Coldrex HotRem with honey and lemon flavor sachets 5 g, 5 pcs. (Paracetamol, Phenylephrine, Ascorbic Acid)
Special Price
$23.76
Regular Price
$24.00
In stock
SKU
florida463022
Briefly about the product
Coldrex HotRem - a combined product whose effect is due to the active components included in it: srdl is required to be used
Phenylephrine is a vasoconstrictor, relieves nasal congestion (narrows the vessels of the nasal mucosa and paranasal sinuses) and facilitates breathing.
Ascorbic acid (Vitamin C) fulfills the need for Vitamin C in case of rest and flu.
The active substances of Coldrex HotRem do not cause drowsiness. *
* Instructions for medical use, RU Рџ N016305 / 01 Buy Coldrex HotRem with honey and lemon flavor sachets 5 g, 5 pcs. (Paracetamol, Phenylephrine, Ascorbic Acid) in florida free shipping. Fast international shipping USA, AU, EU, UK and others.
Coldrex HotRem - a combined product whose effect is due to the active components included in it: srdl is required to be used
Phenylephrine is a vasoconstrictor, relieves nasal congestion (narrows the vessels of the nasal mucosa and paranasal sinuses) and facilitates breathing.
Ascorbic acid (Vitamin C) fulfills the need for Vitamin C in case of rest and flu.
The active substances of Coldrex HotRem do not cause drowsiness. *
* Instructions for medical use, RU Рџ N016305 / 01 Buy Coldrex HotRem with honey and lemon flavor sachets 5 g, 5 pcs. (Paracetamol, Phenylephrine, Ascorbic Acid) in florida free shipping. Fast international shipping USA, AU, EU, UK and others.
Briefly about the product
Coldrex HotRem - a combined product whose effect is due to the active components included in it: srdl is required to be used
Phenylephrine is a vasoconstrictor, relieves nasal congestion (narrows the vessels of the nasal mucosa and paranasal sinuses) and facilitates breathing.
Ascorbic acid (Vitamin C) fulfills the need for Vitamin C in case of rest and flu.
The active substances of Coldrex HotRem do not cause drowsiness. *
* Instructions for medical use, RU Рџ N016305 / 01
Latin name
Coldrex Hotrem
Packaging
5 g - sachets (5) - packs of cardboard.
Pharmacological action
Combined agent whose action is due to its constituent components.
Paracetamol is an analgesic and antipyretic. The mechanism of its action is supposedly to suppress the synthesis of prostaglandins, mainly in the central nervous system.
Paracetamol has an extremely small effect on the synthesis of prostaglandins in peripheral tissues, it does not alter the water-electrolyte metabolism and does not damage the mucous membrane of the gastrointestinal tract.
This property of paracetamol makes the drug particularly suitable for patients with a history of gastrointestinal diseases (for example, patients with a history of gastrointestinal bleeding or elderly patients) or patients taking concomitant medication in which suppression of the synthesis of peripheral prostaglandins may be undesirable .
Phenylephrine hydrochloride is a sympathomimetic drug whose action is aimed at stimulating adrenoreceptors (mainly -adrenoreceptors), which leads to in which suppression of the synthesis of peripheral prostaglandins may be undesirable.
Phenylephrine hydrochloride is a sympathomimetic drug whose action is aimed at stimulating adrenoreceptors (mainly -adrenoreceptors), which leads to in which suppression of the synthesis of peripheral prostaglandins may be undesirable.
Phenylephrine hydrochloride is a sympathomimetic drug whose action is aimed at stimulating adrenoreceptors (mainly -adrenoreceptors), which leads toreduce swelling of the nasal mucosa and facilitate nasal breathing.
Ascorbic acid (vitamin C) makes up for the increased need for vitamin C for “colds” and flu, especially in the initial stages of the disease.
The components of the preparation do not cause drowsiness or disturb attention span.
Indications
To eliminate the symptoms of acute respiratory infections and flu, including: - elevated body temperature
- headache
- chills
- pain in the joints and muscles
- nasal congestion
- sore throat and sinuses.
Contraindications
- Severe liver dysfunction
- pronounced hypertension. including thyrotoxicosis)
- diabetes mellitus
- sucrose / isomaltase deficiency, fructose intolerance, glucose / galactose malabsorption syndrome, because the preparation contains sucrose
- heart disease (severe stenosis of the aortic orifice, acute myocardial infarction, tachyarrhythmia)
- arterial hypertension
- simultaneous administration of tricyclic antidepressants, beta-blockers, MAO inhibitors and the period up to 14 days after their cancellation
- simultaneous administration of other paracetamol-containing agents and agents to alleviate the symptoms of colds, flu and nasal congestion
- benign prostatic hyperplasia
- angle-closure glaucoma
- children's age up to 12 years
- increased components of the drug
Recommendations for using
If you have one of the listed diseases / conditions / risk factors, be sure to consult your doctor before taking the drug:
Benign hyperbilirubinemia.
Impaired liver and kidney function of mild to moderate severity.
Alcoholic liver disease.
Cardiovascular disease, including high blood pressure, obliterating vascular disease (Raynaud's syndrome).
Pheochromocytoma.
The presence of severe infections, including sepsis, because taking the drug may increase the risk of metabolic acidosis.
Patients with glutathione deficiency (in particular, extremely malnourished patients suffering from anorexia, chronic alcoholism or patients with a low body mass index).
Concomitant use of antihypertensive drugs.
Pregnancy and the period of breastfeeding.
Use during pregnancy and lactation
Pregnancy
The drug should not be used during pregnancy without first consulting a doctor!
In studies, conducted on animals and humans, there was no risk of paracetamol during pregnancy or a negative effect on fetal development.
There are no sufficient data on the effect of drugs containing phenylephrine on pregnancy.
Breastfeeding period
The drug should not be used during breastfeeding without first consulting a doctor!
Paracetamol crosses the placental barrier and into breast milk. In studies conducted in humans, no adverse effects on the baby’s body were found during breastfeeding.
Phenylephrine may pass into breast milk.
Special instructions
The patient should be informed that if symptoms persist, the doctor should be advised and should be advised to take the drug 5 days later .
The drug should be taken only at recommended doses.
The patient should stop taking the drug and consult a doctor immediately if the following side effects occur:
allergic reactions: itching or redness of the skin, difficulty breathing or swelling of the lips, tongue, throat or face
rash or peeling on the skin, ulceration of the mucous membrane
mouth bruising or bleeding
vision loss. This may be due to increased intraocular pressure. Very rarely, but with the greatest likelihood, this side effect is observed in patients with glaucoma
a feeling of a strong heartbeat or an increase in heart rate or heart rhythm disturbances
difficulty urinating. More often this side effect is observed in patients with prostatic hypertrophy.
You should not take the drug if respiratory problems have been observed while taking acetylsalicylic acid or other NSAIDs.
The drug should not be taken simultaneously with other drugs containing paracetamol, as well as other non-narcotic analgesics (metamizole sodium), NSAIDs (acetylsalicylic acid, ibuprofen), barbiturates, anticonvulsants, rifampicin and chloramphenicol, sympathomimetics (such as decatomimetics appetite suppressants, amphetamine-like psychostimulants), with other agents to relieve symptoms of the common cold and flu.
When conducting tests to determine uric acid and the level of glucose in the blood, the patient must inform the doctor about the use of Coldrex® HotRem, as the drug may distort the results of laboratory tests evaluating the concentration of glucose and uric acid.
Before taking Coldrex® HotRem (lemon), you need to consult a doctor if: taking metoclopramide, domperidone (used to eliminate nausea and vomiting) or colestyramine used to lower blood cholesterol
taking drugs to reduce blood coagulation (for example, warfarin)
low sodium diet - each sachet contains 0. 12 g of sodium
of a serious infectious disease (including sepsis) in patients with glutathione deficiency, because while taking paracetamol, the risk of metabolic acidosis may increase, signs of which are a violation of the frequency and depth of breathing, accompanied by a feeling of lack of air (shortness of breath), nausea, vomiting, loss of appetite. If the patient discovers these, consult a doctor immediately.
Patients with phenylketonuria are not recommended to take Coldrex® HotRem (lemon-honey), as it contains aspartame, which is a source of phenylalanine. Before taking Coldrex® HotRem (lemon-honey), you need to consult a doctor in the following cases: taking warfarin or other indirect anticoagulants
taking medications to control blood pressure, for example beta-blockers
taking digoxin or other cardiac glycosides to treat heart failure
taking drugs to reduce appetite or psychostimulants
taking drugs to treat depression (tricyclic antidepressants - amitriptyline)
taking metoclopramide, domperidone or used by
to lower
blood cholesterol if a hyponatrium diet is required (each packet contains 0.12 g of sodium).
In order to avoid toxic liver damage, paracetamol should not be combined with alcoholic beverages, and should also be taken by people who drink alcohol chronically.
Effect on the ability to drive vehicles and mechanisms
When taken in recommended doses, the drug does not affect the ability to drive vehicles and mechanisms, as well as engage in other potentially dangerous activities that require concentration and speed of psychomotor reactions. When dizziness occurs, it is not recommended to drive vehicles or work with mechanisms.
Composition
phenylephrine
Paracetamol
ascorbic acid
Dosage and administration
For oral administration.
Do not exceed the specified dose!
The lowest dose needed to achieve the effect should be used!
The minimum interval between doses of Coldrex® HotRem should be at least 4 hours.
Contain 1 sachet in a mug, pour hot water, stir until dissolved.
Add cold water and sugar if necessary.
Adults (including the elderly) and children over 12 years: Inside, single dose - 1 sachet. Repeated use of the drug is possible no earlier than 4-6 h and no more than 4 times / day. The maximum daily dose should not exceed 4 sachets. The maximum duration of the drug without consulting a doctor should be no more than 5 days.
Do not take at the same time as other paracetamol-containing agents, decongestants and agents to relieve the symptoms of colds and flu, as well as ethanol-containing agents and drinks.
If the symptoms of the disease persist when taking the drug, you should consult a doctor.
Side effects
Determination of the frequency of side effects: very often (? 1/10), often (? 1/100 and <1/10), infrequently (? 1/1000 and <1/100), rarely (? 1 / 10 000 and <1/1000), very rarely (? 1/100 000 and <1/10 000).
At recommended doses, the drug is usually well tolerated.
Paracetamol rarely has a side effect.
From the hemopoietic system: very rarely - thrombocytopenia, leukopenia, agranulocytosis.
Allergic reactions: very rare - anaphylactic shock, skin rash, urticaria, angioedema, Stevens-Johnson syndrome.
From the respiratory system: very rarely - bronchospasm in patients sensitive to acetylsalicylic acid and other NSAIDs.
From the liver and biliary tract: very rarely - impaired liver function.
With prolonged use in excess of the recommended dose, hepatotoxic and nephrotoxic effects may be observed.
Phenylephrine
From the nervous system: often - irritability, headache, dizziness, insomnia very rarely - irritability, nervous tension.
From the cardiovascular system: often - increased blood pressure rarely - tachycardia, palpitations.
From the digestive system: often - nausea, vomiting.
From the sensory organs: rarely - mydriasis, an acute attack of glaucoma in most cases in patients with angle-closure glaucoma.
Allergic reactions: rarely - skin rash, urticaria, allergic dermatitis.
From the urinary system: rarely - dysuria, urinary retention in patients with obstruction of the outlet of the bladder with prostatic hypertrophy.
Ascorbic acid
The incidence of side effects has not been established.
Allergic reactions: skin rash, flushing of the skin.
From the digestive system: irritation of the gastrointestinal mucosa.
From the hemopoietic system: thrombocytosis, hyperprothrombinemia, erythropenia, neutrophilic leukocytosis.
Other: hypokalemia.
When taking ascorbic acid more than 600 mg / day, moderate pollakiuria is possible.
In case of side effects, the patient should immediately stop taking the drug and consult a doctor as soon as possible.
If any of the above side effects get worse, or any other side effects appear, the patient should inform your doctor.
Drug Interaction
Paracetamol, when taken for a long time, increases the effect of indirect anticoagulants (warfarin and other coumarins), which increases the risk of bleeding. Episodic intake of a single dose of the drug has no significant effect on the effect of indirect anticoagulants.
Inductors of microsomal oxidation enzymes in the liver (barbiturates, diphenin, carbamazepine, rifampicin, zidovudine, phenytoin, ethanol, flumecinol, phenylbutazone and tricyclic antidepressants) increase the risk of hepatotoxic action with paratotoxic action.
Microsomal oxidation inhibitors (cimetidine) reduce the risk of hepatotoxic action.
Paracetamol reduces the effectiveness of diuretics.
Metoclopramide and domperidone increase, and cholestyramine reduces the absorption rate of paracetamol.
Paracetamol enhances the effects of MAO inhibitors, sedatives, ethanol.
Phenylephrine, when taken with MAO inhibitors, can lead to increased blood pressure.
Phenylephrine reduces the effectiveness of beta-blockers and antihypertensive drugs, increases the risk of hypertension and disorders of the cardiovascular system.
Concomitant use of phenylephrine with sympathomimetic amines may increase the risk of side effects from the cardiovascular system.
Tricyclic antidepressants enhance the sympathomimetic effect of phenylephrine, may increase the risk of side effects from the cardiovascular system.
Co-administration of halothane with phenylephrine increases the risk of ventricular arrhythmia.
Phenylephrine reduces the hypotensive action of guanethidine, which in turn enhances the alpha-adrenostimulating activity of phenylephrine.
Antidepressants, antiparkinsonian agents, antipsychotics, phenothiazine derivatives increase the risk of urinary retention, dry mouth, constipation.
Co-administration of ACS with phenylephrine increases the risk of glaucoma.
When used with digoxin and cardiac glycosides, the risk of developing heart rhythm or heart attack may be increased.
Ascorbic acid increases the risk of crystalluria when treated with short-acting salicylates and sulfanilamides, slows the elimination of kidneys by acids, increases the excretion of drugs that have an alkaline reaction (including alkaloids), lowers the blood concentration of oral contraceptives.
Ethanol promotes acute pancreatitis.
Myelotoxic drugs increase the manifestation of the hematotoxicity of the drug.
Overdose
In the event of an overdose of Caldrex® HotRem (even with good health), the risk of delayed signs of serious liver damage should be considered.
Symptoms caused by paracetamol: for 24 hours - pale skin, nausea, vomiting, anorexia, abdominal pain for 12-48 hours may show signs of impaired liver function, signs of impaired glucose metabolism and metabolic acidosis. Toxic effect in adults is possible after a single ingestion of more than 10 g of paracetamol - increased activity of hepatic transaminases, the clinical picture of liver damage manifests itself in 1-6 days.
In the case of severe poisoning, severe hepatic failure may develop up to hepatic encephalopathy, coma and death. Acute renal failure with acute tubal necrosis, which is diagnosed by severe lumbar pain, hematuria and proteinuria, can develop without severe liver dysfunction. There have been reports of cardiac arrhythmias and pancreatitis with an overdose of paracetamol.
In the early period, symptoms may be limited only by nausea and vomiting and may not reflect the severity of the overdose or the degree of risk of damage to the internal organs.
Treatment: Within the first hour after the presumed overdose, it is advisable to administer activated charcoal inside. 4 or more hours after the presumed overdose, a determination of the plasma concentration of paracetamol is required (earlier determination of the paracetamol concentration may be unreliable).
A specific antidote for paracetamol poisoning is acetylcysteine. Acetylcysteine treatment can be performed up to 24 h after administration of paracetamol, however, the maximum hepatoprotective effect can be obtained within the first 8 h after overdose. After that, the effectiveness of the antidote drops sharply. If necessary, acetylcysteine can be given in / in. In the absence of vomiting, the alternative (in the absence of the possibility of rapid receipt of inpatient care) is the appointment of methionine inside. Treatment of patients with severe liver dysfunction 24 hours after taking acetaminophen should be carried out in conjunction with specialists at the toxicology center or specialized department of liver disease.
Symptoms caused by phenylephrine: irritability, headache, dizziness, insomnia, increased blood pressure, nausea, vomiting, increased excitability, reflex bradycardia. In severe cases of overdose development of hallucinations, confusion, convulsions, arrhythmias is possible. An overdose with phenylephrine can cause symptoms similar to side effects.
Treatment: symptomatic therapy with severe hypertension using alpha-blockers such as phentolamine.
Symptoms caused by ascorbic acid: Ascorbic acid in high doses (more than 3000 mg) can cause temporary osmotic diarrhea and gastrointestinal disorders such as nausea, stomach discomfort. Manifestations of ascorbic acid overdose can be categorized as those caused by severe liver damage as a result of paracetamol overdose.
Treatment: symptomatic, forced diuresis.
At the first signs of overdose, you should seek immediate medical attention, even in the absence of clear symptoms of poisoning.
Expiration
Expiration
3 years.
GlaxoSmithKline, UK
Coldrex HotRem with honey and lemon flavor sachets 5 g, 5 pcs. (Paracetamol, Phenylephrine, Ascorbic Acid) florida in pharmacy online. Cheap price, instruction, side effects, dosage. Coldrex HotRem with honey and lemon flavor sachets 5 g, 5 pcs. - Sale. PayPal accept. Free shipping florida. Fast international shipping.
Coldrex HotRem - a combined product whose effect is due to the active components included in it: srdl is required to be used
Phenylephrine is a vasoconstrictor, relieves nasal congestion (narrows the vessels of the nasal mucosa and paranasal sinuses) and facilitates breathing.
Ascorbic acid (Vitamin C) fulfills the need for Vitamin C in case of rest and flu.
The active substances of Coldrex HotRem do not cause drowsiness. *
* Instructions for medical use, RU Рџ N016305 / 01
Latin name
Coldrex Hotrem
Packaging
5 g - sachets (5) - packs of cardboard.
Pharmacological action
Combined agent whose action is due to its constituent components.
Paracetamol is an analgesic and antipyretic. The mechanism of its action is supposedly to suppress the synthesis of prostaglandins, mainly in the central nervous system.
Paracetamol has an extremely small effect on the synthesis of prostaglandins in peripheral tissues, it does not alter the water-electrolyte metabolism and does not damage the mucous membrane of the gastrointestinal tract.
This property of paracetamol makes the drug particularly suitable for patients with a history of gastrointestinal diseases (for example, patients with a history of gastrointestinal bleeding or elderly patients) or patients taking concomitant medication in which suppression of the synthesis of peripheral prostaglandins may be undesirable .
Phenylephrine hydrochloride is a sympathomimetic drug whose action is aimed at stimulating adrenoreceptors (mainly -adrenoreceptors), which leads to in which suppression of the synthesis of peripheral prostaglandins may be undesirable.
Phenylephrine hydrochloride is a sympathomimetic drug whose action is aimed at stimulating adrenoreceptors (mainly -adrenoreceptors), which leads to in which suppression of the synthesis of peripheral prostaglandins may be undesirable.
Phenylephrine hydrochloride is a sympathomimetic drug whose action is aimed at stimulating adrenoreceptors (mainly -adrenoreceptors), which leads toreduce swelling of the nasal mucosa and facilitate nasal breathing.
Ascorbic acid (vitamin C) makes up for the increased need for vitamin C for “colds” and flu, especially in the initial stages of the disease.
The components of the preparation do not cause drowsiness or disturb attention span.
Indications
To eliminate the symptoms of acute respiratory infections and flu, including: - elevated body temperature
- headache
- chills
- pain in the joints and muscles
- nasal congestion
- sore throat and sinuses.
Contraindications
- Severe liver dysfunction
- pronounced hypertension. including thyrotoxicosis)
- diabetes mellitus
- sucrose / isomaltase deficiency, fructose intolerance, glucose / galactose malabsorption syndrome, because the preparation contains sucrose
- heart disease (severe stenosis of the aortic orifice, acute myocardial infarction, tachyarrhythmia)
- arterial hypertension
- simultaneous administration of tricyclic antidepressants, beta-blockers, MAO inhibitors and the period up to 14 days after their cancellation
- simultaneous administration of other paracetamol-containing agents and agents to alleviate the symptoms of colds, flu and nasal congestion
- benign prostatic hyperplasia
- angle-closure glaucoma
- children's age up to 12 years
- increased components of the drug
Recommendations for using
If you have one of the listed diseases / conditions / risk factors, be sure to consult your doctor before taking the drug:
Benign hyperbilirubinemia.
Impaired liver and kidney function of mild to moderate severity.
Alcoholic liver disease.
Cardiovascular disease, including high blood pressure, obliterating vascular disease (Raynaud's syndrome).
Pheochromocytoma.
The presence of severe infections, including sepsis, because taking the drug may increase the risk of metabolic acidosis.
Patients with glutathione deficiency (in particular, extremely malnourished patients suffering from anorexia, chronic alcoholism or patients with a low body mass index).
Concomitant use of antihypertensive drugs.
Pregnancy and the period of breastfeeding.
Use during pregnancy and lactation
Pregnancy
The drug should not be used during pregnancy without first consulting a doctor!
In studies, conducted on animals and humans, there was no risk of paracetamol during pregnancy or a negative effect on fetal development.
There are no sufficient data on the effect of drugs containing phenylephrine on pregnancy.
Breastfeeding period
The drug should not be used during breastfeeding without first consulting a doctor!
Paracetamol crosses the placental barrier and into breast milk. In studies conducted in humans, no adverse effects on the baby’s body were found during breastfeeding.
Phenylephrine may pass into breast milk.
Special instructions
The patient should be informed that if symptoms persist, the doctor should be advised and should be advised to take the drug 5 days later .
The drug should be taken only at recommended doses.
The patient should stop taking the drug and consult a doctor immediately if the following side effects occur:
allergic reactions: itching or redness of the skin, difficulty breathing or swelling of the lips, tongue, throat or face
rash or peeling on the skin, ulceration of the mucous membrane
mouth bruising or bleeding
vision loss. This may be due to increased intraocular pressure. Very rarely, but with the greatest likelihood, this side effect is observed in patients with glaucoma
a feeling of a strong heartbeat or an increase in heart rate or heart rhythm disturbances
difficulty urinating. More often this side effect is observed in patients with prostatic hypertrophy.
You should not take the drug if respiratory problems have been observed while taking acetylsalicylic acid or other NSAIDs.
The drug should not be taken simultaneously with other drugs containing paracetamol, as well as other non-narcotic analgesics (metamizole sodium), NSAIDs (acetylsalicylic acid, ibuprofen), barbiturates, anticonvulsants, rifampicin and chloramphenicol, sympathomimetics (such as decatomimetics appetite suppressants, amphetamine-like psychostimulants), with other agents to relieve symptoms of the common cold and flu.
When conducting tests to determine uric acid and the level of glucose in the blood, the patient must inform the doctor about the use of Coldrex® HotRem, as the drug may distort the results of laboratory tests evaluating the concentration of glucose and uric acid.
Before taking Coldrex® HotRem (lemon), you need to consult a doctor if: taking metoclopramide, domperidone (used to eliminate nausea and vomiting) or colestyramine used to lower blood cholesterol
taking drugs to reduce blood coagulation (for example, warfarin)
low sodium diet - each sachet contains 0. 12 g of sodium
of a serious infectious disease (including sepsis) in patients with glutathione deficiency, because while taking paracetamol, the risk of metabolic acidosis may increase, signs of which are a violation of the frequency and depth of breathing, accompanied by a feeling of lack of air (shortness of breath), nausea, vomiting, loss of appetite. If the patient discovers these, consult a doctor immediately.
Patients with phenylketonuria are not recommended to take Coldrex® HotRem (lemon-honey), as it contains aspartame, which is a source of phenylalanine. Before taking Coldrex® HotRem (lemon-honey), you need to consult a doctor in the following cases: taking warfarin or other indirect anticoagulants
taking medications to control blood pressure, for example beta-blockers
taking digoxin or other cardiac glycosides to treat heart failure
taking drugs to reduce appetite or psychostimulants
taking drugs to treat depression (tricyclic antidepressants - amitriptyline)
taking metoclopramide, domperidone or used by
to lower
blood cholesterol if a hyponatrium diet is required (each packet contains 0.12 g of sodium).
In order to avoid toxic liver damage, paracetamol should not be combined with alcoholic beverages, and should also be taken by people who drink alcohol chronically.
Effect on the ability to drive vehicles and mechanisms
When taken in recommended doses, the drug does not affect the ability to drive vehicles and mechanisms, as well as engage in other potentially dangerous activities that require concentration and speed of psychomotor reactions. When dizziness occurs, it is not recommended to drive vehicles or work with mechanisms.
Composition
phenylephrine
Paracetamol
ascorbic acid
Dosage and administration
For oral administration.
Do not exceed the specified dose!
The lowest dose needed to achieve the effect should be used!
The minimum interval between doses of Coldrex® HotRem should be at least 4 hours.
Contain 1 sachet in a mug, pour hot water, stir until dissolved.
Add cold water and sugar if necessary.
Adults (including the elderly) and children over 12 years: Inside, single dose - 1 sachet. Repeated use of the drug is possible no earlier than 4-6 h and no more than 4 times / day. The maximum daily dose should not exceed 4 sachets. The maximum duration of the drug without consulting a doctor should be no more than 5 days.
Do not take at the same time as other paracetamol-containing agents, decongestants and agents to relieve the symptoms of colds and flu, as well as ethanol-containing agents and drinks.
If the symptoms of the disease persist when taking the drug, you should consult a doctor.
Side effects
Determination of the frequency of side effects: very often (? 1/10), often (? 1/100 and <1/10), infrequently (? 1/1000 and <1/100), rarely (? 1 / 10 000 and <1/1000), very rarely (? 1/100 000 and <1/10 000).
At recommended doses, the drug is usually well tolerated.
Paracetamol rarely has a side effect.
From the hemopoietic system: very rarely - thrombocytopenia, leukopenia, agranulocytosis.
Allergic reactions: very rare - anaphylactic shock, skin rash, urticaria, angioedema, Stevens-Johnson syndrome.
From the respiratory system: very rarely - bronchospasm in patients sensitive to acetylsalicylic acid and other NSAIDs.
From the liver and biliary tract: very rarely - impaired liver function.
With prolonged use in excess of the recommended dose, hepatotoxic and nephrotoxic effects may be observed.
Phenylephrine
From the nervous system: often - irritability, headache, dizziness, insomnia very rarely - irritability, nervous tension.
From the cardiovascular system: often - increased blood pressure rarely - tachycardia, palpitations.
From the digestive system: often - nausea, vomiting.
From the sensory organs: rarely - mydriasis, an acute attack of glaucoma in most cases in patients with angle-closure glaucoma.
Allergic reactions: rarely - skin rash, urticaria, allergic dermatitis.
From the urinary system: rarely - dysuria, urinary retention in patients with obstruction of the outlet of the bladder with prostatic hypertrophy.
Ascorbic acid
The incidence of side effects has not been established.
Allergic reactions: skin rash, flushing of the skin.
From the digestive system: irritation of the gastrointestinal mucosa.
From the hemopoietic system: thrombocytosis, hyperprothrombinemia, erythropenia, neutrophilic leukocytosis.
Other: hypokalemia.
When taking ascorbic acid more than 600 mg / day, moderate pollakiuria is possible.
In case of side effects, the patient should immediately stop taking the drug and consult a doctor as soon as possible.
If any of the above side effects get worse, or any other side effects appear, the patient should inform your doctor.
Drug Interaction
Paracetamol, when taken for a long time, increases the effect of indirect anticoagulants (warfarin and other coumarins), which increases the risk of bleeding. Episodic intake of a single dose of the drug has no significant effect on the effect of indirect anticoagulants.
Inductors of microsomal oxidation enzymes in the liver (barbiturates, diphenin, carbamazepine, rifampicin, zidovudine, phenytoin, ethanol, flumecinol, phenylbutazone and tricyclic antidepressants) increase the risk of hepatotoxic action with paratotoxic action.
Microsomal oxidation inhibitors (cimetidine) reduce the risk of hepatotoxic action.
Paracetamol reduces the effectiveness of diuretics.
Metoclopramide and domperidone increase, and cholestyramine reduces the absorption rate of paracetamol.
Paracetamol enhances the effects of MAO inhibitors, sedatives, ethanol.
Phenylephrine, when taken with MAO inhibitors, can lead to increased blood pressure.
Phenylephrine reduces the effectiveness of beta-blockers and antihypertensive drugs, increases the risk of hypertension and disorders of the cardiovascular system.
Concomitant use of phenylephrine with sympathomimetic amines may increase the risk of side effects from the cardiovascular system.
Tricyclic antidepressants enhance the sympathomimetic effect of phenylephrine, may increase the risk of side effects from the cardiovascular system.
Co-administration of halothane with phenylephrine increases the risk of ventricular arrhythmia.
Phenylephrine reduces the hypotensive action of guanethidine, which in turn enhances the alpha-adrenostimulating activity of phenylephrine.
Antidepressants, antiparkinsonian agents, antipsychotics, phenothiazine derivatives increase the risk of urinary retention, dry mouth, constipation.
Co-administration of ACS with phenylephrine increases the risk of glaucoma.
When used with digoxin and cardiac glycosides, the risk of developing heart rhythm or heart attack may be increased.
Ascorbic acid increases the risk of crystalluria when treated with short-acting salicylates and sulfanilamides, slows the elimination of kidneys by acids, increases the excretion of drugs that have an alkaline reaction (including alkaloids), lowers the blood concentration of oral contraceptives.
Ethanol promotes acute pancreatitis.
Myelotoxic drugs increase the manifestation of the hematotoxicity of the drug.
Overdose
In the event of an overdose of Caldrex® HotRem (even with good health), the risk of delayed signs of serious liver damage should be considered.
Symptoms caused by paracetamol: for 24 hours - pale skin, nausea, vomiting, anorexia, abdominal pain for 12-48 hours may show signs of impaired liver function, signs of impaired glucose metabolism and metabolic acidosis. Toxic effect in adults is possible after a single ingestion of more than 10 g of paracetamol - increased activity of hepatic transaminases, the clinical picture of liver damage manifests itself in 1-6 days.
In the case of severe poisoning, severe hepatic failure may develop up to hepatic encephalopathy, coma and death. Acute renal failure with acute tubal necrosis, which is diagnosed by severe lumbar pain, hematuria and proteinuria, can develop without severe liver dysfunction. There have been reports of cardiac arrhythmias and pancreatitis with an overdose of paracetamol.
In the early period, symptoms may be limited only by nausea and vomiting and may not reflect the severity of the overdose or the degree of risk of damage to the internal organs.
Treatment: Within the first hour after the presumed overdose, it is advisable to administer activated charcoal inside. 4 or more hours after the presumed overdose, a determination of the plasma concentration of paracetamol is required (earlier determination of the paracetamol concentration may be unreliable).
A specific antidote for paracetamol poisoning is acetylcysteine. Acetylcysteine treatment can be performed up to 24 h after administration of paracetamol, however, the maximum hepatoprotective effect can be obtained within the first 8 h after overdose. After that, the effectiveness of the antidote drops sharply. If necessary, acetylcysteine can be given in / in. In the absence of vomiting, the alternative (in the absence of the possibility of rapid receipt of inpatient care) is the appointment of methionine inside. Treatment of patients with severe liver dysfunction 24 hours after taking acetaminophen should be carried out in conjunction with specialists at the toxicology center or specialized department of liver disease.
Symptoms caused by phenylephrine: irritability, headache, dizziness, insomnia, increased blood pressure, nausea, vomiting, increased excitability, reflex bradycardia. In severe cases of overdose development of hallucinations, confusion, convulsions, arrhythmias is possible. An overdose with phenylephrine can cause symptoms similar to side effects.
Treatment: symptomatic therapy with severe hypertension using alpha-blockers such as phentolamine.
Symptoms caused by ascorbic acid: Ascorbic acid in high doses (more than 3000 mg) can cause temporary osmotic diarrhea and gastrointestinal disorders such as nausea, stomach discomfort. Manifestations of ascorbic acid overdose can be categorized as those caused by severe liver damage as a result of paracetamol overdose.
Treatment: symptomatic, forced diuresis.
At the first signs of overdose, you should seek immediate medical attention, even in the absence of clear symptoms of poisoning.
Expiration
Expiration
3 years.
GlaxoSmithKline, UK
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