Rhumenol Flu 500 medipharco treatment of headache, mild to medium fever (25 blisters x 4 tablets)

Dosage form Box of 25 blisters x 4 tablets
Specifications Acetaminophen, dextromethorphan, loratadine

Ingredient

Composition information	Content
Acetaminophen	500mg
Dextromethorphan	15mg
Loratadine	5mg

Uses

indications

Rhumenol Flu 500 is indicated in the following cases:

Rhumenol Flu 500 is used in the treatment of pain ( headaches , muscle aches, osteoarthritis pain ...) and mild to medium fever, cough due to throat and bronchial stimulation when the cold or when inhaling stimulants.

dextromethorphan hydrobromid is a cough reduction drug that works on cough center in the brain. Although the chemical structure is related to morphine, the 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 chronic cough treatment, without sputum. The drug is often used in combination with many other substances in the treatment of upper respiratory symptoms. The drug has no effect on phlegm.

The effect of dextromethorphan is almost equivalent to the validity of the codeine. Compared to Codeine, Dextromethorphan 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, but with very high doses can inhibit the central nervous system.

loratadin

Loratadin is a 3 -ring antihistamine that has a selective antagonistic effect on the peripheral H1 receptor and has no soothing effect on the central nervous system. Loratadin belongs to the second -generation H1 receptor antagonist group (unsafe). Loratadine has the effect of gently reducing the symptoms of rhinitis and allergic conjunctivitis due to histamine release. Loratadine also has anti -itching and urticaria effects related to histamines. However, Loratadin has no protection or clinical assistance for severe histamine release as anaphylaxis. In that case, the main treatment is adrenalin and corticosteroids.

Antihistamine drugs do not play a role in asthma treatment.

The second -generation H1 antagonists (unsafe) such as Terfenadin, Astemizol, Loratadin, non -distributed into the brain, when taking the drug in normal doses. Therefore, Loratadin has no sedative effect, contrary to the sedative side effects of the first -generation antihistamine drugs.

To treat allergic rhinitis and urticaria, Loratadin has a faster effect than Astemizol and has the same effect as azatadin, cetirizin, chlopheniramine, clemastin, terfenadin and mequitazin. Loratadine has a frequency of side effects, especially for the central nervous system, lower than other second -generation antihistamine drugs.

Therefore, Loratadin used once a day, quickly, especially without sedative effect, is the first choice to treat allergic rhinitis or allergic urticaria. Antihistamine drugs do not have the effect of cure the cause but only help to mild symptoms. Allergic rhinitis may be chronic and recurring; For successful treatment, it is often necessary to take long -term antihistamines and interrupt, and use other drugs such as glucocorticoids used in inhaled lines, and prolonged use.

can combine loratadin with pseudoephedrin hydrochloride to gently reduce the symptoms of nasal congestion in the treatment of allergic rhinitis with nasal congestion.

acetaminophen (paracetamol)

Paracetamol (acetaminophen or N - acetyl - P - Aminophenol) is a metabolic substance with the activity of phenacetin, an effective analgesic - antipyretic drug that can replace aspirin; However, unlike aspirin, paracetamol is not effective in treating inflammation. With equal dose in grams, paracetamol has analgesic and antipyretic effects similar to Aspirin.

paracetamol reduces the body temperature in fever, but rarely reduces the body temperature in normal people. The drug acts on the hypothalamus causing cooling, increasing heat due to vasodilation and increasing peripheral blood flow.

Paracetamol, with treatment dose, less impact on the cardiovascular and respiratory system, does not change acid -base balance, does not cause irritation, scratches or stomach bleeding as when using salicylate, because paracetamol does not work on cycloxygenase, only affect cycloxygenase/prostaglandin of central nervous system. Paracetamol does not work on platelets or bleeding time.

When overdose of paracetamol, a metabolic substance is N - Acetyl - Benzoquinonimin that is toxic to the liver. Normal doses, paracetamol tolerated well, without many side effects of aspirin. However, an acute overdose (over 10g) causes liver damage to death, and the poisoning and suicide with paracetamol has increased worrying in recent years. In addition, many people including physicians, seemingly unaware of Paracetamol's poor anti -inflammatory effects.

pharmacokinetics

dextromethorphan

Dextromethorphan is quickly absorbed through the gastrointestinal tract and works within 15 - 30 minutes after drinking, lasting about 6-8 hours (12 hours with slow liberation form). The drug is metabolized in the liver and excreted through the urine in the form of constant and Demethyl metabolites, among them dextrorphan also has a slight cough reduction effect.

loratadin

Loratadin absorbs quickly after drinking. The average plasma peak concentration of loratadine and its active metabolites (descarboethoxyloratadine) respectively is 1.5 and 3.7 hours.

97% Loratadin binds to plasma proteins. Loratadin's half -life is 17 hours and of Descarboethoxyloratadin is 19 hours. Half of the drug of the drug transforms a lot between individuals, is not affected by blood urea, increasing in the elderly and people with cirrhosis.

The clearance of the drug is 57 - 142ml/min/kg and is not affected by blood urea but decreased in patients with cirrhosis. The distribution of the drug 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; Loratadin is weak to convert into descarboethoxyloratadin, which is a transformer with pharmacological effects.

About 80% of the total dose of loratadin secreted the urine and stool equally, in the form of metabolites, within 10 days.

After taking Loratadin, the antihistamine effect of the drug appears within 1-4 hours, reaching a maximum after 8-12 hours, and lasting more than 24 hours. The concentration of loratadin and descarboethoxyloratadin reaches a stable state in most patients around the fifth day of medication.

paracetamol

absorption

Paracetamol is quickly absorbed and almost completely through the gastrointestinal tract. Foods can make long -lasting release pellets in partially absorbed Paracetamol and carbon -rich foods that reduce the absorption rate of paracetamol. The peak concentration of plasma is within 30 to 60 minutes after drinking with the dose of treatment.

Distribution

Paracetamol is distributed quickly and evenly in most body tissues. About 25% Paracetamol in the blood combined with plasma protein.

Elimination

The half -life of paracetamol plasma is 1.25 - 3 hours may be prolonged for toxic doses or in patients with liver damage.

After the treatment dose, 90 to 100%of the urine can be found on the first day, mainly after the liver combination with glucuronic acid (about 60%), sulfuric acid (about 35%) or cysteine (about 3%); Small amounts of hydroxyl metabolites are found - chemical and reducing acetyl. Children are less likely to glucuro than drugs than adults.

paracetamol is n - hydroxylation by cytochrom P450 to create N - Acetyl - Benzoquinonimin, an intermediate reaction. This metabolites normally react with sulthydryl groups in glutathion and thus ductive. However, if taking high doses of paracetamol, this metabolic is formed in sufficient amount to exhaust the glutathion of the liver; In this situation, its reaction to the sulfhydryl group of liver protein increases, which can lead to liver necrosis.

Before taking Rhumenol Flu 500 medipharco treatment of headache, mild to medium fever (25 blisters x 4 tablets)

How to use

oral medication.

Dosage

Adults and children over 12 years: take 1 capsule/time, 2 times a day.

Children 6 - 12 years old: Take 1/2 tablets/time, 2 times a day.

or take it according to the instructions of the physician.

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?

Symptoms

Related to acetaminophen: Nausea, vomiting, and abdominal pain usually occur within 2-3 hours after taking the poisonous dose of the drug. Methemoglobin - Blood, leading to purple blue, mucous and nail is a sign of acute poisoning P - Minophenol. When severe poisoning, it may initially stimulate the central nervous system, agitation, and delusion. Next can be inhibiting the central nervous system; Stunned, lower body temperature; tired; Breathing fast, shallow; fast, weak, uneven circuit; Low blood pressure ; and circulation.

Related to Loratadin: Sleep, tachycardia, headache.

Related to dextromethorphan: nausea, vomiting, drowsiness, blurred vision, eyeball shake, urinary retention, numbness, hallucinations, loss of air conditioning, respiratory failure, convulsions.

Handling

Related to acetaminophen: Gastric wash in any case. The main detoxification is the use of sulfhydryl compounds, perhaps partly due to the addition of glutathion reserves in the liver.

Related to loratadine: In case of acute Loratadin overdose, vomiting with ipeca syrup to remove the stomach immediately. Using activated carbon after vomiting can help to prevent Loratadin absorption.

Regarding dextromethorphan: using Naloxon 2mg intravenously, for reminders if needed a total dose of 10mg.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Rhumenol Flu 500 , you may experience unwanted effects (ADR).

Common

usually erythema or urticaria, but sometimes worse and may be accompanied by fever due to drugs and mucosal lesions. Headache, dry mouth , fatigue, dizziness, tachycardia, nausea.

Dehydration (neutropenia, hypoglycemia, leukopenia), anemia . Kidney disease, kidney toxicity when abused for a long time. Dry nose and sneezing.

Rare

Hypersensitivity reaction, depression . Heart beat fast, tachycardia on ventricle, brushing chest drum. Unusual liver function, irregular menstruation, and anaphylaxis. The odd behavior of poisoning, inhibiting the central nervous system and respiratory failure can occur when the dose is too high. ADR

Notify the doctor with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Drugs rhumenol flu 500 contraindicated in the following cases:

Hypersensitivity to the ingredients of the drug.

Patients with anemia many times or heart, lung, kidney or liver disease.

Patients with glucose deficiency - 6 - Phosphate dehydro - Genase.

Patients who are treating Monoamin oxydase inhibitors (Mao).

Children under 6 years old.

Be cautious when using

must use Rhumenol Flu 500 cautious in patients with liver failure, or anemia before. Drinking plenty of alcohol can cause increased toxicity to the liver of acetaminophen; Should avoid or limit drinking. Patients with coughs have too many sputum and chronic cough in smokers, asthma or air overflow. Patients are at risk or respiratory decline.

Use Rhumenol Flu 500 is related to histamine release and should be cautious for children with allergies. When using loratadin, there is a risk of dry mouth, especially in the elderly, and increasing the risk of tooth decay.

Acetaminophen can cause serious side effects on the skin, although the incidence is not high but serious, even life -threatening including: Steven - Johnson (SJS), toxic skin necrosis syndrome: Toxic Epidermal Necrolysis (Ten) or Lyell syndrome, Surgery syndrome of acne bodies Pustulosis (AGEP).

Symptoms of the above -mentioned syndrome are described as follows:

Steven - Johnson syndrome (SJS): is an allergy to puffiness, puffiness localities around natural cavities: eyes, nose, mouth, ears, genitals and anus. In addition, it may be accompanied by high fever, pneumonia, liver dysfunction. Diagnosis of Steven - Johnson syndrome (SJS) has at least 2 naturally damaged cavities.

Poisoned skin necrosis syndrome (Ten): is the most severe allergy, including:

Diverse lesions in the skin: measles rash, pink pink, pink or bullous puffiness, damage quickly spread throughout the body.

Eye mucosa damage: corneal inflammation, pus conjunctivitis, corneal ulcer.

Damage to the gastrointestinal mucosa: stomatitis, mouth mucosa, pharyngeal ulcer, esophagus throat, stomach, intestines.

Damage to the mucosa of genital tract, urinary tract.

There are also serious systemic symptoms such as fever, gastrointestinal bleeding, pneumonia, glomerulonephritis, hepatitis ... high mortality rate 15 - 30%.

Excavity of the acne pustules (AGEP); Small sterile pustules arise on the spreading pink background. Damage often appears in folds such as armpits, groin and face, then can spread the whole body. Systemic symptoms are often fever, high neutral blood leukemia tests.

When detecting signs of rash on the first skin or any other hypersensitive reactions, patients need to stop using the drug. People who have had severe skin reactions caused by Paracetamol must not use the drug again and when they come to medical examination and treatment, they need to notify the medical staff on this issue.

The ability to drive and operate machinery

Use cautiously while driving or operating machinery due to drugs that inhibit the central nervous system of dextromethorphan.

Pregnancy

should only use Rhumenol Flu 500 in pregnant people when needed

Breastfeeding period

Avoid using Rhumenol Flu 500 with ethanol for nursing mothers. Loratadin and metabolites Descarboethoxyloratadin secreted into breast milk. If you need to use Rhumenol Flu 500 in nursing mothers, only use in low doses and in a short time.

Medicinal interaction

long -term oral high doses Rhumenol Flu 500 increases the anticoagulant effect of COUMARIN and derivatives. Drinking too much and long alcohol can increase the risk of acetaminophen toxic to the liver.

Simultaneous treatment Rhumenol Flu 500 and cimetidine leads to increased loratadine levels in plasma 60%.

Simultaneous treatment of Rhumenol Flu 500 and Ketoconazole leads to an increase in loratadine concentration in plasma 3 times, due to CYP3A4 inhibitors.

Simultaneous treatment of rhumenol flu 500 and erythromycin leads to increased plasma Loratadin concentration. Avoid simultaneous use with capillary inhibitors. Concomitant use with central neurological inhibitors can enhance the central neurological inhibitor of these drugs or of dextromethorphan.

Storage

In a dry place, temperatures below 30 ° C, avoid light.

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