Maxigan

Maxigan is a combination drug with antispasmodic and analgesic properties.

Indications Maxigan

Among the indications:

• moderate or mild pain due to spasms occurring in smooth muscles - manifested by spasms of the bladder or ureter, as well as colic in the kidneys;
• intestinal, and in addition biliary colic;
• dysfunction of the biliary tract, chronic colitis, and also postcholecystectomy syndrome;
• algomenorrhea or pathologies of the organs located in the pelvis.

The medicine can be used for short-term therapy for neuralgia, as well as for muscle or joint pain, and for sciatica.

As an adjuvant medicine for pain that develops as a result of diagnostics or in the postoperative period.

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Release form

Available as tablets or injection solution. Blister strips contain 10, 20 or 100 tablets, one blister per package. Glass ampoules with solution have a volume of 5 ml. One cell strip contains 5 ampoules; 1 cell per pack.

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Pharmacodynamics

Analgin is a non-opioid analgesic, a derivative of pyrazolone. Its properties include pain relief, anti-inflammatory, and antipyretic.

Pitofenone hydrochloride has myotropic properties and has a fairly strong relaxing effect on smooth muscles in internal organs.

Fenpiverinium bromide has an m-cholinergic negative effect, which allows it to have an additional calming effect on smooth muscles.

These three substances, when combined, mutually increase the strength of each other's pharmacological effects, which allows the drug to reduce pain, relax smooth muscles and lower temperature.

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Dosing and administration

Maxigan tablets should be taken orally (for children aged 15 and over and adults) in a dosage of 1-2 tablets 2-3 times a day. No more than 6 tablets are allowed per day. The duration of the treatment course is a maximum of 5 days.

For children aged 6-8 years, the dosage is 0.5 tablet, at the age of 9-12 years - three quarters of a tablet, and at 13-15 years - 1 tablet. Frequency of administration - 2-3 times a day.

It is recommended to take the tablets immediately after meals.

The injection solution of the medicine is administered intravenously or intramuscularly. Children over 15 years of age and adults, in case of acute colic in severe form, should be administered the medicine intravenously (slowly - 1 ml over 1 minute) in a dosage of 2 ml. If necessary, the medicine can be administered again after 6-8 hours.

The drug is administered intramuscularly twice a day at a dosage of 2 ml. No more than 4 ml can be administered per day. The duration of the treatment course is a maximum of 5 days.

The solution is administered to children (both intravenously and intramuscularly) in accordance with their weight and age.

For children aged 3-11 months (weight 5-8 kg), only intramuscular injections can be administered at a dosage of 0.1-0.2 ml.

For children aged 1-2 years (weight 9-15 kg): dosage for intravenous injections is 0.1-0.2 ml; intramuscular injections are 0.2-0.3 ml.

For children aged 3-4 years (weight 16-23 kg): dosage for intravenous injections is 0.2-0.3 ml; intramuscular injections are 0.3-0.4 ml.

For children aged 5-7 years (weight 24-30 kg): the dosage for intravenous injections is 0.3-0.4 ml; intramuscular injections are 0.4-0.5 ml.

For children aged 8-12 years (weight 31-45 kg): dosage for intravenous injections is 0.5-0.6 ml; intramuscular injections are 0.6-0.7 ml.

For children aged 12-15 years (weight 46-53 kg): dosage for intravenous injections is 0.8-1 ml; intramuscular injections are 0.8-1 ml.

If necessary, the medicine can be administered again in the same dosage.

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Use Maxigan during pregnancy

The medicine should not be used in the first trimester or the last 6 weeks of pregnancy.

Contraindications

Among the contraindications:

• individual intolerance to the components of the drug (as well as pyrazolone derivatives);
• suppression of hematopoiesis processes in the bone marrow;
• severe form of liver or kidney failure;
• G6PD deficiency in the body;
• the presence of tachyarrhythmia, severe angina pectoris, decompensated form of CHF;
• closed-angle glaucoma;
• prostate hypertrophy (with clinical signs);
• intestinal obstruction;
• collapse, and besides that, megacolon;
• breastfeeding period.

Intravenous use of the drug is prohibited for infants under 3 months (or weighing up to 5 kg). Tablets are prohibited for children under 5 years of age.

Caution is required when used by patients with bronchial asthma, as well as liver or kidney failure, Samter's triad, a tendency to lower blood pressure, and intolerance to NSAIDs.

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Side effects Maxigan

Side effects include:

• allergy: itching and skin rashes; urticaria, anaphylaxis, Quincke's edema may occasionally develop; isolated cases of Lyell's or Stevens-Johnson syndromes;
• digestive system organs: isolated cases – dry mouth, as well as a burning sensation in the epigastric region;
• CNS organs: isolated cases – dizziness and headaches, as well as accommodation paresis;
• organs of the hematopoietic system: thrombocyto- and leukopenia, and also agranulocytosis (among its symptoms are chills, increased temperature, problems with swallowing, sore throat, vaginitis, stomatitis, and proctitis);
• respiratory system: bronchial spasms (especially in patients predisposed to this);
• cardiovascular system: decreased blood pressure and tachycardia;
• urinary system organs: rarely (mainly due to prolonged use or overdose of the drug) – development of anuria and oliguria, as well as proteinuria and tubulointerstitial nephritis; in addition, urine may acquire a red tint (due to metamizole breakdown products); isolated cases – problems with urination;
• local reactions: after intramuscular injection, infiltrates may appear at the site of the procedure;
• others: isolated – decreased sweating.

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Overdose

As a result of an overdose, the following symptoms occur: decreased blood pressure, vomiting with nausea, a feeling of drowsiness, dry mouth, confusion, pain in the epigastrium, kidney or liver dysfunction, seizures and changes in sweating patterns.

Therapy involves gastric lavage and activated charcoal. If necessary, symptomatic treatment can be performed.

Interactions with other drugs

As a result of the combination of Maxigan with other non-opioid analgesics, a mutual increase in toxic effects may be observed.

Tricyclics, oral contraceptives, and allopurinol have a destructive effect on the metabolism of metamizole sodium, and also increase its toxic properties.

Barbiturates with phenylbutazone and other drugs that induce microsomal liver enzymes reduce the effectiveness of the active component of Maxigan.

As a result of the combination of the active substance with cyclosporine, the levels of the latter in the blood decrease.

Sedatives and tranquilizers increase the strength of the analgesic effect of metamizole sodium.

In case of combination of Maxigan with butyrophenones, substances blocking histamine receptors (H1), amanatadine, as well as quinidine and phenothiazines, the strength of the m-cholinergic negative effect may increase.

The combination of Maxigan and ethanol can contribute to a mutual increase in their effects on the body.

As a result of the combined use of the drug with chlorpromazine or other phenothiazine derivatives, severe hyperthermia may develop.

Metamizole sodium is capable of disrupting the binding of oral antidiabetic drugs, GCS, as well as indomethacin and anticoagulants (indirect action) with proteins. At the same time, it also increases their effectiveness.

Combined use with cytostatic drugs or thiamisole increases the risk of developing leukopenia in the patient.

In case of combination with drugs that block histamine receptors (H2), and also with codeine and propranolol, the rate of inactivation of metamizole sodium decreases and its effect on the body increases.

The injection solution must not be mixed in the syringe with any other drug solutions.

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Storage conditions

The medicine should be kept in a place protected from sunlight, moisture, and children. The room temperature should not exceed 25°C.

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Shelf life

Maxigan is permitted to be used for 3 years from the date of manufacture of the drug.

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