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Lemsip
Last reviewed: 04.07.2025
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Lemsip is an antipyretic and analgesic medication. Contains paracetamol with phenylephrine.
The principle of paracetamol's influence is based on the suppression of PG binding within the central nervous system, and in addition to this, on the effect on the thermoregulatory center within the hypothalamus.
Phenylephrine is a sympathomimetic. Its activity is primarily associated with direct stimulation of adrenoreceptor activity. Indirectly, its effect develops with the release of norepinephrine. The substance reduces swelling of the nasal mucosa and facilitates respiratory processes. At the same time, it leads to narrowing of arterioles and an increase in blood pressure and total peripheral vascular resistance.
Indications Lemsipa
It is used to eliminate symptoms of illness in the case of flu and acute respiratory infections – pain affecting the joints, throat and muscles, nasal congestion, headaches and fever.
Release form
The drug is released in the form of an oral liquid - inside a sachet with a volume of 4.8 g. Inside the pack there are 5 or 10 sachets.
Pharmacokinetics
After oral administration, paracetamol is absorbed at high speed in the gastrointestinal tract. Plasma Cmax values are noted after 0.5-1 hour. After administration of therapeutic doses, the half-life is 1-4 hours.
Metabolic processes involving paracetamol are realized inside the liver, mostly by means of conjugation. Taking into account the plasma values of the substance, it is partially involved in hydroxylation and deacetylation.
It is excreted mainly in the urine (90-100% over a 24-hour period) in the form of glucuronide conjugates (60%), as well as sulfates (35%) or cysteine (3%).
Phenylephrine hydrochloride is absorbed inside the gastrointestinal tract (the absorption process has a variable rate); exchange processes are carried out inside the liver with the intestine. After taking the drug, the plasma level Cmax is recorded after 60-120 minutes.
The average half-life is 2-3 hours. Excretion as a sulfate conjugate occurs in the urine.
Dosing and administration
You need to pour the powder from 1 sachet into a cup, then pour hot boiled water over it. The mixture needs to be stirred until the powder is completely dissolved; if necessary, you can sweeten the liquid, which is consumed warm.
It is necessary to take 1 sachet, repeating the portion at 4-6 hour intervals, if necessary. But at the same time, you cannot consume more than 4 sachets per day.
The therapeutic cycle should be a maximum of 3-5 days.
Contraindications
Main contraindications:
- severe intolerance arising from the influence of the constituent elements of the drug;
- problems with kidney or liver function;
- hyperbilirubinemia of a congenital nature;
- G6PD deficiency;
- fructose malabsorption (a rare hereditary form);
- glucose-galactose malabsorption;
- sucrose-isomaltose deficiency;
- blood pathologies, thrombosis, severe anemia, thrombophlebitis, and also leukopenia;
- sleep disorders, alcoholism and states of high agitation;
- organic lesions of the cardiovascular system (including atherosclerosis) and greatly increased blood pressure values;
- having a decompensated form of heart failure, a tendency to develop vascular spasms, intracardiac conduction disorder and coronary heart disease;
- glaucoma;
- hypertrophy affecting the prostate;
- pancreatitis in the active phase;
- thyrotoxicosis or severe diabetes mellitus;
- epilepsy;
- use together with β-blockers or tricyclics or taking MAOIs in the last 14 days;
- use in combination with medications that enhance or suppress appetite, as well as amphetamine-like psychostimulants;
- phenylketonuria;
- a tendency to form blood clots or increased blood clotting.
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Side effects Lemsipa
Side effects include:
- lesions associated with subcutaneous tissues or epidermis: urticaria, SJS, erythroderma, rashes, and also TEN, allergic dermatitis, itching, erythema multiforme, purpura and hemorrhages;
- immune disorders: anaphylaxis, allergy symptoms (including Quincke's edema);
- mental disorders: fear, anxiety, restlessness and irritability, agitation of a psychomotor or nervous nature, sleep or orientation disorder, depression, insomnia, hallucinations, sedation and confusion;
- neurological problems: tremors, headaches, paresthesia and dizziness;
- lesions affecting the vestibular apparatus and auditory organs: vertigo or tinnitus;
- signs associated with the visual organs: increased intraocular pressure, mydriasis and visual or accommodative disorder;
- lesions in the gastrointestinal tract: ulcers affecting the oral mucosa, pain and discomfort in the abdominal area, nausea, heartburn, hypersalivation, vomiting, and in addition diarrhea, dry oral mucosa, loss of appetite and hemorrhages;
- problems with hepatobiliary function: hepatonecrosis, liver dysfunction, jaundice, increased activity of intrahepatic enzymes and liver failure;
- disorders affecting the blood system and lymph: leuko-, thrombocyto-, pancyto- or neutropenia, anemia (also hemolytic), agranulocytosis, sulf- and methemoglobinemia;
- urinary and renal disorders: urinary retention (usually in individuals with prostate hypertrophy) or impaired urination, renal colic, oliguria and nephrotoxic reaction;
- signs from the cardiovascular system: palpitations, swelling, dyspnea, increased blood pressure, reflex bradycardia or tachycardia, arrhythmia and heart pain;
- problems affecting respiratory function and the work of the organs of the mediastinum and sternum: bronchial spasms in people with intolerance to aspirin or other NSAIDs;
- Others: fever, glucosuria, systemic weakness, hyper- or hypoglycemia and hyperhidrosis.
Overdose
Paracetamol poisoning can lead to liver failure. Liver damage develops after ingestion of 10+ g of paracetamol (in adults) and 0.15+ g/kg (in children).
Signs of paracetamol (or phenylephrine) intoxication that appear within the first 24 hours: pallor, hyperhidrosis, headaches, psychomotor agitation or CNS depression, tachycardia, tremor, dizziness, extrasystole, and in addition insomnia, hyperreflexia, heart rhythm disorders, reflex bradycardia, anorexia, nausea, anxiety, vomiting, abdominal pain and irritability.
In case of severe overdose, convulsions, hallucinations, arrhythmia and disturbance of consciousness appear.
Manifestations of liver damage may develop after 12-48 hours from the moment of poisoning. Metabolic acidosis and sugar metabolism disorders may occur. Acute intoxication causes toxic encephalopathy with impaired consciousness and comatose state, which sometimes leads to death.
Administration of large doses may cause urinary disorders – development of nephrotoxicity (necrotic papillitis, colic in the kidney area and tubulointerstitial nephritis). ARF accompanied by tubulonecrosis may also occur without liver damage. There is information about the development of arrhythmia with pancreatitis.
Long-term administration of large doses causes pancyto-, thrombocyto-, leuko- or neutropenia, aplastic anemia or agranulocytosis.
There is an opinion that the additional volume of toxic metabolic elements during intoxication is irreversibly synthesized in intrahepatic tissues.
In case of paracetamol poisoning, the patient should be given immediate medical care, even if there are no signs of overdose. In order to provide the required care and treatment, a person who has taken more than 7.5 g of paracetamol should be hospitalized. Symptomatic actions are also required. Within 48 hours from the moment of intoxication, an antidote to paracetamol (methionine or N-acetylcysteine) can be taken orally.
In case of phenylephrine intoxication, it is necessary to take activated charcoal, wash out the stomach and carry out symptomatic actions; in case of a strong increase in blood pressure, α-blockers (for example, phentolamine) are used.
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Interactions with other drugs
Concomitant use with tricyclics, MAOIs or methyldopa may result in a marked increase in blood pressure, hyperthermia, tachycardia and dysfunction of vital organs, which may result in death.
The drug potentiates the activity of anticonvulsants, ethyl alcohol and ethanol-containing substances, as well as sedative drugs.
Combination with antihypertensive drugs weakens their medicinal effect.
When administered together with anticonvulsants, rifampicin, certain sleeping pills, ethyl alcohol and barbiturates, non-toxic doses of paracetamol cause liver damage. In addition, barbiturates weaken the antipyretic activity of paracetamol.
The combination of paracetamol and azidothymidine may lead to neutropenia.
The combination of paracetamol with chloramphenicol potentiates the hepatotoxic effect of the latter.
Paracetamol enhances the activity of indirect anticoagulants.
The rate of absorption of paracetamol is increased when administered with domperidone or metoclopramide, and is decreased when used with cholestyramine.
Phenylephrine, when combined with MAOIs, leads to the development of hypertensive activity.
Use with tricyclics (eg, amitriptyline) increases the likelihood of developing cardiovascular adverse symptoms.
Administration in combination with SG and digoxin causes myocardial infarction or heart palpitations.
The combination of phenylephrine and other sympathomimetics increases the likelihood of developing adverse cardiovascular events.
Phenylephrine can weaken the therapeutic effect of β-blockers and other antihypertensive agents (methyldopa with reserpine), increasing the likelihood of hypertension and other negative symptoms associated with cardiovascular disease.
Lemsip should not be prescribed to people who are using MAOIs or who have completed treatment with them less than 14 days ago.
Storage conditions
Lemsip should be stored in a place out of reach of small children. Temperature level – maximum 25°C.
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Shelf life
Lemsip can be used for a period of 3 years from the date of sale of the medicinal substance.
Attention!
To simplify the perception of information, this instruction for use of the drug "Lemsip" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.