Grippex

Grippex is a combination drug designed to relieve cold and flu symptoms. It contains three active ingredients, each of which performs a specific function to combat various manifestations of the disease:

1. Paracetamol (Acetaminophen) - has an antipyretic and analgesic effect. Paracetamol is effective in reducing fever and reducing pain such as headache, muscle pain, sore throat.
2. Pseudoephedrine hydrochloride is a vasoconstrictor that helps reduce swelling in the nose and sinuses, making breathing easier and reducing nasal congestion.
3. Dextromethorphan hydrobromide is an antitussive that acts on the cough center in the brain, which helps reduce coughing.

Indications Grippex

1. Fever: Grippex contains paracetamol, which helps reduce body temperature and relieve fever.
2. Nasal congestion: Pseudoephedrine hydrochloride, found in Grippex, is a decongestant and helps constrict the blood vessels in the nose, which reduces congestion and makes breathing easier.
3. Cough: Dextromethorphan hydrobromide is an antitussive and helps reduce the frequency and severity of cough.
4. Body aches: Paracetamol also has analgesic properties and can help relieve muscle and bone pain that often accompanies flu and colds.
5. General malaise: Grippex can help improve your well-being and relieve common cold and flu symptoms such as weakness, fatigue and irritability.

Release form

Grippex is usually available in the form of tablets or powder for suspension.

Pharmacodynamics

1. Paracetamol: This is an analgesic (painkiller) and antipyretic (fever reducer). Paracetamol helps reduce fever and relieve pain associated with flu and colds.
2. Pseudoephedrine hydrochloride: This is a sympathomimetic agent that is used in decongestants to constrict blood vessels and reduce swelling of the nasal mucosa, which relieves nasal congestion and improves breathing.
3. Dextromethorphan hydrobromide: This is an antitussive drug that suppresses cough by acting on the cough reflex center in the brain, which helps reduce the frequency and intensity of coughing.

Pharmacokinetics

The pharmacokinetics of Grippex, which contains paracetamol, pseudoephedrine hydrochloride and dextromethorphan hydrobromide, includes aspects of the absorption, distribution, metabolism and elimination of each of these active ingredients. Here is how they function in the body:

Paracetamol (Acetaminophen)

1. Absorption: Paracetamol is rapidly and almost completely absorbed from the gastrointestinal tract. Maximum plasma concentrations are reached approximately 30-60 minutes after oral administration.
2. Distribution: Paracetamol is distributed evenly throughout most tissues of the body. The volume of distribution is normally about 1 l/kg.
3. Metabolism: Metabolized in the liver. The main metabolic pathways involve conjugation with glucuronide or sulfate. A minor portion is metabolized by cytochrome P450, leading to the formation of the toxic metabolite N-acetyl-p-benzoquinone imine, which is neutralized by glutathione.
4. Excretion: Excreted via the kidneys mainly as metabolites, less than 5% is excreted unchanged.

Pseudoephedrine hydrochloride

1. Absorption: Pseudoephedrine is absorbed from the gastrointestinal tract. Peak plasma concentrations are reached 1-3 hours after administration.
2. Distribution: Has a relatively high volume of distribution.
3. Metabolism: Metabolized in the liver to a limited extent.
4. Excretion: The major part of the dose is excreted unchanged by the kidneys.

Dextromethorphan hydrobromide

1. Absorption: Dextromethorphan is rapidly absorbed after oral administration, reaching peak plasma concentrations in approximately 2-4 hours.
2. Distribution: Widely distributed in body tissues.
3. Metabolism: Extensively metabolized in the liver. The main metabolic pathway involves N-demethylation by CYP2D6, leading to the formation of the active metabolite, dextrorphan.
4. Excretion: Excreted primarily through the kidneys in the form of metabolites.

Dosing and administration

Directions for use:

• Grippex is taken orally.
• The drug should be taken with water, preferably after meals, to minimize stomach irritation.
• The tablets should be swallowed whole, without chewing or crushing.

Dosage:

• Adults and adolescents over 12 years: The usual recommended dose is 1-2 tablets every 4-6 hours, depending on symptoms. Do not exceed 8 tablets in 24 hours.
• Children: Grippex is not recommended for use in children under 12 years of age unless prescribed by a doctor.

Important considerations:

• Maximum dose: It is important not to exceed the recommended maximum dose, especially for paracetamol, as this can cause serious liver damage.
• Side effects: Watch for possible side effects such as dizziness, insomnia, high blood pressure, or allergic reactions. If these occur, stop taking the medicine and contact your doctor.
• Drug Interactions: Pseudoephedrine may interact with other medications, including antidepressants and blood pressure medications. Ask your doctor or pharmacist about possible interactions.
• Special warnings: Patients with heart disease, high blood pressure, diabetes, liver disease or kidney disease should consult a doctor before taking Grippex.

Use Grippex during pregnancy

The use of Grippex during pregnancy requires caution and should only be done after consultation with a doctor, since the combination of substances it contains may have different effects on the pregnant woman and the fetus.

1. Paracetamol:

   • Paracetamol is generally considered safe to use during pregnancy when taken at recommended doses. However, it should be used with caution and only as directed by a doctor to avoid the risk of overdose, which can lead to serious complications for the mother and fetus.

2. Pseudoephedrine hydrochloride:

   • Pseudoephedrine may increase the risk of adverse cardiovascular effects, such as high blood pressure. In some studies, pseudoephedrine has been linked to a risk of birth defects, especially when taken in the first trimester of pregnancy. Because of this, many doctors recommend avoiding its use, especially in the first trimester and in women with high blood pressure.

3. Dextromethorphan hydrobromide:

   • Dextromethorphan is generally considered relatively safe for use during pregnancy, but data is limited. You should always consult with your doctor before using it, as there are potential risks, especially when used in the first trimester of pregnancy.

Recommendations:

• During pregnancy, you should consult your doctor before taking any medication, including Grippex. Your doctor will evaluate the potential risks and benefits of the medication in your particular case.
• Your doctor may recommend safer alternatives for treating cold and flu symptoms during pregnancy.
• You should also consider other safety measures, such as humidifying the air, drinking plenty of fluids, and resting, which may help relieve symptoms without the use of medication.

Contraindications

1. Known individual intolerance: People with known individual intolerance to any of the components of the drug (paracetamol, pseudoephedrine hydrochloride or dextromethorphan hydrobromide) should avoid using it.
2. Pregnancy and breastfeeding: Grippex should only be used during pregnancy and breastfeeding on the advice of a doctor. Paracetamol is considered relatively safe for use during these periods, but pseudoephedrine and dextromethorphan may have limitations.
3. Childhood: The drug can be prescribed to children only from a certain age and in accordance with the doctor's recommendations. Some components may not be suitable for children under a certain age.
4. Hypertension and Cardiovascular Disease: Pseudoephedrine may increase blood pressure and increase heart rate, so it should be used with caution in patients with hypertension, arterial hypertension, arrhythmias and other cardiovascular diseases.
5. Enlarged prostate and urinary problems: Pseudoephedrine may increase symptoms in patients with enlarged prostate or urinary problems.
6. Kidney and liver disease: Paracetamol is metabolized in the liver, so in patients with liver disease, as well as renal failure, it should be used with caution and under medical supervision.

Side effects Grippex

1. Drowsiness or restlessness: Pseudoephedrine hydrochloride, which is contained in Grippex, may cause drowsiness in some people and may also lead to restlessness or nervousness.
2. High Blood Pressure: Pseudoephedrine hydrochloride may increase blood pressure, which is especially important for people with hypertension.
3. Insomnia: Pseudoephedrine may cause insomnia or decreased sleep quality in some people.
4. Dry mouth: This is a common side effect of dextromethorphan hydrobromide and can cause dry mouth.
5. Gastrointestinal problems: Some people may experience stomach problems such as nausea, vomiting, diarrhea, or constipation caused by one of the ingredients in this medicine.
6. Allergic reactions: Some people may be allergic to any of the ingredients in Grippex and develop an allergic reaction that may include rash, itching, swelling of the face, or difficulty breathing.

Overdose

1. Paracetamol: Overdosing on paracetamol can cause severe liver damage, including liver failure, hepatitis and even liver necrosis. It is especially dangerous if you take more than the recommended dose of paracetamol in a short period of time or if you drink alcohol.
2. Pseudoephedrine hydrochloride: Overdose of pseudoephedrine may cause cardiac problems such as hypertension, arrhythmia, dizziness, headache, anxiety, insomnia, and hallucinations. Increased blood pressure and central nervous system excitation may also occur.
3. Dextromethorphan hydrobromide: Overdosing on dextromethorphan can cause drowsiness, dizziness, headache, nausea, vomiting, loss of coordination, respiratory depression, and even coma. Allergic reactions are also possible.

Interactions with other drugs

1. Medicines containing paracetamol: When used together with other medicines containing paracetamol, there may be an increased risk of overdose of this substance, which can lead to liver damage.
2. MAO inhibitors (monoamine oxidase inhibitors): Pseudoephedrine may increase the symptoms of serotonin syndrome, especially when used with MAO inhibitors.
3. Blood pressure lowering drugs: Pseudoephedrine may enhance the effects of blood pressure lowering drugs, which may lead to a hypertensive crisis.
4. CNS (central nervous system) depressants: Dextromethorphan may enhance the depressant effects of CNS depressants such as benzodiazepines, barbiturates, alcohol.