ReenieCold Max

RhinoCold Max is a combination medicine intended for symptomatic treatment of cold and flu conditions. It contains the same active ingredients as Rinza and provides relief from symptoms such as headache, fever, nasal congestion, body aches and allergic reactions associated with colds and flu. Here is more information about the composition of RhinoCold Max and the action of each ingredient:

Components of RhinoCold Max:

1. Paracetamol:

   • Antipyretic and analgesic action.
   • Reduces fever and relieves pain without causing significant gastrointestinal irritation.

2. Caffeine:

   • Stimulates the central nervous system, reduces fatigue and increases alertness.
   • Enhances the analgesic effect of paracetamol.

3. Phenylephrine hydrochloride:

   • A sympathomimetic that constricts blood vessels in the nasal mucosa, which helps to reduce swelling and make breathing through the nose easier.

4. Chlorphenamine maleate:

   • An antihistamine agent that reduces allergy symptoms such as sneezing, itching and runny nose by blocking the action of histamine.

RhinoCold Max is used for symptomatic treatment of colds and flu, relieving symptoms such as headache, fever, nasal congestion and allergic reactions.

Before starting to take RhinoCold Max, it is important to consult your doctor, especially if you have chronic diseases or are taking other medications, to avoid possible side effects and interactions. You should also carefully study the instructions for use and follow the recommended dosage and duration of treatment.

Indications ReenieCold Max

1. Fever: Reduces an elevated body temperature caused by a cold or flu.
2. Headache: Relief of head pain associated with colds or flu.
3. Body and Muscle Pain: Reduces pain caused by the flu or cold, including muscle pain, joint pain, and pain with movement.
4. Nasal congestion: Reduces swelling of the nasal mucosa and facilitates breathing through the nose.
5. Sneezing, itching and runny nose: Reduces allergic reactions and relieves symptoms of rhinorrhea (runny nose) caused by colds.
6. Allergic Reactions: Symptomatic treatment of upper respiratory tract allergic reactions that may accompany a cold or flu.

Release form

Tablets: Each tablet contains a specific amount of active ingredients to provide a comprehensive response to cold and flu symptoms, including pain relief, fever reduction, runny nose breathing relief and reduction of allergic reactions.

Pharmacodynamics

The pharmacodynamics of RhinoCold Max is due to the combined action of its active ingredients, which work together to relieve cold and flu symptoms. Here is how these components work:

1. Paracetamol (acetaminophen)

• Action: Paracetamol has analgesic (analgesic) and antipyretic (antipyretic) action. The mechanism involves inhibition of cyclooxygenase (COX) in the CNS, which leads to a decrease in the synthesis of prostaglandins, mediators of pain and inflammation.
• Effect: Reduces body temperature in fever and reduces pain.

2. Caffeine

• Action: Caffeine acts as a central nervous system stimulant by blocking adenosine receptors, which leads to reduced fatigue and increased alertness. In addition, caffeine enhances the analgesic effect of paracetamol.
• Effect: Improved vigor and general well-being, increased analgesic effect of paracetamol.

3. Phenylephrine hydrochloride

• Action: Phenylephrine is a selective agonist of α1-adrenoreceptors, causing constriction of blood vessels of the nasal mucosa, which leads to a decrease in edema and improved nasal breathing.
• Effect: Reduces nasal congestion and eases breathing.

4. Chlorphenamine maleate

• Action: Chlorphenamine is an antagonist of H1-histamine receptors and blocks the action of histamine, which plays an important role in the development of allergic reactions and inflammation.
• Effect: Reduces allergy symptoms such as sneezing, itching and runny nose.

The combination of these ingredients makes RhinoCold Max effective in alleviating a variety of cold and flu symptoms, including headache, fever, nasal congestion and allergic reactions. It is important to note that each component contributes to the overall effect of the drug, providing a comprehensive approach to treatment.

Pharmacokinetics

Studies on the pharmacokinetics of the active ingredients in RhinoCold Max, including caffeine, paracetamol, phenylephrine hydrochloride and chlorphenamine maleate, provide insight into how these substances are absorbed, distributed, metabolized and eliminated from the human body. Here are the key findings:

1. Paracetamol and caffeine: A study on the pharmacokinetics of paracetamol and caffeine in combination products similar to RhinoCold Max showed the main pharmacokinetic parameters. For paracetamol, the time to reach maximum plasma concentration (t_max) was about 1.03±0.76 hours, with a half-life (t_1/2) of about 4.33±1.18 hours. For caffeine, t_max was about 0.89±0.50 hours and t_1/2 about 5.37±2.15 hours (Li Fa-mei, 2007).
2. Phenylephrine hydrochloride, chlorphenamine maleate, paracetamol and caffeine: Another study focused on the development and validation of a method to identify these components in tablet form, suggesting that this method can be used to assess the quality and efficacy of the medication, ensuring the correct dosage (Rushikesh Bandelwar, A. Nikam, S. Sawant, 2013).
3. Simultaneous determination: The study of simultaneous determination of paracetamol, phenylephrine hydrochloride and chlorphenamine maleate in commercial tablets using a rapid isocratic HPLC method offers an efficient and accurate approach for analyzing the pharmacokinetics and quality control of complex formulations like RhinoCold Max (Afsaneh Nabi, Mohamad Saber Tehrani, S. Farrokhzadeh, N. Sadeghi, 2020).
4. Bioequivalence study: A bioequivalence study of two formulations containing paracetamol, phenylephrine and chlorphenamine showed that both formulations are bioequivalent, indicating that generic versions of such drugs can be exchanged without compromising their efficacy.

Dosing and administration

The following is general information on routes of administration and doses for adults and children over a certain age:

Adults and children over 12 years of age:

• The usual dose for adults and children over 12 years of age is 1-2 tablets every 4-6 hours, depending on symptoms.
• Do not exceed the maximum daily dose, which is usually 4 g for paracetamol (about 8 tablets per day if one tablet contains 500 mg paracetamol) and in accordance with the manufacturer's instructions for the other ingredients.

Children under 12 years of age:

• The use of RhinoCold Max in children under 12 years of age should only be administered and supervised by a physician. The dosage and the ability of children to tolerate the components of the drug may differ significantly from adults.

Special Instructions:

• The drug should be taken with plenty of liquid, preferably water.
• To avoid insomnia, it is not recommended to take RhinoCold Max just before bedtime, especially considering the caffeine content.
• If symptoms persist for more than 3-5 days, a physician should be consulted to reassess the condition and treatment approaches.
• Particular caution should be exercised in the presence of chronic diseases such as hypertension, diabetes, heart, liver or kidney disease, and when taking other medications concomitantly.

Use ReenieCold Max during pregnancy

1. Caffeine: Moderate caffeine consumption during pregnancy is generally considered safe, but high doses of caffeine may be associated with a risk of pregnancy complications. It is recommended to minimize caffeine intake during pregnancy.
2. Paracetamol: Paracetamol is considered relatively safe for use during pregnancy, especially in the first and second trimesters. However, a doctor should be consulted before its use.
3. Phenylephrine hydrochloride: The use of phenylephrine during pregnancy may be associated with a risk to fetal development. Before using RhinoCold Max containing phenylephrine, you should always consult your doctor.
4. Chlorphenamine maleate: The use of chlorphenamine during pregnancy should be restricted only for strict medical reasons, as its safety in pregnant women has not been established.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to caffeine, paracetamol, phenylephrine hydrochloride, chlorphenamine maleate or other ingredients of the drug should not use RhinoCold Max.
2. Cardiovascular diseases: The use of phenylephrine hydrochloride may be undesirable in patients with cardiovascular diseases such as hypertension, arterial hypertension or arrhythmias.
3. Glaucoma: Phenylephrine hydrochloride may exacerbate symptoms of glaucoma, so its use should be avoided in patients with this condition.
4. Liver and kidney disease: The use of paracetamol may be undesirable in patients with liver or kidney disease, as it is metabolized in the liver and may cause toxic effects if it accumulates in the body.
5. Pregnancy and breastfeeding: The use of RhinoCold Max is not recommended during pregnancy or breastfeeding without medical advice due to potential adverse effects on the fetus or breast milk.
6. Pediatric age: RhinoCold Max may not be advisable for children under a certain age. Dosage and use should be coordinated with a doctor.
7. Thyroid Disease: Caffeine may increase symptoms of hyperthyroidism in patients with thyroid disease.

Side effects ReenieCold Max

Here are the most common side effects for each component of RhinoCold Max:

Paracetamol:

• Rarely: allergic reactions such as rash, urticaria, itching.
• Very rare: liver damage with high doses or prolonged use.

Caffeine:

• Nervousness, insomnia.
• Dizziness, headache.
• Tachycardia (rapid heartbeat).
• Gastrointestinal disorders such as nausea and vomiting.

Phenylephrine hydrochloride:

• High blood pressure.
• Heart palpitations.
• Dizziness, headache.
• Anxiety, nervousness.

Chlorphenamine maleate:

• Drowsiness or fatigue.
• Dry mouth.
• Difficulty urinating.
• Visual disturbances such as blurred vision.

Common side effects:

• Allergic reactions including angioedema, anaphylaxis, rash and pruritus.
• Gastrointestinal disorders such as abdominal discomfort, diarrhea or constipation.

Overdose

1. Paracetamol: An overdose of paracetamol is particularly dangerous as it can cause severe liver damage, a potentially life threatening condition. Symptoms may include nausea, vomiting, loss of appetite, pallor, and fatigue. In severe cases, acute liver failure may occur.
2. Caffeine: Caffeine overdose can lead to insomnia, nervousness, anxiety, rapid heartbeat, gastrointestinal disturbances, muscle tremors, and in some cases, more serious heart problems.
3. Phenylephrine hydrochloride: Phenylephrine overdose may cause dizziness, headache, reflex bradycardia or tachycardia, high blood pressure and in severe cases - cardiovascular complications.
4. Chlorphenamine maleate: Overdose of chlorphenamine may result in sedation, dry mouth, constipation, difficulty urinating, visual hallucinations, agitation, and in rare cases, seizures.

Interactions with other drugs

RhinoCold Max contains several active ingredients, so it is important to be careful about its interactions with other medications. Here are some possible interactions:

1. Paracetamol:

   • Paracetamol may increase the effect of anticoagulants such as warfarin, which may lead to an increased risk of bleeding.
   • Combining paracetamol with alcohol may increase the risk of liver damage.
   • Paracetamol can increase the levels of methotrexate in the body, which can lead to methotrexate toxicity.

2. Caffeine:

   • Caffeine can increase the effects of adrenaline and other sympathomimetic drugs, which can lead to increased blood pressure and heart rate.
   • Combining caffeine with alcohol or nicotine can increase their stimulant effects on the central nervous system.

3. Phenylephrine hydrochloride:

   • Phenylephrine may increase the effects of sympathomimetics, including adrenaline and norepinephrine, which may result in increased blood pressure and heart rate.
   • Combining phenylephrine with monoamine oxidase inhibitors (MAOIs) may result in increased blood pressure.

4. Chlorphenamine maleate:

   • Chlorphenamine may increase the effects of other sedatives, including alcohol, benzodiazepines, and anti-allergic drugs.
   • Combining chlorphenamine with central depressants may increase the risk of central nervous system depression.