Deflucold day Danapha temporarily reduces symptoms of colds and flu (2 blisters x 10 tablets)
Dosage form Box of 2 blisters x 10 tablets
Specifications Paracetamol, phenylephrin hydrochloride, dextromethophan hydrobromid
Ingredient
| Composition information | Content |
| Paracetamol | 500mg |
| Phenylephrin hydrochloride | 5mg |
| Dextromethophan hydrobromid | 15mg |
Uses
indications
Deflucold day used in the following cases:
dextromethorphan is an analgesic drug they are not opioid. The drug acts on the center in the brain, which increases the threshold of cough but does not have the effect of relieving pain, sedation or respiratory inhibition at the normal cough treatment.
Phenylephrin acts directly on the receptors of A-adrenergic and indirectly acting by releasing noradrenalin from the follicles. Phenylephrin is used as a nasal congestion drug, alleviating the symptoms of vasoconstriction that leads to redistribution of local blood flow, helping to reduce nasal mucosal edema, thereby improving ventilation, blood drainage and nasal congestion.
pharmacokinetics
paracetamol
absorption: Paracetamol is absorbed quickly and almost completely through the digestive tract. Food slowly absorbs paracetamol.
Distribution: Paracetamol is distributed into most tissues in the body. At the treatment dose, paracetamol binds very little with plasma proteins but the level of bond increases when increasing the dose.
Metabolism: Paracetamol is metabolized in the liver and excreted through urine mainly in the form of glucuronid and sulphat metabolites. The metabolites of paracetamol include a small amount of toxic metabolites to the liver, which is inactive by combining with glutathion. However, this metabolite has an accumulation of paracetamol overdose (more than 150 mg/kg or 10 g of oral paracetamol) and if left untreated, can cause non -recovery liver necrosis.
Elimination: Under 5 % of paracetamol is eliminated in a constant form. About 85 % of the paracetamol dose is excreted in the urine in the form of free and combined within 24 hours after drinking. In patients with severe and medium renal failure, can lead to the accumulation of paracetamol metabolites. Sell waste time varies from 1 - 3 hours.
dextromethorphan hydrobromid
After drinking, dextromethorphan is well absorbed through the gastrointestinal tract. Dextromethorphan is metabolized in the liver, through the Cytochrom P450 system (CYP2D6).
dextromethorphan is excreted in urine in a constant form and Demethyl metabolites, among which dextrorphan also works to reduce cough. Dextromethorphan's waste sale time is 1.2 - 3.9 hours, in poor metabolic people, the sale time is 45 hours.
phenylephrin hydrochloride
Phenylephrin is very abnormal absorption through the gastrointestinal tract due to the first metabolized drug by monoamine oxidase in the liver - intestinal cycle. Therefore, the bioavailability of phenylephrin is reduced when used orally.
Phenylephrin metabolizes mainly in the intestinal wall (for the first time) and in the liver. The main metabolic paths include sulfate conjugate (first in the intestinal wall) and oxidative amino reducing (by monoamine oxidase), glucuronide also occurs at a lower level.
Phenylephrin quickly distributed into the peripheral tissue. The phenylephrin distribution is from 200 - 500 liters, the drug is less through the brain barrier.
Before taking Deflucold day Danapha temporarily reduces symptoms of colds and flu (2 blisters x 10 tablets)
How to use
Deflucold day oral use.
Dosage
Adults and children aged 12 and older: 2 capsules/time, drink every 4-6 hours if needed. Maximum 4 tablets in 24 hours.
The drug can cause insomnia, do not take the drug before going to bed a few hours.
Do not use the drug for many days unless the doctor's prescription.
Do not use more than 48 hours for children aged 12 to 17 unless the doctor's instructions.
Not for children under 12 years old.
Do not overdose.
Do not be used with drugs containing paracetamol, dextromethorphan, phenylephrin or anti -congestion drugs, other treatments and other colds.
People with kidney failure and liver failure
Patients who have been diagnosed with liver failure or renal failure must consult a doctor before taking this drug because the drug contains paracetamol.
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 overdose?
paracetamol
Symptoms: Paracetamol overdose can cause liver failure, which can lead to liver transplant or death.
Management: Apply medical control measures immediately after overdose, even when symptoms of overdose are not appearing.
may require n-acetylcysteine treatment.
phenylephrin
Symptoms: Other symptoms such as irritability, restlessness, hypertension and slow heartbeat. In serious cases, it can lead to confusion, hallucinations, epilepsy and arrhythmia.
Management: The treatment should depend on clinical status. Severe hypertension should be treated with alpha blockers like phentolamine.
dextromethorphan
Symptoms: Other symptoms such as stimulation, confusion, restlessness, stress, irritability, stunning, insomnia, muscular disorder, hallucinations, mental disorders and respiratory inhibitors.
Treatment: Symptomatic treatment and support should be applied. If overdose is serious, can be treated with naloxon, especially for patients with respiratory failure.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 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 following convention is used to classify unwanted effects: very common (ADR ≥ 1/10), common (1/100 ≤ ADR paracetamol
Not common (1/1000 ≤ ADR
phenylephrin
Common (1/100 ≤ ADR
Eye disorders: Delonged pupils, acute angle glaucoma, often occurs in patients with a history of glaucoma closed angle.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Deflucold day contraindications in the following cases:
Be cautious when used
Paracetamol -containing drugs, not simultaneously used with other drugs that contain paracetamol, anti -congestive drugs, antihistamines or colds and flu medications. Concentrated use with other drugs containing paracetamol can lead to overdose, causing liver failure, which can lead to liver transplant or death.
Cases of liver dysfunction/liver failure have been reported in patients with glutathion deficiency such as malnutrition, serious anorexia, low body mass index or chronic alcoholic.
Paracetamol, dextromethorphan, cautious in patients with renal impairment, liver failure. The unwanted effect of paracetamol in the liver increases in patients who are suffering from liver diseases.
Be cautious when used for patients with cardiovascular disease, hypertension, hyperthyroidism, prostate hypertrophy, diabetes, glaucoma, adrenal marrow, epilepsy, blood vessel blockage (such as Raynauds syndrome), bronchitis, bronchitis, bronchial asthma, and in chronic patients (asthma and emphysema) or cough.
Be cautious for patients with glutathion deficiency such as blood infections. The use of paracetamol in these patients may increase the risk of metabolic acid infection.
Avoid simultaneous use with alcohol due to drugs containing dextromethorphan.
Simultaneously used with sedative drugs such as anxiety, sleeping pills can increase the sedative effect, so it is necessary to consult a doctor before using them simultaneously with these drugs.
Be cautious for patients who are taking beta blockers or antihypertensive drugs, 3 -round antidepressants, Serotonin (SSRI).
.Do not use other sympathetic nervous stimulants such as anti -congestion drugs, appetite inhibitors, nervous stimulants like amphetamin.
Consult your doctor if they still last or accompanied by high fever, rash, persistent headache.
Doctors need to warn patients on signs of serious skin reactions such as Stevens - Johnson syndrome (SJS), toxic skin necrosis syndrome (Ten) or Lyell syndrome, acute pustules syndrome (AGEP).
Lactose -containing drugs, patients with rare genetic problems such as galactose tolerance, lactase deficiency, or malposure - Galactose should not be used.
The drug contains green lake color, which can cause allergies.
Use drugs for women during pregnancy and lactation
Pregnancy
Do not use this drug during pregnancy without a doctor's prescription.
Breastfeeding period
Do not use this medication during breastfeeding without a doctor's prescription.
paracetamol is excreted into breast milk. Using Paracetamol at normal analgesic dose does not seem to be at risk for breastfed babies.
Phenylephrin can be excreted into breast milk.
There is no data on dextromethorphan.
The effect of the drug on the ability to drive and operate machinery
Patients who do not drive or operate machinery if drowsy or dizzy due to drug use.
Drug interaction
paracetamol
Coumarin and warfarin: use paracetamol daily, prolonged increasing anticoagulant effect, leading to increased risk of bleeding.
Reducing anticoagulant dose if long -term treatment contains paracetamol.
The drugs empty the stomach fast (such as metoclopramid): Increased paracetamol absorption.
Slow agents that remove stomach empty (such as propanthelin, anti -cholinergic antidepressants, narcotic analgesic): reducing paracetamol absorption.
chloramphenicol: The drug concentration may increase by paracetamol.
substances that can poison the liver or liver enzyme induction (such as alcohol, epilepsy medications): Increased risk of paracetamol poisoning.
Probenecid: can affect the excretion of paracetamol and change the concentration of paracetamol in plasma.
Colestyramin: Reduce the absorption of paracetamol if used within an hour after using paracetamol.
phenylephrin
Monoamine inhibitors Oxidase: Hypertension or serious hypertension may occur.
Sympathetic stimulating amines such as other anti -congestion medications, inhibitors inhibit
appetite, nerve stimulants like amphetamine: may increase the risk of side effects on the heart and other side effects.
beta blockers and other lower blood pressure drugs (including debilisoquin, guanethidin, reserpin, methyldopa): phenylephrin can reduce the effectiveness of beta blockers and other lowering blood pressure drugs. The risk of hypertension and other cardiovascular side effects may increase.
Triple -level antidepressants (such as amitriptylin): may increase the risk of side effects on the heart due to phenylephrin. Hypertension can also occur.
Digoxin and cardiac glycosides: Increased risk of abnormal heart rate or stroke.
dextromethorphan
Monoamine inhibitors of oxidase: Dextromethorphan should not be used in patients who are using Monoamine oxidase inhibitors (MAIIS) or have used Maois within 14 days ago because it may increase the risk of serious side effects such as hypertension, heat increase and convulsions.
Selective recovery inhibitors (SSRI), three -round antidepressants: simultaneous use of dextromethorphan with Serotonin recovery inhibitors (SSRIs) such as fluoxetin or three -ring anti -depression drugs such as clomipramin and imipramine, which can lead to Serotonin syndrome with mental status muscle force, increased reflexes, sweating, tremor.
Central neurological inhibitors (such as alcohol, narcotic analgesics and sedatives): simultaneous use of dextromethorphan with these substances can increase the central nervous inhibitor.
CYP2D6 inhibitors: Dextromethorphan concentration in serum can increase when used simultaneously with CYP2D6 inhibitors, such as Quinidine and Amiodaron anti -arrhythmic drugs, antidepressants such as fluoxetin and paroxetin, or 1 | CYP2D6 other like Haloperidol and Thioridazin.
Storage
Store at a temperature not exceeding 30 ° C in the original packaging, avoid moisture and avoid light.
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