachycardia;
the urinary system often reacts with the appearance of problems with the functioning of the kidneys and the occurrence of nephritis.

Also, the body of a person who takes Pentalgin for a long time reacts with tinnitus, and a decrease in visual acuity is observed. In addition, an allergic reaction may occur in the form of a rash, swelling, or anaphylactic shock.

If such phenomena occur, you can perform gastric lavage and drink activated carbon. If after taking Pentalgin side effects persist for some time, you should stop taking it and consult your doctor.

The medicine "Pentalgin", which helps for many indications, has 5 active components that determine its effect.

The non-steroidal anti-inflammatory substance Naproxen provides antipyretic, analgesic and anti-inflammatory effects. This is achieved due to the ability of the component to inhibit the reproduction of prostaglandins.

Drotaverine hydrochloride has an antispasmodic effect, normalizes the functioning of the smooth muscles of the biliary tract, gastrointestinal, genitourinary and vascular systems.

The presence of paracetamol as an active element allows the medicine to have an analgesic and antipyretic effect. This occurs by blocking cyclooxygenase, an enzyme that promotes the formation of the inflammatory process, as well as inhibition of pain centers and thermoregulation.

Caffeine tones blood circulation, dilates blood vessels in the brain, heart and other organs. The substance invigorates and eliminates drowsiness. Caffeine shows psychostimulating properties and enhances the effect of other active ingredients.

Due to the inclusion of pheniramine in the composition, antispasmodic and sedative properties are slightly manifested, and the analgesic effect of naproxen and paracetamol increases.

The drug "Pentalgin", reviews and instructions for use confirm this, can provoke unpleasant effects and disorders in the functioning of various body systems. As a result, the following side effects may occur:

allergies;
itching, agitation, nausea or vomiting;
kidney dysfunction, skin rash;
heartbeat failure, hearing impairment;
hives, headache, constipation;
leukopenia, tremor, angioedema;
hypertension, anxiety, thrombocytopenia;
dizziness, agranulocytosis, arrhythmia;
anemia, sleep disorders, methemoglobinemia.

Spasmoanalgesic.

Pentalgin is a combined medication that has anti-inflammatory, antipyretic, analgesic and antispasmodic effects.

Paracetamol is an antipyretic and analgesic substance, the effect of which is due to inhibition of cyclooxygenase in the central nervous system and a direct effect on the thermoregulation and pain centers in the hypothalamus.
Naproxen is a nonsteroidal anti-inflammatory drug with pronounced antipyretic and analgesic properties.
Pheniramine belongs to the group of H1-histamine receptor blockers. It is an antispasmodic with a slight sedative effect. Enhances the analgesic properties of naproxen and paracetamol.
Drotaverine has a myotropic antispasmodic effect, which is caused by suppression of the activity of the phosphodiesterase-4 enzyme.
Caffeine stimulates the dilation of blood vessels in the heart, kidneys and skeletal muscles, improves physical endurance and mental performance, eliminates drowsiness and fatigue, and also increases the bioavailability of non-narcotic painkillers. Tones the blood vessels of the brain.

With the development of a hypersensitivity reaction, skin rashes (urticaria) may appear and Quincke's edema may develop.

Possible side effects of Pentalgin:

hyperreflexia;
shiver;
dizziness;
headache;
insomnia;
pain in the abdominal area;
noise in ears;
decreased acuity of auditory perception;
rapid breathing;
inhibition of hematopoiesis (manifested by anemia, thrombocytopenia and leukopenia);
arterial hypertension (high blood pressure);
heart rhythm disturbances;
heartbeat;
tachycardia;
psycho-emotional arousal;
unmotivated feeling of anxiety;
impaired ability to concentrate;
dyspeptic disorders;
damage to the mucous membranes of the digestive organs (erosions and ulcers);
decreased functional activity of the liver and (or) kidneys;
skin inflammatory reactions (dermatitis).

If at least one of the listed symptoms develops, treatment with the drug should be stopped and the doctor should be informed about side effects.

Release forms

Sold in blister packs, 2-12 tablets per pack.

Producing countries:

Belmedpreparaty (Belarus);
Tomskkhimpharm (Russia).

International name: Pentalgin.

Dosage form – film-coated tablets: capsule-shaped, biconvex, light green to green in color, with beveled edges, lined on one side, embossed “PENTALGIN” on the other; The cut tablet is light green in color with white inclusions (2, 6, 10 or 12 tablets in a strip pack, 1 or 2 packs in a cardboard pack).

Active ingredients in 1 tablet:

Paracetamol – 325 mg;
Pheniramine maleate – 10 mg;
Naproxen – 100 mg;
Drotaverine hydrochloride – 40 mg;
Caffeine – 50 mg.

Additional substances: hyprolose (hydroxypropylcellulose) (Klucel EF), magnesium stearate, croscarmellose sodium, potato starch, microcrystalline cellulose, talc, butylated hydroxytoluene (E321), citric acid monohydrate, indigo carmine (E132), quinoline yellow dye (E104).

Film shell composition: polysorbate 80 (Tween 80), povidone (medical medium molecular weight polyvinylpyrrolidone), talc, titanium dioxide, hypromellose (hydroxypropyl methylcellulose), indigo carmine (E132), quinoline yellow dye (E104).

Analogues of Pentalgin, price in pharmacies

Pentalgin tablets are sold in pharmacies without a doctor's prescription. The shelf life of the drug is 3 years from the production date; after this period, the drug is not recommended for use.

It is necessary to store in a dry place, out of reach of children, at a temperature of no more than 25 degrees, avoiding direct sunlight on the blister.

If necessary, you can replace Pentalgin with an analogue in terms of therapeutic effect - these are the following drugs:

Sedalgin;
Pentalffen;
Pentamyalgin;
Plivalgin.

By ATX code:

Gevadal,
Kaffetin,
Migraine,
No-shpalgin.

When choosing analogues, it is important to understand that the instructions for use of Pentalgin, the price and reviews of drugs with similar effects do not apply. It is important to consult a doctor and not change the drug yourself.

Store at a temperature not exceeding 25 °C, in a dry place, protected from light and out of reach of children. Shelf life – 2 years. Conditions for dispensing from pharmacies - without a prescription.

Dispensed without a doctor's prescription.

Dosage and method of administration

Take one tablet after meals. You can take no more than 4 pieces of the drug per day.

The tablets are taken orally after meals with clean water.

Standard dosages of Pentalgin according to the instructions for use are 1 tablet once up to 3 times a day. The interval between taking tablets is at least 6 hours.

The maximum daily dosage is 4 tablets.

The drug can be used as an antipyretic for 3 days, an analgesic for 5 days. Longer use requires consultation with a doctor.

special instructions

Pentalgin should not be prescribed with other drugs based on paracetamol or containing NSAIDs, drugs to relieve symptoms of colds, flu and nasal congestion.

If the patient takes the drug for more than 7 days, monitoring of peripheral blood counts and liver functions is necessary.

The influence of caffeine in the drug can have both an exciting and inhibitory effect on the central nervous system.

Side effects

The instructions warn about the possibility of developing the following side effects when prescribing Pentalgin:

From the digestive tract - damage to the gastrointestinal mucosa, exacerbation of chronic diseases of the digestive canal, nausea, stomach pain, sometimes vomiting, stool disorders, liver damage, lack of appetite;
From the blood system - decreased levels of platelets and leukocytes in the blood, anemia, agranulocytosis;
From the central nervous system - tremors of the limbs, headaches, dizziness, insomnia, lethargy, decreased concentration;
From the heart and blood vessels - tachycardia, cardiac arrhythmia, increased blood pressure;
From the urinary system - development of interstitial nephritis, impaired renal function;
Tinnitus, glaucoma, decreased visual acuity in rare cases;
Allergic reactions - skin rash, development of angioedema, urticaria, and in rare cases, anaphylactic shock.

Contraindications

It is contraindicated to prescribe Pentalgin in the following cases:

erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, intolerance to acetylsalicylic acid or other NSAIDs (including a history);
severe liver failure;
severe renal failure;
condition after coronary artery bypass surgery;
severe organic diseases of the cardiovascular system (including acute myocardial infarction);
paroxysmal tachycardia;
hyperkalemia;
pregnancy and lactation (breastfeeding);
age under 18 years;
hypersensitivity to the components of the drug.

The drug should be used with caution in patients with cerebrovascular diseases, diabetes mellitus, peripheral arterial diseases, a history of ulcerative lesions of the gastrointestinal tract, mild or moderate renal and hepatic insufficiency, viral hepatitis, alcoholic liver damage, benign hyperbilirubinemia (Gilbert, Dubin-syndromes). Johnson and Rotor), epilepsy, with a tendency to seizures, glucose-6-phosphate dehydrogenase deficiency and elderly patients.

Overdose

Symptoms of overdose are pale skin, anorexia (lack of appetite), abdominal pain, nausea, vomiting, gastrointestinal bleeding, agitation, restlessness, confusion, tachycardia, arrhythmia, hyperthermia (increased body temperature), frequent urination, headache pain, tremors, or muscle twitching.

Epileptic seizures, increased activity of liver transaminases, hepatonecrosis, and increased prothrombin time are possible.

Symptoms of liver dysfunction may appear 12-48 hours after an overdose.

In case of severe overdose, liver failure develops with progressive encephalopathy, coma, and death. Acute renal failure with tubular necrosis, arrhythmia, pancreatitis.

If you suspect an overdose, you should immediately seek medical help.

The administration of acetylcysteine is important within 8 hours after taking paracetamol. In case of gastrointestinal bleeding, it is necessary to administer antacids and gastric lavage with an ice-cold 0.9% sodium chloride solution.

Maintain ventilation and oxygenation. For epileptic seizures - intravenous administration of diazepam, maintaining the balance of fluid and salts.

The instructions for use indicate that Pentalgin is prescribed orally, 1 tablet. 1-3 times/day. The maximum daily dose is 4 tablets.

The duration of treatment is no more than 3 days as an antipyretic and no more than 5 days as an analgesic. Continuation of treatment with the drug is possible only after consultation with a doctor.

Do not exceed the indicated doses of the drug.

In cases of using tablets for a long time in high doses, an overdose may occur, which is accompanied by symptoms: pale skin, anorexia, abdominal pain, nausea, vomiting, gastrointestinal bleeding, agitation, anxiety, confusion, tachycardia, arrhythmia, hyperthermia, increased urination, headaches pain, tremors, epileptic seizures and so on.

More severe forms of overdose are: development of liver failure with increasing encephalopathy, arrhythmia, pancreatitis, coma, death.

Typically, treatment includes: gastric lavage, taking activated charcoal, administering a specific antidote - acetylcysteine or other drugs, depending on the symptoms.

Contraindications and side effects

Pentalgin for cough

Suitable for treating cough, but only as an adjuvant. Take 2-3 tablets per day after meals. It is prohibited to use the drug for more than 3 days. Before use, you should consult your doctor.

Pentalgin for migraines

Pentalgin will help with migraines, but it is too strong a medicine. For headaches, it is better to use No-Shpu or Tamipul. It is advisable to consult a neurologist. You should also understand that this drug may not be suitable for everyone, for various reasons.

Pentalgin for toothache

The duration of the course depends on the complexity of the situation. It is advisable not to take more than 1 tablet per day. Duration of treatment – 3 days. Should be used only as prescribed by a dentist.

Pentalgin and alcohol

Drinking alcohol is strictly prohibited. The effect of phenobarbital is enhanced, which can cause nervous disorders and cerebral coma (extremely rare). Also, the combination of alcohol and 5 active substances at once (codeine, caffeine, naproxen, metamizole sodium and phenobarbital) negatively affects the functioning of the liver and kidneys.

Pentalgin during pregnancy

The use of Pentalgin is prohibited during pregnancy. The drug should not be used while breastfeeding. The active substance codeine can enter the fetus, which can cause various defects and complications. It is also possible to become addicted to the drug.

Pentalgin during menstruation

For painful periods, Pentalgin can be used. Most women and girls are advised to take this medicine on menstrual periods. However, if the pain is not very severe, it is better to take No-Shpu or any other painkiller, since Pentalgin is a fairly strong medicine. This drug should be used only in extreme cases.

The instructions for use prohibit taking the medicine "Pentalgin" when:

individual non-acceptance of the constituent components;
severe kidney failure;
hyperkalemia;
ventricular extrasystole;
high blood pressure;
ulcers and erosions of the stomach and intestines;
aspirin asthma or triad;
sinus polyps;
paroxysmal tachycardia;
myocardial infarction and other complex diseases of the heart and blood vessels;
after coronary artery bypass surgery;
internal bleeding;
inhibition of bone marrow hematopoiesis.

You should not use the medicine "Pentalgin" during pregnancy, children under adulthood, or during lactation. Caution during therapy is necessary for elderly people, as well as those suffering from diabetes, kidney and liver failure in the initial stages, pathologies of the arteries, convulsions, hepatitis, and stomach ulcers in the past.

What does Pentalgin help with? According to the instructions, the drug is prescribed in the following cases:

pain syndrome of various origins, incl. pain in joints, muscles, radiculitis, algodismenorrhea, neuralgia, toothache, headache (including those caused by cerebral vasospasm);
pain syndrome associated with spasm of smooth muscles, incl. for chronic cholecystitis, cholelithiasis, postcholecystectomy syndrome, renal colic;
post-traumatic and postoperative pain syndrome, incl. accompanied by inflammation;
colds accompanied by fever (as symptomatic therapy).

What does it help with? The use of Pentalgin is indicated for pain relief:

Caused by spasm of smooth muscles (according to the instructions, the drug is effective, including for renal colic, cholelithiasis, chronic cholecystitis, dysfunction of the sphincter of Oddi and a number of other diseases).
Dental, headache (including pain associated with vasospasm in the brain), muscle or joint pain, as well as pain arising from algodismenorrhea, neuralgia, etc.
Occurring against the background of injuries and surgical operations (including when pain is accompanied by the development of an inflammatory process).

In addition, Pentalgin can be used for colds that are accompanied by febrile syndrome (used as a symptomatic antipyretic and analgesic).

Contraindications include:

severe renal failure;
gastrointestinal bleeding;
severe arterial hypertension;
inhibition of bone marrow hematopoiesis;
hyperkalemia;
frequent ventricular extrasystole;
individual intolerance to the components included in the drug;
erosive and ulcerative lesions of the digestive system in the acute stage;
condition after coronary artery bypass grafting;
severe organic diseases of the cardiovascular system (for example, myocardial infarction);
a combination of recurrent polyposis of the paranasal sinuses, nose, as well as bronchial asthma against the background of hypersensitivity to acetylsalicylic acid or other non-steroidal drugs;
paroxysmal tachycardia;
age up to 18 years.

It is not recommended to take Pentalgin during pregnancy or during breastfeeding. The medication is prescribed with extreme caution in old age and for such conditions as: peripheral arterial diseases, cerebrovascular diseases, alcoholic liver damage, epilepsy, liver and kidney failure in the early stages, diabetes mellitus, glucose-6-phosphate dehydrogenase deficiency, tendency to seizures , viral hepatitis, a history of ulcerative lesions of the digestive system and benign hyperbilirubinemia.

How does Pentalgin work?

Pentalgin consists of 5 active substances, which determine its effectiveness:

Naproxen. Substance of the propionic acid type. It has an antipyretic and analgesic effect. It is used in the treatment of arthritis and other rheumatic ailments, diseases of the musculoskeletal system, as well as dysmenorrhea and severe gout.
Drotaverine hydrochloride. Myotropic antispasmodic. It is similar in chemical structure and pharmacological properties to papaverine, but has a stronger and longer-lasting effect.
Paracetamol. It is a common central non-narcotic analgesic that has rather weak anti-inflammatory properties. Antipyretic and analgesic action.
Caffeine. Is a psychostimulant. Caffeine can be found in plants such as the coffee tree, cocoa, yerba mate, guarana, and cola. Normalizes blood circulation, improves tone.
Pheniramine maleate. Penetrating into the body, the substance travels along with the bloodstream. Its highest concentration is recorded an hour after consumption. Calms and has an analgesic effect.

Use during pregnancy and lactation

The drug is contraindicated for use in pregnant women. The active components included in the tablet can have a detrimental effect on the development of the internal organs of the fetus and cause developmental abnormalities.

Since the components of the drug Pentalgin can be excreted in breast milk, the use of this drug for nursing mothers is contraindicated. If treatment is necessary, a woman should stop breastfeeding and temporarily transfer him to an adapted milk formula.

Analogues of Pentalgin

Compound

The combined effect of Pentalgin is due to the properties of five active substances. The composition of Pentalgin tablets depends on the type of drug. The manufacturer produces the drug with four names: this allows you to select the appropriate drug for a person’s individual sensitivity to analgesics. Pentalgin of all four varieties necessarily includes paracetamol.

It begins to relieve pain, affecting the centers of thermoregulation and pain, and relieves spasms. Together with the analgesic, it has an anti-inflammatory and antipyretic effect. In combination with paracetamol, the manufacturer uses other active substances. Pentalgin additionally contains four substances, the names of which are indicated in the instructions. The active elements of the drug together with paracetamol may be:

Naproxen. This non-steroidal substance regulates the synthesis of prostaglandins, which are responsible for muscle contraction. It relieves spasm, inflammation, and lowers temperature.
Caffeine. It has the ability to dilate blood vessels, increases brain activity, relieves signs of fatigue, drowsiness, and increases the effect of other painkillers.
Drotaverine hydrochloride. Relieves spasm of smooth muscles of the genitourinary system, gastrointestinal tract, biliary tract, blood vessels.
Pheniramine maleate. It blocks the synthesis of histamine, has a sedative effect, and fights inflammatory processes. The substance relieves spasms, increases the effect of paracetamol and naproxen.
Propyphenazone.
Codeine. It is a narcotic element. Affects opioid receptors and changes the perception of pain. Reduces the degree of excitation of the center responsible for coughing, enhances the effect of anti-inflammatory and sedative substances. Long-term use may cause drug dependence.
Phenobarbital. Refers to barbiturates, increases the analgesic effect of paracetamol and metamizole.
Metamizole sodium. A non-steroidal drug that has an analgesic effect.

Dosage

How to take Pentalgin? The instructions contain the maximum dosage limits for the drug. The dosage of Pentalgin is one tablet half an hour before or after a meal with plenty of water, the daily norm is three tablets, in special cases four. It is necessary to maintain an interval of four hours between doses of the medicine.

Side effects

Contraindications

It is not recommended to use tablets while taking other medications, because in combination with other active substances the toxicity of the drug may increase or the effect of the drug may decrease. It is forbidden to use Pentalgin and alcohol; you cannot take pills while driving, because they reduce attention. Pentalgin should be taken with caution by older people with viral hepatitis, alcoholic liver damage, and epilepsy.

special instructions

Before you start using the drug, read the special instructions:

During the treatment period you should not drink alcoholic beverages.
Paracetamol distorts the results of laboratory tests of glucose and uric acid in blood plasma.
When using the drug Pentalgin for more than 5-7 days, peripheral blood counts and the functional state of the liver should be monitored.
The effect of caffeine on the central nervous system depends on the type of nervous system and can manifest itself as both excitation and inhibition of higher nervous activity.
If it is necessary to determine 17-ketosteroids, Pentalgin should be discontinued 48 hours before the study. Please note that naproxen increases bleeding time.
The simultaneous use of Pentalgin with other drugs containing paracetamol and/or NSAIDs, as well as with drugs to relieve symptoms of colds, flu and nasal congestion should be avoided.

During the treatment period, the patient must be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Interaction with other drugs

To avoid deterioration of the patient's well-being, the interaction of Pentalgin and other medications should be taken into account. For example, it is prohibited to drink it together with:

This drug contains substances that can reduce the therapeutic effect of medications used to treat diabetes. This must be taken into account even during periodic use of the drug. As a result, during correction of the condition with Pentalgin, it is important to simultaneously monitor blood sugar levels.

Today, pharmacies offer many medications that have a pronounced antispasmodic, antipyretic, and analgesic effect. Nevertheless, Pentalgin remains an undeniable leader. This is due to the fact that its combined composition makes it possible to solve many problems with the help of 1 tablet.

Pharmacies can offer the following as analogues:

Plivalgin.
Sedalgin.
Pentamialgin.
Pentalffen.

Replacing Pentalgin should be entrusted to the attending physician, since some analogues have serious contraindications that can cause a deterioration in the patient’s well-being.

Pentalgin, thanks to its composition, allows you to solve many problems. It is especially effective for headaches of various etiologies and intensity. However, uncontrolled use of the drug can cause a lot of negative consequences. To avoid side effects, you must follow the instructions and recommendations of your doctor.

The drug is not recommended to be prescribed simultaneously with barbiturates, Rifampicin, tricyclic antidepressants, drugs that contain ethanol, since such drug interactions increase the risk of toxic liver damage.

The drug should not be prescribed with other medications that contain Paracetamol, as this can lead to the development of serious side effects and hepatotoxicity.

Pentalgin should not be taken simultaneously with Nurofen or other drugs from the group of non-steroidal anti-inflammatory drugs, as the risk of bleeding increases.

Drug interaction with Acetylsalicylic acid leads to the formation of ulcers and erosions on the mucous membranes of the gastrointestinal tract, and also increases the risk of bleeding.

Pentalgin should not be combined with alcoholic beverages and medications that contain ethanol, as in this case there is a high risk of developing acute pancreatitis and severe toxic liver damage.

Naproxen, which is part of the drug, reduces the therapeutic effect of diuretics and enhances the effect of indirect anticoagulants, which should be taken into account and in order to avoid the development of side effects, do not prescribe these drugs to the patient at the same time.

With the simultaneous use of drugs that contain caffeine, an excessive stimulating effect on the central nervous system is possible, as a result of which the patient will be restless, nervous, and suffer from insomnia.

When using the drug, it is necessary to take into account interactions with other medications:

Long-term use of barbiturates reduces the effectiveness of paracetamol.
The simultaneous use of paracetamol with ethanol increases the risk of acute pancreatitis.
Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxic action of paracetamol.
Paracetamol enhances the effect of indirect anticoagulants and reduces the effectiveness of uricosuric drugs.
Concomitant use of caffeinated beverages and other CNS stimulants may result in excessive CNS stimulation.
When used concomitantly, drotaverine may weaken the antiparkinsonian effect of levodopa.
When taking the drug Pentalgin simultaneously with barbiturates, tricyclic antidepressants, rifampicin, ethanol, the risk of hepatotoxicity increases (these combinations should be avoided).
Naproxen can cause a decrease in the diuretic effect of furosemide, an increase in the effect of indirect anticoagulants, increases the toxicity of sulfonamides and methotrexate, reduces the excretion of lithium and increases its concentration in the blood plasma.
When used simultaneously with diflunisal, the plasma concentration of paracetamol increases by 50%, which increases the risk of developing hepatotoxicity.
With simultaneous use of pheniramine with tranquilizers, hypnotics, MAO inhibitors, ethanol, the depressant effect on the central nervous system may be enhanced.
With the combined use of caffeine and barbiturates, primidone, anticonvulsants (hydantoin derivatives, especially phenytoin), it is possible to increase metabolism and increase the clearance of caffeine; while taking caffeine and cimetidine, oral contraceptives, disulfiram, ciprofloxacin, norfloxacin - a decrease in the metabolism of caffeine in the liver (slowing its excretion and increasing its concentration in the blood).

Detailed instructions for use are published on this page. Pentalgina. The available dosage forms of the painkiller are listed (tablets H, ICN, Plus, green without codeine and without a prescription), as well as its analogues. Information is provided on the side effects that Pentalgin can cause and on interactions with other medications. In addition to information about the diseases for the treatment and prevention of which the drug is prescribed (headache, toothache, fever), administration algorithms, possible dosages for adults and children are described in detail, and the possibility of use during pregnancy and breastfeeding is clarified. The abstract for Pentalgin is supplemented with reviews from patients and doctors. Composition of the drug.

Instructions for use and dosage

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

The drug should not be taken for more than 5 days as an analgesic and for more than 3 days as an antipyretic without a doctor’s prescription.

Do not exceed the indicated doses of the drug.

Compound

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

Metamizole sodium + Naproxen + Caffeine + Phenobarbital + Codeine (in phosphate form) + excipients (Pentalgin N).

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

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

Release forms

Tablets (green OTC, no Codeine).

Tablets (N, ICN, Plus).

Pentalgin- a combined drug that has analgesic, anti-inflammatory, antispasmodic, antipyretic effects.

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

Naproxen is a non-steroidal anti-inflammatory drug that has anti-inflammatory, analgesic and antipyretic effects associated with non-selective suppression of COX activity, which regulates the synthesis of prostaglandins.

Caffeine is a psychostimulant that causes dilation of the blood vessels of skeletal muscles, heart, and kidneys; increases mental and physical performance, helps eliminate fatigue and drowsiness; increases the permeability of histohematic barriers and increases the bioavailability of non-narcotic analgesics, thereby enhancing the therapeutic effect. It has a tonic effect on the blood vessels of the brain.

Drotaverine - has a myotropic antispasmodic effect due to inhibition of PDE 4, acts on the smooth muscles of the gastrointestinal tract, biliary tract, genitourinary system, and blood vessels.

Pheniramine is a histamine H1 receptor blocker. It has an antispasmodic and mild sedative effect, reduces exudation, and also enhances the analgesic effect of paracetamol and naproxen.

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

Phenobarbital is a barbiturate that increases the analgesic effectiveness of metamizole sodium and paracetamol.

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

Pharmacokinetics

The components of the drug are well absorbed from the gastrointestinal tract.

Metamizole sodium

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

Naproxen

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

Caffeine

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

Codeine

Slightly binds to plasma proteins. It undergoes biotransformation in the liver (10% goes into morphine by demethylation). Excreted by the kidneys (5-15% unchanged).

Phenobarbital

Penetrates well through the placental barrier. Biotransformed in the liver. The main metabolite has no pharmacological activity. Excreted by the kidneys, incl. 20-25% - unchanged.

Indications

pain syndrome of various origins, including pain in the joints, muscles, radiculitis, algodismenorrhea, neuralgia, toothache, headache (including those caused by cerebral vasospasm);
pain syndrome associated with spasm of smooth muscles, incl. for chronic cholecystitis, cholelithiasis, postcholecystectomy syndrome, renal colic;
post-traumatic and postoperative pain syndrome, incl. accompanied by inflammation;
colds accompanied by fever (as symptomatic therapy).

Contraindications

erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
gastrointestinal bleeding;
complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including a history);
severe liver failure;
severe renal failure;
anemia, leukopenia;
inhibition of bone marrow hematopoiesis;
condition after coronary artery bypass surgery;
severe organic diseases of the cardiovascular system (including acute myocardial infarction);
paroxysmal tachycardia;
frequent ventricular extrasystole;
severe arterial hypertension;
alcohol intoxication;
glaucoma;
hyperkalemia;
deficiency of glucose-6-phosphate dehydrogenase;
pregnancy;
lactation period (breastfeeding);
children and adolescents up to 18 years of age;
hypersensitivity to the components of the drug.

special instructions

The simultaneous use of Pentalgin with other drugs containing paracetamol and/or non-steroidal anti-inflammatory drugs (NSAIDs), as well as with drugs to relieve symptoms of colds, flu and nasal congestion should be avoided.

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

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

If it is necessary to determine 17-ketosteroids, Pentalgin should be discontinued 48 hours before the study. Please note that naproxen increases bleeding time.

The effect of caffeine on the central nervous system depends on the type of nervous system and can manifest itself as both excitation and inhibition of higher nervous activity.

During the treatment period, the patient should avoid drinking alcohol.

Impact on the ability to drive vehicles and operate machinery

In some cases, a decrease in concentration and speed of psychomotor reactions is possible, therefore, during the treatment period, the patient should be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Side effect

skin rash;
hives;
angioedema;
thrombocytopenia, leukopenia, agranulocytosis, anemia;
excitation;
anxiety;
strengthening reflexes;
tremor;
headache;
sleep disorders;
dizziness;
decreased concentration;
heartbeat;
arrhythmias;
increased blood pressure;
erosive and ulcerative lesions of the gastrointestinal tract;
nausea, vomiting;
epigastric discomfort;
stomach ache;
constipation;
renal dysfunction;
hearing loss;
noise in ears;
increased intraocular pressure in patients with angle-closure glaucoma;
dermatitis;
increased breathing.

Drug interactions

When taking the drug Pentalgin simultaneously with barbiturates, tricyclic antidepressants, rifampicin, ethanol (alcohol), the risk of hepatotoxicity increases (these combinations should be avoided).

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

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

When used simultaneously with paracetamol and ethanol (alcohol), the risk of acute pancreatitis increases.

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

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

Naproxen can cause a decrease in the diuretic effect of furosemide, an increase in the effect of indirect anticoagulants, increases the toxicity of sulfonamides and methotrexate, reduces the excretion of lithium and increases its concentration in the blood plasma.

With the combined use of caffeine and barbiturates, primidone, anticonvulsants (hydantoin derivatives, especially phenytoin), it is possible to increase metabolism and increase the clearance of caffeine; while taking caffeine and cimetidine, oral contraceptives, disulfiram, ciprofloxacin, norfloxacin - a decrease in the metabolism of caffeine in the liver (slowing its excretion and increasing its concentration in the blood).

Concomitant use of caffeinated beverages and other CNS stimulants may result in excessive CNS stimulation.

When used concomitantly, drotaverine may weaken the antiparkinsonian effect of levodopa.

With simultaneous use of pheniramine with tranquilizers, hypnotics, MAO inhibitors, ethanol (alcohol), the depressant effect on the central nervous system may be enhanced.

Analogues of the drug Pentalgin

Structural analogues of the active substance:

Pentalgin Plus.
Plivalgin.

Use in elderly patients

The drug should be used with caution in elderly patients.

Use in children

Pentalgin is contraindicated in children and adolescents under 18 years of age.

Use during pregnancy and breastfeeding

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

Today, pharmacological companies produce several varieties of the drug Pentalgin - the composition of the medications varies depending on the full name. The effectiveness of each drug is assessed according to the causes of pain.

Composition of Pentalgin tablets

The type of pain reliever in question is the only type that is available without a prescription. Its formula has recently been improved in such a way as to eliminate pain not only due to inflammatory processes and nervous tension, but also due to vascular spasms.

New or green Pentalgin has a composition without codeine and:

naproxen;
drotaverine;
paracetamol;
pheniramine maleate;
anhydrous caffeine.

The combination of these 5 components provides an antispasmodic, anti-inflammatory, analgesic and mild antipyretic effect.

It is important to note that the possibility of purchasing such Pentalgin over-the-counter does not exclude the need to consult with your doctor. The fact is that the ingredients of the medication produce a lot of negative side effects, especially for the digestive and cardiovascular systems. Moreover, high concentrations of caffeine provoke an increase in blood pressure, which is unacceptable for people suffering from hypertension.

Composition of Pentalgina Plus

This type of drug differs in the content of an additional analgesic – propyphenazone. This ingredient has low anti-inflammatory activity, but has pronounced analgesic and antipyretic properties. The combination with the other components of the medication allows you to achieve the fastest possible effect even with very severe pain.

Full composition:

codeine phosphate;
phenobarbital;
caffeine;
propyphenazone.

As a rule, the described type of Pentalgin is prescribed for diseases and injuries of joints, muscles, pinched nerves, toothache and headaches. It is sometimes used to relieve the symptoms of febrile syndrome.

Composition of the drug Pentalgin-ICN

The presented form of the line of analgesics refers to high-intensity painkillers. The combination of active chemical compounds provides stable and rapid relief of pain even in chronic diseases of the cardiovascular and nervous system. Pentalgin-ICN successfully relieves the clinical manifestations of migraine and smooth muscle spasms.

The drug consists of the following ingredients:

metamizole sodium;
codeine phosphate;
paracetamol;
caffeine;
phenobarbital.

Like the previous version of Pentalgin, the medicine in question is dispensed only with a prescription written by a doctor.

Composition of Pentalgin N or Neo

The latest form of the drug is produced without paracetamol. This Pentalgin has excellent antispasmodic and analgesic properties, but has less pronounced anti-inflammatory and antipyretic activity. This is achieved thanks to the inclusion of naproxen, a non-steroidal substance with high analgesic properties.

Release form, composition and packaging

◊ Film-coated tablets light green to green in color, biconvex, capsule-shaped with beveled edges, scored on one side and embossed “PENTALGIN” on the other; When cut, the tablet is light green in color with white splashes.

Excipients: microcrystalline cellulose, potato starch, croscarmellose sodium, hyprolose (hydroxypropyl cellulose (Klucel EF)), citric acid monohydrate, butylated hydroxytoluene (E321), magnesium stearate, talc, quinoline yellow dye (E104), indigo carmine (E132).

Film shell composition: hypromellose (hydroxypropyl methylcellulose), povidone (medium molecular weight polyvinylpyrrolidone), polysorbate 80 (Tween 80), titanium dioxide, talc, quinoline yellow dye (E104), indigo carmine (E132).

12 pcs. - contour cellular packaging (1) - cardboard packs.

Clinical and pharmacological group

Spasmoanalgesic

pharmachologic effect

The combined drug has analgesic, anti-inflammatory, antispasmodic, antipyretic effects.

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

Naproxen- NSAIDs have anti-inflammatory, analgesic and antipyretic effects associated with non-selective suppression of COX activity, which regulates the synthesis of prostaglandins.

Caffeine- a psychostimulant, causes dilation of the blood vessels of skeletal muscles, heart, kidneys; increases mental and physical performance, helps eliminate fatigue and drowsiness; increases the permeability of histohematic barriers and increases the bioavailability of non-narcotic analgesics, thereby enhancing the therapeutic effect. It has a tonic effect on the blood vessels of the brain.

Drotaverine- has a myotropic antispasmodic effect due to inhibition of PDE 4, acts on the smooth muscles of the gastrointestinal tract, biliary tract, genitourinary system, and blood vessels.

Pheniramine- blocker of histamine H1 receptors. It has an antispasmodic and mild sedative effect, reduces exudation, and also enhances the analgesic effect of paracetamol and naproxen.

Pharmacokinetics

Data on the pharmacokinetics of the drug Pentalgin ® are not provided.

Indications for use of the drug

— pain syndrome of various origins, including pain in joints, muscles, radiculitis, algodismenorrhea, neuralgia, toothache, headache (including those caused by cerebral vasospasm);

— pain syndrome associated with spasm of smooth muscles, incl. for chronic cholecystitis, cholelithiasis, postcholecystectomy syndrome, renal colic;

— post-traumatic and postoperative pain syndrome, incl. accompanied by inflammation;

- colds accompanied by febrile syndrome (as symptomatic therapy).

Dosage regimen

The drug is prescribed orally, 1 tablet. 1-3 times/day. The maximum daily dose is 4 tablets.

The duration of treatment is no more than 3 days as an antipyretic and no more than 5 days as an analgesic. Continuation of treatment with the drug is possible only after consultation with a doctor.

Do not exceed the indicated doses of the drug.

Side effect

Allergic reactions: skin rash, itching, urticaria, angioedema.

From the hematopoietic system: thrombocytopenia, leukopenia, agranulocytosis, anemia, methemoglobinemia.

From the side of the central nervous system: agitation, anxiety, increased reflexes, tremors, headache, sleep disturbances, dizziness, decreased concentration.

From the cardiovascular system: palpitations, arrhythmias, increased blood pressure.

From the digestive system: erosive and ulcerative lesions of the gastrointestinal tract, nausea, vomiting, epigastric discomfort, abdominal pain, constipation, impaired liver function.

From the urinary system: renal dysfunction.

From the senses: hearing loss, tinnitus, increased intraocular pressure in patients with angle-closure glaucoma.

Others: dermatitis, tachypnea (increased breathing).

If any of the side effects indicated in the instructions get worse, or the patient notices any other side effects not listed in the instructions, he should inform the doctor.

Contraindications to the use of the drug

- erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);

- gastrointestinal bleeding;

- complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including a history);

- severe liver failure;

- severe renal failure;

- inhibition of bone marrow hematopoiesis;

— condition after coronary artery bypass grafting;

- severe organic diseases of the cardiovascular system (including acute myocardial infarction);

- paroxysmal tachycardia;

- frequent ventricular extrasystole;

- severe arterial hypertension;

- hyperkalemia;

- pregnancy;

- lactation period (breastfeeding);

- children and adolescents up to 18 years of age;

- hypersensitivity to the components of the drug.

WITH caution the drug should be used in patients with cerebrovascular diseases, diabetes mellitus, peripheral arterial diseases, a history of ulcerative lesions of the gastrointestinal tract, mild or moderate renal and liver failure, viral hepatitis, alcoholic liver damage, benign hyperbilirubinemia (Gilbert, Dubin-Johnson and Rotor), epilepsy, with a tendency to seizures, deficiency of glucose-6-phosphate dehydrogenase, in elderly patients. If any of the listed diseases and conditions are present, the patient should consult a doctor before using the drug.

Use of the drug during pregnancy and lactation

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

Use for liver dysfunction

Use is contraindicated in severe liver failure.

Use for renal impairment

Use is contraindicated in severe renal failure.

special instructions

The simultaneous use of Pentalgin ® with other drugs containing paracetamol and/or NSAIDs, as well as with drugs to relieve symptoms of colds, flu and nasal congestion should be avoided.

When using the drug Pentalgin ® for more than 5-7 days, peripheral blood counts and the functional state of the liver should be monitored.

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

If it is necessary to determine 17-ketosteroids, Pentalgin ® should be discontinued 48 hours before the study. Please note that naproxen increases bleeding time.

The effect of caffeine on the central nervous system depends on the type of nervous system and can manifest itself as both excitation and inhibition of higher nervous activity.

During the treatment period, the patient should avoid drinking alcohol.

Impact on the ability to drive vehicles and operate machinery

Overdose

Symptoms: pale skin, anorexia (lack of appetite), abdominal pain, nausea, vomiting, gastrointestinal bleeding, agitation, restlessness, confusion, tachycardia, arrhythmia, hyperthermia (increased body temperature), frequent urination, headache, tremor or muscle twitching; epileptic seizures, increased activity of liver transaminases, hepatonecrosis, increased prothrombin time. Symptoms of liver dysfunction may appear 12-48 hours after an overdose. In case of severe overdose, liver failure develops with progressive encephalopathy, coma, and death; acute renal failure with tubular necrosis; arrhythmia, pancreatitis. If you suspect an overdose, you should immediately seek medical help.

Treatment: gastric lavage followed by taking activated charcoal. The specific antidote for paracetamol poisoning is acetylcysteine. The administration of acetylcysteine is important within 8 hours after taking paracetamol. In case of gastrointestinal bleeding, it is necessary to administer antacids and gastric lavage with an ice-cold 0.9% sodium chloride solution; maintaining pulmonary ventilation and oxygenation; for epileptic seizures - intravenous administration of diazepam; maintaining fluid and salt balance.

Drug interactions

When taking the drug Pentalgin ® simultaneously with barbiturates, tricyclic antidepressants, rifampicin, ethanol, the risk of hepatotoxicity increases (these combinations should be avoided).

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

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

When used simultaneously with paracetamol and ethanol, the risk of acute pancreatitis increases.

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

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

Concomitant use of caffeinated beverages and other CNS stimulants may result in excessive CNS stimulation.

When used concomitantly, drotaverine may weaken the antiparkinsonian effect of levodopa.

With simultaneous use of pheniramine with tranquilizers, hypnotics, MAO inhibitors, ethanol, the depressant effect on the central nervous system may be enhanced.

Conditions for dispensing from pharmacies

The drug is approved for use as a means of OTC.

Storage conditions and periods

The drug should be stored out of the reach of children, in a dry place, protected from light, at a temperature not exceeding 25°C. Shelf life - 2 years.