Description
Pharmacological action
Analgesic non-narcotic drug.
ATX code [N02BB02]
Pharmacological properties of
Pharmacodynamics
It has analgesic, antipyretic and mild anti-inflammatory effects, the mechanism of which is associated with inhibition of prostaglandin synthesis. It is a derivative of pyrazolone.
Pharmacokinetics
With intravenous administration: onset of action – after 5-10 minutes, maximum effect – after 5-30 minutes, duration of action – up to 2 hours. It is metabolized in the liver, a small concentration of unchanged metamizole sodium is found in plasma, excreted by the kidneys. In therapeutic doses, it passes into breast milk.
Indications
Pain syndrome (mild to moderate): incl. neuralgia, myalgia, arthralgia, biliary colic, intestinal colic, renal colic, injuries, burns, decompression sickness, herpes zoster, orchitis, radiculitis, myositis, postoperative pain, headache, toothache, algomenorrhea. Feverish syndrome (infectious and inflammatory diseases, insect bites – mosquitoes, bees, gadflies, etc., post-transfusion complications).
The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease.
Contraindications
Hypersensitivity to pyrazolone derivatives (phenylbutazone, tribuzon), tendency to bronchospasm.
Severe impairment of liver and / or kidney function, glucose-6-phosphate dehydrogenase deficiency, blood diseases, hemopoiesis suppression (agranulopitosis, cytostatic or infectious neutropenia), as well as anemia and leukopenia. Bronchial obstruction, rhinitis, urticaria provoked by the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including a history of) active liver disease, condition after coronary artery bypass grafting confirmed hyperkalemia, erosive-ulcerative changes in the mucous membrane of the stomach and duodenum, active gastrointestinal bleeding, inflammatory bowel disease. Infant age up to 3 months.
Use during pregnancy and lactation.
Do not use during pregnancy (especially in the first 3 months and last 6 weeks) and during lactation.
Precautions
Coronary heart disease, chronic heart failure, cerebrovascular disease, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, creatinine clearance less than 60 ml / min. anamnestic data on the development of ulcerative lesions of the gastrointestinal tract, the presence of H. pylori infection, advanced age, prolonged use of non-steroidal anti-inflammatory drugs, severe somatic diseases, concomitant use of oral glucocorticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetip, sertraline).
Special care is required when prescribing to patients with systolic blood pressure below 100 mm Hg. Art. or with instability of blood circulation (for example, with myocardial infarction, multiple trauma, beginning shock), with anamnestic indications of kidney disease (pyelonephritis, glomerulonephritis) and with a long alcohol history.
Special instructions
In the treatment of children under 5 years of age and patients receiving cytotoxic drugs, analgin should be taken only under the supervision of a doctor. Patients with atopic bronchial asthma and pollinosis have an increased risk of developing hypersensitivity reactions. With prolonged (more than a week) use, it is necessary to control the picture of peripheral blood and the functional state of the liver. Against the background of taking analginum, the development of agranulocytosis is possible, in connection with which, if there is an unmotivated rise in temperature, chills, sore throat, difficulty swallowing, stomatitis, as well as with the development of vaginitis or proctitis, immediate drug withdrawal is necessary. Intolerance is very rare, but the risk of shock after iv administration of the drug is relatively higher than after taking the drug inside. It is not permissible to use to relieve acute abdominal pain (until the cause is clarified). For intramuscular administration, a long needle must be used.
Composition
Active ingredient: metamizole sodium – 250 mg or 500 mg
excipient: water for injection – up to 1 ml.
Dosage and administration
The drug is administered in / in (for severe pain) or in / m 1 to 2 ml of 250 mg / ml or 500 mg / ml of the solution 2-3 times a day, but not more than 2 g per day .
Children are administered at the rate of 0.1 – 0.2 ml of a 500 mg / ml solution or 0.2 – 0.4 ml of a 250 mg / ml solution for every 10 kg of a child s body weight 2-3 times a day.
For children under 1 year of age, the drug is administered only in oil, the course is no more than 3 days.
Side effects of
In therapeutic doses, the drug is well tolerated. When using the drug in some patients, adverse reactions can occur: allergic reactions (skin rash, Quincke’s edema, rarely anaphylactic shock, Stevens-Johnson and Lyell syndromes, bronchospasm) with prolonged use, agranulocytosis, leukopenia, thrombocytopenia, arterial hypotension, interstinal nephritis can occur. Impaired renal function, oliguria, anuria, proteinuria, staining of urine in red.
With a tendency to bronchospasm, an attack can be provoked. With i / m administration, infiltrates at the injection site are possible.
Overdose
Symptoms: nausea, vomiting, gastralgia, oliguria, hypothermia, decreased blood pressure, tachycardia, shortness of breath, tinnitus, drowsiness, delirium, impaired consciousness, acute agranulocytosis, hemorrhagic syndrome, acute renal failure / or paralysis of the respiratory muscles.
Treatment: induction of vomiting, trans-probe gastric lavage, saline laxatives, activated charcoal, forced diuresis, hemodialysis, with the development of convulsive syndrome – iv administration of diazepam and high-speed barbiturates.
Storage conditions
List B. In a dry, dark place at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Expiration
3 years.
Active ingredient
Metamizole sodium
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Dosage form
injection and infusion
Prescribing
For prescribing children, For children over 15 years old, Pregnant only 2nd trimester by doctor’s appointment, Adults by doctor’s appointment
Indications
Migraine, Radiculitis, Urolithiasis, Neuritis, Zhelchekamennaya disease, arthritis, arthrosis
