Pentalgin is

Pentalgin is a complex medication with antipyretic, anti-inflammatory and analgesic activity. It contains 5 active elements, whose therapeutic effect leads to the development of the medicinal effect of drugs.

Metamizole Na, as well as paracetamol, are non-selective drugs from the NSAID group. [1]

Codeine is a drug substance from the category of opioid analgesics; reduces the excitability of the cough center, and also has an analgesic effect. [2]

In addition, the drug contains phenobarbital with caffeine.

Indications Pentalgin is

It is used to eliminate acute pains of various localization. Among them:

• myalgia with arthralgia, toothache or headaches of various origins and neuralgia;
• algodismenorrhea ;
• migraine attacks, as well as migraine-like headaches.

In addition, the medication is prescribed to eliminate the signs of acute respiratory viral infections or flu - lowering the increased temperature, as well as eliminating pain in the muscle area and inflammation.

Release form

The release of the drug substance is made in tablets - 10 pieces inside the cell pack, 1 pack inside the box.

Pharmacodynamics

Metamizole Na with paracetamol has an intense analgesic and antipyretic effect; metamizole Na also has strong anti-inflammatory activity. The principle of the influence of these elements is based on the ability to suppress the binding of GHGs, slowing down the action of the COX enzyme.

Phenobarbital demonstrates intense muscle relaxant, antispasmodic and sedative effects, helping to potentiate the drug effect of NSAIDs.

The use of codeine in therapeutic portions does not lead to suppression of the respiratory center and does not affect the excretory activity of the bronchi. Frequent administration of codeine or the use of high dosages can provoke drug dependence. The substance causes a potentiation of the activity of NSAIDs and sedatives.

Caffeine stimulates the activity of the central nervous system, prevents collapse and potentiates the medicinal effect of metamizole Na and paracetamol.

Pharmacokinetics

When administered orally, the active elements of the drug are well absorbed inside the gastrointestinal tract.

Metamizole Na is converted inside the intestinal walls; the unchanged element is not registered within the bloodstream. Indices of synthesis of its active metabolic component with plasma protein are equal to 50-60%. Metabolic processes are carried out inside the liver, and excretion mainly occurs through the kidneys in the form of metabolic elements with or without a medicinal effect.

Paracetamol has a high rate of synthesis with intraplasmic protein. Paracetamol with caffeine is involved in intrahepatic metabolism and is excreted in the form of metabolic components mainly through the kidneys. The half-life of paracetamol is 1-4 hours.

Phenobarbital is also a participant in intrahepatic metabolic processes; it induces hepatic microsomal enzymes. Excretion is carried out mainly by the kidneys in the form of metabolic products. The half-life is approximately 3-4 days.

Codeine overcomes the BBB without complications and accumulates inside the body. Its accumulation is observed mainly inside the lungs, adipose tissues, kidneys and liver. The influence of tissue esterases leads to the hydrolysis of codeine, as a result of which it is conjugated with glucuronic acid inside the liver. The breakdown products of codeine have an analgesic effect. Excretion of most of the substance (in the form of metabolic components) occurs through the kidneys; a small part is excreted in the bile.

Dosing and administration

The medicine is taken orally, swallowing the pill whole (no need to grind or chew it). It must be washed down with plain water. It is required to adhere to a minimum of 4-hour interval between the use of drugs.

The duration of the treatment cycle and the size of the portions of the medication are selected by the attending doctor, personally to each patient.

In case of short-term acute pain, you need to take 1 tablet of the medicine 1 time. If the pain lasts for a long time (for diseases associated with lesions of the NS and ODA), you need to take 1 tablet 1-3 times a day. The treatment cycle can last no more than 5 days (unless the attending doctor has chosen a different scheme).

As an antipyretic substance, Pentalgin is often used in 1 tablet 1-3 times a day. The therapy can last a maximum of 3 days, if there is no other medical indication.

You can take no more than 4 tablets per day.

Long-term use of drugs can provoke drug dependence.

If the medicine needs to be taken for more than 1 week in a row, it is required to monitor liver function, as well as morphological blood parameters.

• Application for children

Not assigned to persons under 12 years of age.

Use Pentalgin is during pregnancy

The medication should not be used during pregnancy.

If the medicine needs to be taken during lactation, you should first consider abolishing breastfeeding.

Contraindications

Among the contraindications:

• strong personal sensitivity to the elements of the drug;
• renal or hepatic diseases of a severe nature;
• lesions of the gastrointestinal tract, which have an erosive and ulcerative form;
• problems with hematopoietic activity, including leuko- or thrombocytopenia, as well as anemia;
• pathologies associated with the function of the CVS, including arrhythmia, myocardial infarction in the active phase and increased blood pressure;
• use after a recently obtained TBI, and in addition, with increased ICP rates, which have a different nature;
• lack of G6FD component;
• glaucoma;
• a tendency to develop bronchial spasms;
• conditions in which respiratory depression is noted.

Caution is required when used by people with asthma or disorders of the kidney / liver, the elderly and diabetics.

Side effects Pentalgin is

The main side effects:

• lesions affecting the gastrointestinal tract: loss of appetite, vomiting, indigestion, pain in the epigastric zone, xerostomia, nausea and stool disorders (diarrhea and constipation may also occur). In addition, there may be an increase in the activity of liver enzymes, often not accompanied by the development of jaundice;
• disorders associated with the work of the PNS and CNS: disorder of the daily regimen, increased fatigue, problems with motor coordination, irritability, anxiety, tremors in the extremities and headaches;
• problems with the function of the CVS and hematopoietic activity: disturbances in the rhythm of the heartbeat, an increase in blood pressure values, extrasystole, meth- or sulfhemoglobinemia, as well as anemia (also hemolytic);
• disturbances in the functioning of the sense organs: an increase in IOP indicators, ear noise and visual disturbances;
• signs of allergies: urticaria, Quincke's edema, epidermal rashes, bronchial spasm, itching, SS and TEN;
• others: acute renal failure, renal colic, renal / hepatic disorder, hyperhidrosis, dyspnea, asthenia, tubulointerstitial nephritis and increased blood glucose values. Long-term use of Pentalgin is with its subsequent abrupt termination can lead to withdrawal syndrome.

It must be taken into account that the medication can change the indications when the athletes undergo doping control.

The use of drugs sometimes complicates the diagnosis in persons with abdominal pain in the active phase.

If negative symptoms appear, you need to stop using the medication and consult a doctor.

Overdose

An overdose of medication causes vomiting, allergy symptoms, weakness, nausea, heart rhythm disturbances, a decrease in blood pressure values, pain in the epigastric zone, blanching of the epidermis and hepatonecrosis. The subsequent increase in the portion can lead to suppression of the function of the central nervous system and the respiratory center.

Poisoning with a drug requires gastric lavage, the use of enterosorbents and the performance of symptomatic actions. In case of intoxication with paracetamol, N-acetylcysteine can be administered, as well as methionine taken orally.

Interactions with other drugs

The use of the drug together with NSAIDs, as well as aminophenazone, leads to the potentiation of the toxic activity of both drugs.

The combination of a drug and coumarin-type anticoagulants causes potentiation of their medicinal activity.

Paracetamol weakens the effect of drugs that undergo intensive intrahepatic metabolic processes.

Administration in combination with rifampicin causes a decrease in the drug effect of paracetamol.

The combination with cimetidine weakens the toxic effect of paracetamol and potentiates its therapeutic properties.

Simultaneous use with tricyclics, oral contraception and allopurinol leads to potentiation of the toxicity of metamizole Na.

Administration together with drugs that induce the action of intrahepatic microsomal enzymes weakens the effect of metamizole Na.

When combined with metamizole Na, the blood values of cyclosporine decrease.

The combination with codeine potentiates the activity of drugs that suppress the activity of the central nervous system.

The effects of MAOIs, codeine and tricyclics are mutually potentiated when using such a drug combination.

Caffeine weakens the effect of drugs that suppress the function of the central nervous system, and also potentiates the drug activity of NSAIDs.

Phenobarbital increases the rate of conversion of doxycycline, carbamazepine with quinidine and estrogens.

The combination of Pentalgin is with substances that suppress the work of the central nervous system, leads to the potentiation of the medicinal activity of phenobarbital.

Na valproate, together with valproic acid, used in combination with a medication, leads to a weakening of the metabolic processes of phenobarbital.

Do not use the medicine together with ethyl alcohol.

Storage conditions

Pentalgin is to be stored in a dark and dry place at a temperature not exceeding 25 ° C.

Shelf life

Pentalgin is can be used within a 3-year period from the date of sale of the medicinal product.

Analogs

The analogue of the drug is the Sedal-M substance.