Фармакологическое действие - анальгезирующее, антигистаминное
Показания к применению
Болевой синдром легкой и умеренной выраженности: - головная и зубная боль; - боли при синуситах и кашле; - миалгия; - артралгия; - дисальгоменорея; - боли, сопровождающиеся бессонницей Болевой синдром неревматического происхождения
Противопоказания
Гиперчувствительность; детский возраст (до 12 лет). C осторожностью: печеночная и/или почечная недостаточность, врожденные гипербилирубинемии (синдромы Жильбера, Дубина-Джонсона и Ротора), алкоголизм; закрытоугольная глаукома, задержка мочи (гиперплазия предстательной железы), стенозирующая язвенная болезнь желудка и двенадцатиперстной кишки, стеноз шейки мочевого пузыря, бронхиальная астма, ХОБЛ, эпилепсия. Беременность, период лактации
Применение при беременности и в период грудного вскармливания
Под контролем врача
Способ применения и дозы
Внутрь, по 2 таблетки каждые 6 ч (не более 8 таблеток в сутки); при бессоннице, обусловленной болью, - по 2 таблетки перед сном. Длительность приема - не более 10 дней
Побочное действие
Аллергические реакции (кожная сыпь, зуд, крапивница, ангионевротический отек), тошнота, эпигастральная боль; анемия, тромбоцитопения, агранулоцитоз. Сонливость, сухость слизистой оболочки полости рта, онемение слизистой оболочки полости рта, головокружение, тремор, тошнота, головная боль, астения, снижение скорости психомоторной реакции, фотосенсибилизация, парез аккомодации, нарушения координации движений. У детей возможно парадоксальное развитие бессонницы, раздражительности и эйфории. При длительном применении в больших дозах - гепатотоксическое действие, гемолитическая анемия, апластическая анемия, метгемоглобинемия, панцитопения; нефротоксичность (почечная колика, глюкозурия, интерстициальный нефрит, папиллярный некроз).
Передозировка
Симптомы, обусловленные дифенгидрамином: угнетение ЦНС, развитие возбуждения (особенно у детей) или депрессии, расширение зрачков, сухость слизистой оболочки полости рта, парез органов ЖКТ. Симптомы, обусловленные парацетамолом: бледность кожных покровов, снижение аппетита, тошнота, рвота; гепатонекроз (выраженность некроза вследствие интоксикации прямо зависит от степени передозировки). Повышение активности печеночных трансаминаз, увеличение протромбинового времени (через 12-48 ч после приема); развернутая клиническая картина поражения печени проявляется через 1-6 дней. Редко печеночная недостаточность развивается молниеносно и может осложняться почечной недостаточностью (тубулярный некроз). Лечение: промывание желудка, при необходимости - прием препаратов, повышающих АД, кислород, в/в введение плазмозамещающих жидкостей, и донаторов SH-групп и предшественников синтеза глутатиона - метионина - через 8-9 ч после передозировки и N-ацетилцистеина - через 12 ч. Нельзя использовать эпинефрин и аналептики.
Особые указания
Применение при беременности и кормлении грудью возможно только под контролем врача. При одновременном приеме седативных лекарственных средств необходима консультация врача. Во время лечения дифенгидрамином следует избегать УФ-излучения. Необходимо проинформировать врача о применении этого препарата: противорвотное действие может затруднять диагностику аппендицита и распознавание симптомов передозировки других лекарственных средств. Не следует одновременно применять с другими препаратами, содержащими парацетамол, а также другие ненаркотические анальгетики, НПВС (метамизол, ацетилсалициловую кислоту, ибупрофен и т.п.), барбитураты, противоэпилептические средства, рифампицин, хлорамфеникол. В период лечения необходимо воздерживаться от употребления этанола (возможно развитие гепатотоксического действия). Влияние на способность к вождению автотранспорта и управлению механизмами В период лечения необходимо воздерживаться от управления транспортными средствами и занятий другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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