Andipalus

Andipal is a combination drug that contains several active ingredients:

1. Bendazole: An anti-inflammatory and analgesic drug commonly used to relieve pain and inflammation.
2. Metamizole sodium: Also known as analgin, it is an anti-inflammatory, antipyretic and analgesic drug used to relieve pain and fever.
3. Papaverine hydrochloride: A muscle relaxant that relieves spasms of smooth muscles in organs such as the intestines and urinary tract. Also used to relieve spasms of intragastric muscles.
4. Phenobarbital: An anticonvulsant and hypnotic used to treat seizure disorders and as a sleep aid.

This drug is often used to relieve various types of pain, including headaches, muscle spasms, toothaches, and others. It may be prescribed by a doctor for short-term symptom relief, but is not recommended for long-term use without consulting a doctor because the presence of phenobarbital, which is a barbiturate and may have side effects with long-term use.

Indications Andipala

1. Headache: Includes tension headaches, migraines and other forms of headaches.
2. Muscle spasms: Andipal can help relieve muscle spasms caused by various causes, such as injury, overwork, or other conditions.
3. Intestinal spasms: For various gastrointestinal disorders accompanied by pain and spasms.
4. Menstrual cramps: To relieve pain and discomfort associated with the menstrual cycle.
5. Toothache: For toothache, including dental caries or after tooth extraction.
6. Pain in urological diseases: For pain relief in cystitis, pyelonephritis and other urological diseases.

Release form

Tablets: This is the most common form in which the drug is available. Tablets are usually packaged in blisters or jars and taken orally with water.

Pharmacodynamics

1. Bendazole: Bendazole has anti-inflammatory and analgesic effects. It blocks cyclooxygenase, which leads to a decrease in the formation of prostaglandins responsible for inflammation and pain. This helps reduce inflammation and relieve pain.
2. Metamizole sodium (analgin): Metamizole sodium has anti-inflammatory, antipyretic and analgesic effects. It reduces the formation of prostaglandins, which leads to reduced pain and inflammation.
3. Papaverine hydrochloride: Papaverine is a myotropic antispasmodic. It relaxes the smooth muscles of blood vessels, the gastrointestinal tract and other organs, which helps relieve spasms and improve blood circulation.
4. Phenobarbital: Phenobarbital is a barbiturate that has sedative and anticonvulsant effects. It reduces the excitability of the central nervous system, which can help relieve nervous tension and improve sleep quality.

The combination of these components allows the drug to have a wide spectrum of action and be used to relieve various types of pain and spasms.

Pharmacokinetics

1. Bendazole:

• Suction:
  • Well absorbed from the gastrointestinal tract.
• Distribution:
  • Evenly distributed throughout the tissues of the body.
• Metabolism:
  • Metabolized in the liver to active metabolites.
• Withdrawal:
  • Excreted by the kidneys, mainly in the form of metabolites.
• Half-life:
  • Approximately 2-4 hours.

2. Metamizole sodium (Analgin):

• Suction:
  • Quickly and completely absorbed from the gastrointestinal tract.
• Distribution:
  • Distributes well throughout tissues, penetrates the placental barrier and into breast milk.
• Metabolism:
  • Metabolized in the liver to active metabolites.
• Withdrawal:
  • Excreted by the kidneys, mainly in the form of metabolites.
• Half-life:
  • Approximately 7-12 hours.

3. Papaverine hydrochloride:

• Suction:
  • Well absorbed from the gastrointestinal tract.
• Distribution:
  • Evenly distributed throughout tissues, penetrates the placental barrier and into breast milk.
• Metabolism:
  • Metabolized in the liver.
• Withdrawal:
  • Excreted by the kidneys in the form of metabolites.
• Half-life:
  • Approximately 0.5-2 hours.

4. Phenobarbital:

• Suction:
  • Slowly but completely absorbed from the gastrointestinal tract.
• Distribution:
  • Widely distributed throughout body tissues, including the brain, passes through the placental barrier and into breast milk.
• Metabolism:
  • Metabolized in the liver.
• Withdrawal:
  • Excreted by the kidneys, 25-50% unchanged.
• Half-life:
  • Approximately 2-4 days.

Dosing and administration

1. For Adults: The usual dose for adults is 1-2 tablets (or capsules) of Andipal up to 3 times daily. For greater pain or spasm relief, your doctor may recommend increasing the dosage to 2 tablets (or capsules) per dose. The maximum daily dose usually does not exceed 6 tablets (or capsules).
2. For children: The dosage for children is determined based on the age and weight of the child, so it is important to follow the doctor's instructions or the instructions for the drug.
3. For elderly patients: For elderly patients, it is usually recommended to start with a lower dosage due to possible increased sensitivity to the drug and increased risk of side effects.
4. Dosage: Tablets (or capsules) should be taken orally with a glass of water. The injection solution is administered intramuscularly or intravenously only by a doctor or medical specialist.
5. Duration of treatment: The duration of treatment is determined by the doctor depending on the nature and severity of the disease. Andipal is usually used short-term to relieve symptoms.

Use Andipala during pregnancy

1. Metamizole sodium:

   • Metamizole sodium is not recommended for use during pregnancy due to limited safety data and a possible risk of agranulocytosis (low granulocyte count in the blood), a serious side effect. Studies suggest that metamizole use in the first trimester may increase the risk of congenital anomalies (Dathe et al., 2017).

2. Phenobarbital:

   • Phenobarbital, used as an anticonvulsant, may cause developmental delays and changes in neuroendocrine function in offspring. Animal studies have shown that phenobarbital may impair reproductive function and delay the onset of puberty in offspring exposed to phenobarbital prenatally (Gupta & Yaffe, 1981).
   • Phenobarbital can also reduce the production of gonadotropic hormones, which is important for maintaining pregnancy, and can lead to termination of pregnancy (Patil & Rao, 1982).

3. Papaverine hydrochloride:

   • There is insufficient data on the effect of papaverine hydrochloride on pregnancy. However, it is known to relax smooth muscles and may affect the uterus. The use of papaverine should be carefully justified by a doctor.

4. Bendazole:

   • Bendazole has immunomodulatory and vasodilating properties. There is insufficient data on its safety during pregnancy, which requires caution when using it.

Contraindications

1. Individual intolerance to the components of the drug: People with a known allergy to bendazole, metamizole sodium, papaverine hydrochloride, phenobarbital or other ingredients of the drug should not take Andipal.
2. Severe hepatic or renal impairment: Because the drug is metabolized and eliminated primarily through the liver and kidneys, patients with severe impairment of these organs may be at risk for accumulation of active metabolites or other metabolic byproducts.
3. Hypertension: The drug should be used with caution in patients with hypertension due to the possible effect on blood pressure.
4. Pregnancy and breastfeeding: The use of Andipal during pregnancy or breastfeeding should be discussed with your doctor, since its safety in these cases may not have been sufficiently studied.
5. Children's age: The use of Andipal in children should be carried out under the strict supervision of a physician and only if the benefits outweigh the potential risks.
6. Porphyria: Andipal is contraindicated in patients with porphyria due to the possibility of causing an exacerbation of this disease.

Side effects Andipala

1. Drowsiness and dizziness: This is one of the most common side effects that can be caused by using the drug. Patients may experience drowsiness, fatigue, or dizziness after taking Andipal.
2. Lowering Blood Pressure: The papaverine contained in Andipal may cause a decrease in blood pressure in some patients, especially when the drug is administered quickly.
3. Dry mouth: This is one of the common side effects associated with antispasmodic and analgesic drugs.
4. Gastrointestinal Disorders: Various gastrointestinal disturbances, such as nausea, vomiting, diarrhea, or constipation, may occur.
5. Allergic reactions: Some patients may experience allergic reactions such as skin rash, itching, or angioedema.
6. Central nervous system depression: The phenobarbital contained in Andipal can cause central nervous system depression, manifested by drowsiness, fatigue and even respiratory depression in overdose.
7. Seizures: Some patients may experience seizures as a result of using the drug.
8. Other side effects: Other side effects may also occur, such as heart rhythm disturbances, changes in blood pressure, increased liver activity, etc.

Overdose

1. Severe drowsiness or fainting.
2. Severe heart rhythm problems, including a fast or slow heartbeat.
3. Dizziness and severe headache.
4. Seizures or muscle spasms.
5. Severe breathing problems, including stopping breathing.
6. Changes in blood pressure, including high or low blood pressure.

Interactions with other drugs

1. Alcohol: The combined use of alcohol with Andipal may increase its sedative effect and cause drowsiness and dizziness.
2. Central-acting drugs: The use of Andipal together with other drugs that have a depressant effect on the central nervous system, such as hypnotics, sedatives, antidepressants or antipsychotics, may increase the sedative effect and cause increased drowsiness.
3. Anticonvulsants: Using Andipal with anticonvulsants may reduce their effectiveness or increase side effects.
4. Antidepressants: Concomitant use of Andipal with serotonin reuptake inhibitors (for example, sertraline, fluoxetine) may increase the risk of developing serotonin syndrome.
5. Antihypertensive drugs: Papaverine contained in Andipal can enhance the hypotensive effect of antihypertensive drugs, which can lead to a significant decrease in blood pressure.