Flupex

Grippex is a combination medicine intended to relieve the symptoms of colds and flu. It includes three active components, each of which performs a specific function to combat various manifestations of the disease:

1. Paracetamol (Acetaminophen) - has antipyretic and analgesic effects. 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 of the nasal mucosa 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 cough.

Indications Influenza

1. Fever: Grippex contains paracetamol, which helps lower 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 relieves congestion and makes breathing easier.
3. Cough: Dextromethorphan hydrobromide is an antitussive and helps reduce the frequency and intensity of cough.
4. Body pain: Paracetamol also has analgesic properties and can help relieve muscle and bone pain that often accompanies flu and colds.
5. General Malaise: Grippex may help improve your well-being and relieve common cold and flu symptoms such as weakness, tiredness and irritability.

Release form

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

Pharmacodynamics

1. Paracetamol: It is an analgesic (pain reliever) and antipyretic (fever reducer). Paracetamol helps reduce fever and pain from colds and flu.
2. Pseudoephedrine hydrochloride: This is a sympathomimetic agent 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 agent that suppresses cough by acting on the cough reflex center in the brain, which helps reduce the frequency and intensity of cough.

Pharmacokinetics

The pharmacokinetics of Grippex, which contains paracetamol, pseudoephedrine hydrochloride and dextromethorphan hydrobromide, includes aspects of the absorption, distribution, metabolism and excretion of each of these active components. Here's 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 achieved approximately 30-60 minutes after oral administration.
2. Distribution: Paracetamol is evenly distributed throughout most tissues of the body. The normal volume of distribution is about 1 l/kg.
3. Metabolism: Metabolized in the liver. Major metabolic pathways include conjugation with glucuronide or sulfate. A minority is metabolized by cytochrome P450, leading to the formation of the toxic metabolite N-acetyl-p-benzoquinoneimine, which is neutralized by glutathione.
4. Excretion: Excreted through the kidneys mainly in the form of metabolites, less than 5% is excreted unchanged.

Pseudoephedrine hydrochloride

1. Absorption: Pseudoephedrine is absorbed from the gastrointestinal tract. Maximum plasma concentration is achieved 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 main 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: Intensively metabolized in the liver. The main route of metabolism 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

Method of application:

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

Dosage:

• Adults and adolescents over 12 years of age: The usual recommended dose is 1-2 tablets every 4-6 hours depending on symptoms. Do not exceed 8 tablets in 24 hours.
• Children: Influenza is not recommended for children under 12 years of age without a doctor's prescription.

Important considerations:

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

Use Influenza 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 for use during pregnancy when taken at recommended doses. However, it should be used with caution and only as prescribed by a doctor to avoid the risk of overdose, which can lead to serious complications in the mother and fetus.

2. Pseudoephedrine hydrochloride:

   • Pseudoephedrine may increase the risk of adverse cardiovascular effects such as increased blood pressure. In some studies, pseudoephedrine has been associated with 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 are limited. You should always consult your doctor before using it as there are potential risks, especially if used in the first trimester of pregnancy.

Recommendations:

• During pregnancy, you should consult your doctor before taking any medications, including Influenza. The doctor will evaluate the potential risks and benefits of the medicine 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 rest, which may help relieve symptoms without the use of medications.

Contraindications

1. Known individual intolerance: People with a known individual intolerance to any of the components of the drug (paracetamol, pseudoephedrine hydrochloride or dextromethorphan hydrobromide) should avoid its use.
2. Pregnancy and breastfeeding: The use of Grippex during pregnancy and breastfeeding should only be done on the recommendation of a doctor. Paracetamol is considered relatively safe for use during these periods, but pseudoephedrine and dextromethorphan may have limitations.
3. Children's age: The drug can be prescribed to children only from a certain age and in accordance with the doctor's recommendations. Some ingredients may be unsuitable for children under certain ages.
4. Hypertension and Cardiovascular Disease: Pseudoephedrine may increase blood pressure and heart rate and should be used with caution in patients with hypertension, hypertension, arrhythmias, and other cardiovascular disease.
5. Prostatic hypertrophy and urinary problems: Pseudoephedrine may increase symptoms in patients with prostatic hypertrophy or urinary problems.
6. Kidney and liver diseases: Paracetamol is metabolized in the liver, so in patients with diseases of this organ, as well as renal failure, it should be used with caution and under the supervision of a physician.

Side effects Influenza

1. Drowsiness or restlessness: Pseudoephedrine hydrochloride, contained in Grippex, may cause drowsiness in some people, as well as 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 poor 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 have stomach problems such as nausea, vomiting, diarrhea, or constipation caused by one of the ingredients in this drug.
6. Allergic reactions: Some people may be allergic to any of the components of Grippex and develop an allergic reaction, which may include rashes, itching, swelling of the face, or difficulty breathing.

Overdose

1. Paracetamol: Overdose of paracetamol can lead to severe liver damage, including liver failure, hepatitis and even hepatic necrosis. It is especially dangerous to exceed the recommended dose of paracetamol for a short time or when drinking alcohol.
2. Pseudoephedrine hydrochloride: An overdose of pseudoephedrine can cause cardiac problems such as hypertension, arrhythmias, dizziness, headache, anxiety, insomnia and hallucinations. Increased blood pressure and stimulation of the central nervous system may also occur.
3. Dextromethorphan hydrobromide: An overdose of dextromethorphan can cause drowsiness, dizziness, headache, nausea, vomiting, incoordination, respiratory depression and even coma. Allergic reactions may also occur.

Interactions with other drugs

1. Medicines containing paracetamol: When used together with other drugs containing paracetamol, there may be an increased risk of overdose with this substance, which may lead to liver damage.
2. MAO inhibitors (monoamine oxidase inhibitors): Pseudoephedrine may increase symptoms of serotonin syndrome, especially when used in combination 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, and alcohol.