Biviflu BRV medicine treats the symptoms of the flu (10 blisters x 12 tablets)
Dosage form Box of 10 blisters x 12 tablets
Specifications Dextromethorphan hydrobromid, loratadin, paracetamol
Ingredient BRV
Ingredient
Thành phần cho 1 viên
| Composition information | Content |
| Dextromethorphan hydrobromid | 15mg |
| Loratadin | 5mg |
| Paracetamol | 500mg |
Uses
Indications
Biviflu drug indicated in the following cases:
Biviflu is a combination of a painkiller, reducing paracetamol with a new generation of Loratadin antihistamines along with an anti -addictive substance, dextromethorphan that works as follows
paracetamol (acetaminophen): is a metabolic substance that is active in phenacetin, an effective analgesic and antipyretic drug that can replace aspirin but less anti -inflammatory properties. The drug acts on the lower area of
causing cooling down, increasing heat due to vasodilation and increasing peripheral blood flow. Paracetamol is usually well tolerated, without many side effects of aspirin.
Loratadin: is a 3 -round antihistamine that has a long -lasting effect with selective antagonistic activity on the H1 receptor on the periphery and has no soothing effect on the central nervous system. The drug has the effect of reducing the symptoms of rhinitis and allergic conjunctivitis due to histamine release. Loratadine also has anti -itching and urticaria effects related to histamines. The drug begins to have antihistamine resistance
within 1-4 hours, reaching maximum after 8 - 12 hours and lasts more than 24 hours and does not cause sedative side effects.
dextromethorphan hydrobromid is a reduced substance they work on cough center in the brain. Although the chemical structure is related to morphine, dextromethorphan has no pain to relieve pain and generally have very little sedative effects. Dextromethorphan is used temporarily due to mild stimulation in the bronchial and throat as usual cold or inhalation of stimulants.
Dextromethorphan is most effective in the treatment of chronic cough, without sputum. The drug has no effect on sputum. The effect of dextromethorphan is almost equivalent to the effectiveness of the codeine but has less side effects in the digestive tract. With the treatment dose, the anti -cough effect of the drug lasts 5-6 hours. Low toxicity, non -addictive, but with very high doses can inhibit the central nervous system.
pharmacokinetic
paracetamol is easily absorbed and almost completely through the gastrointestinal tract. The peak concentration of plasma is achieved within 10 - 60 minutes after drinking. The drug is distributed relatively evenly in the pharynx throughout the body's tissues. The drug goes through the placenta and appears in breast milk. The binding of protein IT in the treatment dose but increased by the dose.
Sell waste time varies from 1-3 hours. The drug is metabolized mostly in the liver and excreted through urine mainly in the form of glycuronid and sulfate. Under 5% is eliminated in the form of intact paracetamol.
A small amount of hydroxylate metabolites (N-Acetyl Benzoquinoneimin) are produced by cytochrom P450 isoenzyme (mainly CYP 2E 1 and CYP 3E 4) in the liver and kidneys. This substance is often detoxified through link with gluthation but can be accumulated after overdose and tissue damage.
Loratadin is quickly absorbed by oral. The average plasma peak concentration of loratadin and metabolites of descarboethoxy loratadin (active) respectively is 1.5 and 3.7 hours respectively. The drug is associated with 97%protein. Loratadin's disposal time is 17 hours and of descarboethoxy Loratadin is 19 hours. The selling time of the drug is transformed among individuals, not affected by blood urea, increasing in the elderly and people with cirrhosis.
The clearance of the drug is 57 - 142 ml/min/kg and is not affected by blood urea but decreased in patients with cirrhosis. The distribution volume is 80 - 120 liters/kg. Loratadin metabolizes a lot when the liver is first passed by the liver by the microsom cytochrom P450 enzyme system; The metabolites are mainly descarboethoxy loratadin. About 80% of the total dose is excreted in urine and feces in nearly equal amounts in the form of metabolites within 10 days.
Dextromethorphan is quickly absorbed through the digestive tract and works within 15 - 30 minutes after drinking, lasting about 6-8 hours. The drug is metabolized in the liver and excreted through the urine in the form of constant and Demethyl metabolites, among them, there is also a slight activity dex.
Before taking Biviflu BRV medicine treats the symptoms of the flu (10 blisters x 12 tablets)
How to use
oral medication. The minimum distance between drug use is 8 hours.
Dosage
Adults and children aged 12: take 1 tablet, 2 times a day.
Do not recommend taking drugs for children under 12 years old.
In case of liver failure, kidney failure: take 1 tablet a day or take a day.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.
What to do when using overdose?
What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
The side effects of the drug due to each active ingredient arranged by classification and frequency are listed in the following table:
due to paracetamol
immune system:
Gastrointestinal tract:
Skin and subcutaneous tissue:
Kidney and urinary tract:
immune system:
Nervous system:
heart:
Gastrointestinal tract:
Skin and subcutaneous tissue:
General:
Do dextromethorphan
Cardiovascular:
Neurological:
Gastrointestinal tract:
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Biviflu drugs contraindicated in the following cases:
Precautions for use
related to paracetamol
Paracetamol is relatively non -toxic to the treatment and when used under the guidance of a physician. However, overdose of paracetamol is the main cause of acute liver failure. Using many preparations containing paracetamol and can lead to harmful consequences (such as paracetamol overdose).
Serious, fatal skin reactions include Stevens-Johnson syndrome (SJS), poisoned epidermal necrosis (ten), external pustules syndrome (AGEP), Lyell syndrome but rare but occurring with paracetamol, often regardless of the effect of other drugs. However, other analgesic and antipyretic (such as NSAIDs) can cause similar reactions, cross -sensitive with paracetamol. Patients need to stop using paracetamol and see a physician when a rash or other skin manifestations or sensitive reactions during treatment. Patients with a history of such reactions should not be used in preparations containing paracetamol.
Sometimes skin reactions include rashes and urticaria; But other sensitive reactions include larynx edema, angioedema and anaphylactic reactions that can rarely occur.
Platelet reduction, leukopenia and all bloody hemoglobin have occurred with the use of p-aminophenol derivatives, especially when used for large doses. Neutral leukopenia and thrombocytopenic hemorrhage occur when using paracetamol. Rarely loss of granulocytes in patients using paracetamol.
Be cautious when using paracetamol for people with liver failure, kidney failure, alcoholic, chronic malnutrition or dehydration. Avoid high doses, prolonged use for people with liver failure.
Be careful for patients with anemia before, because purple blue may not manifest clearly, although high concentrations at a dangerous level of methemoglobin in the blood.
Drinking plenty of alcohol can cause increased toxicity to the liver of paracetamol, should avoid or limit alcohol during medication.
Related Loratadin
For patients with severe hepatic impairment, the initial dose should be lower due to the reduced loratadine clearance.
When using Loratadin may have dry mouth, especially in the elderly, and increase the risk of tooth decay. Need clean oral hygiene to avoid the risk of tooth decay.
Related Dextromethorphan
Be cautious when used for chronic patients such as smoking, asthma or they have too many sputum.
There have been reports on cases of abuse of dextromethorphan, especially in teenagers as well as in patients with a history of drug abuse or psychotropic substances.
Dextromethorphan is metabolized through the cytochrom P450 2D6 in the liver, so be careful when used in patients with slow CYP2D6 metabolism (about 10% of the population) or use CYP2D6 inhibitors such as fluoxetin, proxetin, quinidine and terbinafin.
Use drugs for women during pregnancy and lactation
Do not take medicine for women during pregnancy or nursing mothers without a physician's prescription.
The effect of the drug on the ability to drive and operate machinery
Do not use drugs for drivers and operate machinery because the drug can cause more or less drowsiness, dizziness.
Drug interaction
Due to paracetamol
It is necessary to pay attention to the possibility of serious antipyretics in patients using simultaneously phenothiazine and cooling therapy (such as paracetamol).
Anti -seizure drugs (phenytoin, barbiturat, carbamazepin) cause enzyme induction of the liver microsom, which can increase the liver toxicity of paracetamol due to increased metabolism into toxic substances to the liver.
Simultaneous use of isoniazid with paracetamol may also increase the risk of toxicity to the liver, but it has not yet been determined the exact mechanism of this interaction. The risk of paracetamol causes liver toxicity significantly increases in patients with a larger doses of paracetamol than willow recommended while taking anti -convulsions or isoniazid.
Probenecid can reduce paracetamol elimination and increase the half -life period in the plasma of paracetamol.
Isoniazid and tuberculosis drugs increase the toxicity of paracetamol for the liver.
metoclopramid or domperidon may increase the absorption of paracetamol and vice versa Colestyramin can reduce the absorption of paracetamol.
Do Loratadin
There is an increase in plasma Loratadin concentrations when used at the same time as cimetidine, ketoconazole or erythromycin but there is no clinical change (including changes in electrocardiograms).
Be cautious when used in combination with substances that are known to inhibit CYP3A4 (azithromicin, clarithromycin, clotrimazol, fluconazole, etc.) or inhibit CYP2D6 (fluoxetin, paroxetin, quinidine, celecoxib, etc.)
because it can lead to increased loopin levels and can increase the effects extra.
Should stop using the drug about 48 hours before skin tests because antihistamine drugs may lose or reduce signs of skin -positive reactions.
do dextromethorphan
Do not use at the same time with monoamine oxidase inhibitors (IMAO), because it can cause severe reactions such as high fever, dizziness, hypertension, brain bleeding, even death.
Concentrated with central neurological inhibitors can increase the central neurological inhibitor of these drugs and of dextromethorphan.
Dextromethorphan is initially transformed in the liver by CYP2D6, so simultaneously used with CYP2D6 enzyme inhibitors can increase the concentration of dextromethorphan in the body many times higher than normal. This increases the risk of toxicity of dextromethorphan (agitated, confused, tremor, insomnia, diarrhea and respiratory failure) and the development of serotonin syndrome. Potential CYP2D6 enamel inhibitors include fluoxetin, paroxetin, quinidine and terbinafin. Simultaneous use with quinidine, the concentration of dextromethorphan in plasma has increased by 20 times, increasing side effects on the central nervous system of this substance.
Amiodaron, Flecainid and Propafenon, Sertralin, Bupropion, Methadon, Cinacalcet, Haloperidol, Perphenazin and Thioridazin have similar effects on the metabolism of dextromethorphan.
general
The drinking alcohol can increase the risk of paracetamol's liver toxicity and increase the effect of inhibiting the central nervous system of loratadin and dextromethorphan.Storage
Leave a cool place, avoid light, temperature below 30⁰C.
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