Travicol Flu TV.Pharm quickly reduces the symptoms of the flu (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Acetaminophen, dextromethorphan, loratadine

Ingredient

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

Uses

Indications

Travicol Flu medicine to treat the symptoms of the flu such as:

Fever, headache, muscle aches, osteoarthritis, dry cough, runny nose, stuffy nose, runny nose, watery eyes, allergic rhinitis, sinusitis.

Pharmacokological

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 affects the hypothalamus causing cooling, increasing heat due to vasodilation and increased 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 an 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, acute overdose (over 10 g) causes liver damage to death, 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.

dextromethorphan hydrobromid

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 the treatment of chronic cough, 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 that can inhibit the central economic 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 works like azatadin, cetirizin, chlopheniramine, clemastin, terfenadin and mequitazin.

Loratadin has a frequency of side effects, especially for the central nervous system, lower than other second -generation antihistamines.

Therefore, Loratadin used once a day, a quick effect, especially without sedative effects, is the first choice to treat allergic rhinitis or allergic urticaria.

antihistamine drugs do not treat 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.

pharmacokinetic

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

Paracetamol's plasma sale time is 1.25 - 3 hours, can last 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 metabolic substance normally reacts with sulfhydryl groups in glutathion and thus is dedicated. 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.

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) corresponds to 1.5 and 3.7 hours.

97% Loratadin binds to plasma proteins. Loratadin waste sale time is 17 hours and of Descarboetho-Xyloratadin 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 of the drug is 80 - 120 liters/kg.

Loratadin metabolizes a lot when passing the liver for the first time by the microsom cytochrom P450 enzyme system; Loratadin mainly converted into carbohoxyloratadin, which is a pharmaceutical effect.

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.

Before taking Travicol Flu TV.Pharm quickly reduces the symptoms of the flu (10 blisters x 10 tablets)

How to use

Travicol Flu drugs for oral use.

Dosage

Adults and children over 12 years:

Take 1 capsule 2 times/day.

Children aged 6-12:

Take 1/2 tablets 2 times/day.

The distance between 2 drinks must be more than 4 hours.

severe kidney failure (CLCR

The distance must be at least 8 hours.

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
Paracetamol overdose
Paracetamol poisoning may be due to a single -dose, or due to a large dose of paracetamol (for example, 7.5 - 10 g per day, for 1-2 days), or for long -term medication. Liver necrosis depends on the dose is the most serious toxic effect due to overdose and can be fatal.
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 characteristic sign of acute poisoning P - Aminophenol; A small amount of sulfhemoglobin can also be produced. Children tend to create methemoglobin easier than adults after taking paracetamol.
When severe poisoning, it may initially stimulate the central nervous system, agitated, and delirium. Next can be inhibiting the central nervous system; Stunned, lower body temperature; tired; Breathing fast, shallow; fast, weak, uneven circuit; Low blood pressure; and circulatory failure. Vascular collapse due to relative hypoxia and central inhibition effects, this effect only occurs in huge doses. Shock may occur if a lot of vasodilation. The suffocating convulsions may occur. Often coma occurs before dying suddenly or after a few days of coma.
Clinical signs of liver damage become clearly within 2 to 4 days after taking toxic doses. Aminotransferase plasma increases (sometimes very high) and the concentration of bilirubin in plasma can also increase; In addition, when the liver lesions spread, the long prothrombin time. It is possible that 10% of patients with untreated poisoning have serious liver damage; Among them 10% to 20% finally die from liver failure. Acute renal failure also occurs in some patients. The liver biopsy detects the central necrosis of the lobe except the area around the door vein. In cases of non -death, liver lesions recover after weeks or months.
dextromethorphan
Nausea, vomiting, drowsiness, blurred vision, eyeball, urination, numbness, hallucinations, loss of air conditioning, respiratory failure, convulsions.
loratadin
Sleep, tachycardia, headache.
Overdose
pararcetamol
Early diagnosis is important in the treatment of paracetamol overdose. There are methods to quickly determine the concentration of drugs in plasma. However, do not delay treatment while waiting for the test results if the history is suggested to overdose. When severe poisoning, it is important to treat positive support. Need to wash the stomach in any case, preferably within 4 hours after drinking.
The main detoxification is the use of sulfhydryl compounds, perhaps partly due to the addition of glutathion reserves in the liver.
n - acetylcysteine works when taking or intravenously. Must give the drug immediately if less than 36 hours after taking paracetamol. Treatment with N - Acetylcystein is more effective when giving the drug for less than 10 hours after taking paracetamol. When drinking, dilute N - Acetylcystein solution with water or drinks without alcohol to achieve a 5% solution and must be taken within 1 hour after mixing. Give N - Acetylcysteine at the first dose of 140 mg/kg, then give 17 more doses, each dose of 70 mg/kg 4 hours apart. Termination of treatment if the paracetamol test in plasma shows the risk of low liver toxicity.
The unwanted effect of N - Acetylcystein includes skin rash (including urticaria, no need to stop the drug), nausea, vomiting, diarrhea, and anaphylactic reaction.
If there is no n - acetylcystein, methionine may be used. Also can use activated carbon and/ or salt bleach, they have the ability to reduce the absorption of paracetamol.
dextromethorphan
Support, use Naloxon 2 mg intravenously, for repeated use if the total dose of 10 mg.
loratadin
Treatment of Loratadin overdose is usually symptomatic treatment and support, start immediately and maintain as long as it is necessary. In case of excessive overdose Loratadin, vomiting with ipeca syrup to remove the stomach immediately. Using activated carbon after vomiting can be helpful to prevent Loratadine absorption. If vomiting does not work or contraindicated (for example, patients with fainting, convulsions, or lack of vomiting reflexes), may be carried out with 0.9% sodium chloride solution and intubation to prevent gastric inhalation.

What to do when forgetting a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

Common, ADR> 1/100

DA: Ban.

Body: Fatigue, dizziness.

circulating: tachycardia. digestive: Nausea, vomiting, dry mouth. nerve: headache.

Uncommon, 1/1000

Skin: Red rash or urticaria, but sometimes worse and may be accompanied by drugs and mucosal lesions.

Hematology: Dehydration (neutropenia, all bloody hemorrhage, leukopenia), anemia. kidney: kidney disease, kidney toxicity when abusing for a long time.

Respiratory: dry nose and sneezing.

Other: conjunctivitis.

Rare, 1/10,000

Sometimes sleepy, digestive disorders. The weirdness due to poisoning, inhibiting the central nervous system and respiratory failure can occur when the dose is too high.

nerve: depression. Cardiovascular: Heart beat fast, tachycardia on ventricular, brushing chest. Metabolism: abnormal liver function, irregular menstruation.

Other: Anaphylaxis.

Instructions on how to handle ADR:

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Contraindicated

Travicol Flu drugs are contraindicated in the following cases:

Hypersensitivity to one of the ingredients of the drug.

Children under 6 years old.

Patients are taking Monoaminooxydase inhibitors.

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

Patients with glucose-6-phosphate dehydrogenase.

Caution when using

Precautions when used in patients with liver impairment, patients are at risk of respiratory decline, patients with coughs with many phlegm, chronic cough in smokers, asthma or air overflow.

Drinking alcohol can increase the toxicity of paracetamol to the liver, should avoid or limit drinking alcohol.

Serious side effects on the skin, although the incidence is not high but serious, even life -threatening including Stevens - Jonhson syndrome (SJS), toxic skin necrosis syndrome (Ten) or Lyell syndrome, acute pustules syndrome (AGEP).

When detecting signs of the first skin rash 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

Precautions when used for drivers, operating machinery because the drug can cause dizziness.

Pregnancy

Precautions when used for pregnant women.

Breastfeeding period

Precautions when used for breastfeeding women.

Medicinal interaction

High doses and extension of paracetamol can slightly increase coagulation effects of cooumarin and indandion derivatives.

Anti -seizure drugs (phenyntoin, barbiturat, carbamazepin ...) cause liver enzyme induction that increases paracetamol conversion into toxins for the liver, which can increase the toxicity of paracetamol.

With central neurological inhibitors, if they simultaneously use these substances with dextromethorphan, they can enhance the central neurological inhibitor of these drugs.

cimetidine, ketoconazole, erythromycin increase loratadine levels in plasma, but do not clinically manifest because loratadin has a wide therapeutic range.

Storage

Store in a dry place, not more than 30 ° C, avoid light.

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