Zaldiar

Effective analgesic and anti-inflammatory agent Zaldiere, manufactured by the German corporation Grünental GmbH. This is a complex drug, the active ingredient of which are tramadol and paracetamol.

Indications Zaldiar

The drug under consideration has already received a lot of positive feedback, but do not forget that the patient must be informed before taking the reception that the main active compound tramadol (with prolonged use) is capable of causing opium dependence, therefore, with particular care should be taken of the dosages and duration treatment course. Do not use without doctor's prescription.

Indications for use Zaldiar are caused by the following need:

• Medium or high intensity pain syndrome of different etiology.
• Anesthesia of medical and diagnostic measures.
• Removing the pain after the injury.
• Pain of vascular and inflammatory origin.

Release form

Ten tablets, covered with a yellow coating and "tightened" in a blister of aluminum foil or polypropylene - this is the only form of the drug Zaldiar, which offers a pharmacy market.

[1]

Pharmacodynamics

The active substances of the analgesic in question are paracetamol and tramadol. In connection with this circumstance, the pharmacodynamics Zaldiar looms.

The substance of tramadol is referred to analgesics, it is a synthetic opium chemical compound and has powerful analgesic and sedative properties. A wonderful agonist (when exposed to nerve endings, receives a biological response) of opiate receptors. The characteristics of tramadol are central. The spinal cord receives a pulse effect, which enhances the sedative properties of the drug. This component of the complex medication Zaldiar supports the hyperpolarization of membranes, as well as effectively blocks pain impulses, introducing analgesic properties into Zaldiar's characteristic.

Paracetamol is the strongest analgesic with antipyretic effect. Due to its characteristics, it actively influences the centers of the brain responsible for pain sensations, effectively conducts the thermoregulation of the patient's body, while not irritating the mucous membrane of the gastrointestinal tract. This chemical compound is neutral in the metabolism of water and salt. It is also inert to the synthesis of prostaglandins.

Due to the complex work of chemical compounds, paracetamol promotes the rapid removal of pain symptoms, whereas tramadol allows to maintain the duration of the analgesic effect. The two components "work together" fairly productively, which makes it possible to reduce the likelihood of side effects.

[2]

Pharmacokinetics

Suction pharmacokinetics Zaldiar is very high. It is almost completely and in a short period of time absorbed by the mucosa of the gastrointestinal tract. Paracetamol absorbs much faster than tramadol. It is absorbed in the liver due to cleavage (it is already known about eleven metabolites) and subsequently converges with glucuronic acid. Tramadol is characterized by high pharmacological activity.

The half-life of the tramadol derivatives on average shows 4.7 to 5.1 hours, whereas for the removal of paracetamol, two to three hours are sufficient. When Zaldiar works, the maximum amount of paracetamol in the blood is observed within one hour after taking the drug. Joint work with tramadol, bioavailability of which corresponds to 75%, does not affect the concentration of paracetamol in the plasma. In the case of a repeated course of taking the drug, the bioavailability of tramadol increases to 90%. This allows us to bring the binding properties of tramadol and paracetamol to plasma proteins to 20%.

Through the kidneys with urine, approximately 30% of tramadol with paracetamol and about 60% of tramadol metabolites is excreted from the patient's body.

[3], [4],

Dosing and administration

The medicine Zaldiar is taken in no matter the time when the patient takes food. The tablet is administered orally (through the mouth) without chewing. If, for some reason, one of the tricks was missed, the next time you should not double the dosage. The admission is conducted under the direct supervision of a physician, who paints individually, for each patient (depending on the intensity of the pain syndrome and the sensitivity of the patient) the schedule of taking, the dosage and the duration of the treatment course.

Dosing and Administration: The starting dose of the drug is one two tablets, while the daily amount of the drug should not exceed the number: for tramadol - 300 mg; on paracetamol - 2600 mg, which corresponds to approximately eight tablets. The next dose of Zaldiar should not be earlier than six hours after the previous input.

In case of vital necessity in the use of a medicinal product for a patient of the age category over 75 years, the starting dosage is the same and the duration of the interval between the introduction of the next dose of the drug is significantly extended to 12 hours. This is especially true for patients with renal pathology (when the level of creatinine clearance falls in the range of 10 to 30 ml / min). This is due to the fact that tramadol is slowly removed from the human body.

If the patient has a history of liver pathology, in this case Zaldiar is not recommended. If there is a slight deviation in the functioning of the liver, the medicine is attributed in the starting dosages, while the interval between doses is increased. A patient suffering from alcoholism has, in liver pathology, a greater chance of receiving an overdose of the drug than a non-drinking patient.

[7], [8]

Use Zaldiar during pregnancy

Deep clinical studies that responded to this question were not conducted. Hence it should be concluded that the use of Zaldiar during pregnancy and when feeding a newborn baby is not recommended.

Contraindications

Despite its high pharmacological qualities and activity, and possibly in spite of it, there are also contraindications to the use of Zaldiar.

• Individual hypersensitivity to the active substances of the drug or its secondary elements.
• Hypertension intracranial localization.
• Severe form of poisoning with alcohol, drugs, including medication, which includes narcotic chemical compounds.
• Intoxication due to the use of a significant dose of drugs, reducing the efficiency of the central nervous system.
• It is not necessary to ascribe the drug in question with sleeping pills and psychotropic drugs.
• It is not recommended to use Zaldiar in conjunction with MAO inhibitors (the intake can be started only two weeks after the end of the intake of inhibitors).
• Contraindications to the use of Zaldiar apply to children and adolescents under 14 years of age or, conversely, older people after 75 years of age.
• Creatinine clearance is below 10 ml per minute, which is often found in pathological disorders of kidney or liver function.
• The syndrome of "cancellation" of narcotic substances.
• Some bile duct diseases.
• Attacks of epilepsy, susceptibility to periodic convulsive reflex manifestations.
• Care should be taken if there is a traumatic brain injury in the patient's history.
• Do not allow simultaneous medication Zaldiar with other pain medications central action.
• Viral hepatitis.
• Alcoholism.
• Cirrhosis of the liver.
• And some other diseases.

[5]

Side effects Zaldiar

Adequate use of this medication is able to effectively cope with pain sensations of different etiologies. But, despite a whole bunch of positive characteristics, its use in the protocol of treatment can contribute to the manifestation of some negative symptoms.

Side effects Zaldiar:

• Fast fatiguability.
• Drowsiness.
• Development of drug dependence.
• Increased sweating.
• Decrease in the general tone of the body.
• Insomnia.
• Temporary amnesia or memory impairment.
• Violation of the menstrual cycle.
• Depression and irritability.
• Growing headaches.
• Increased excitability.
• Convulsions, trouble with breathing.
• Visual impairment and taste perception.
• Pain in the abdomen, nausea and vomiting.
• Inadequacy of consciousness.
• Violation of the vestibular apparatus.
• Diarrhea and increased gas separation.
• A long course of treatment is able to develop nephritis, the pathology of the hematopoietic function, lead to the appearance of necrotic ulcers.
• Arrhythmia and tachycardia.
• Edema of the Quincke.
• Dryness in the oral cavity.
• Itching and skin rashes.
• Problems with urination, urinary retention.
• And some other symptoms.

[6]

Overdose

Proceeding from the fact that active ingredient Zaldiar is tramadol and paracetamol, the overdose of this drug also reveals signs and symptoms of excess of these components.

Overdose of tramadol is manifested by such symptoms:

• Nausea and vomiting reflex.
• Myos (narrowing of the pupil).
• Collapse (structural destruction).
• Failures in the rhythm of breathing.
• Coma (severe depression of the central nervous system, followed by death of the brain).
• Reflex cramps.
• A significant one-time amount of paracetamol is able to develop acute symptoms for six to 14 hours, with long-term administration of the drug, similar symptoms can appear within two to four days.

Exceeding the quantitative component of paracetamol leads to the appearance of:

• Collapse.
• Diarrhea (diarrhea in the form of a watery stool).
• Hypoglycemia (decrease in serum glucose level).
• Refuse to eat.
• Edema of the brain.
• Arrhythmia.
• Hypocoagulation (increased blood coagulation, leading to thrombosis.).

Much rarer, but still there is an acute, lightning impairment in the work of the kidneys and liver, up to and including refusal.

The stages of patient withdrawal from this condition are carried out urgently:

• The first thing to do is to immediately wash the stomach.
• Give the patient enterosorbents, for example, polyphepan, activated charcoal.
• It is necessary to constantly monitor all vital functions of the patient's body.
• Conducting therapeutic treatment that cures the emerging symptoms.
• At this time, the patient must be under constant medical supervision.

[9], [10]

Interactions with other drugs

In any case, very carefully, with increased attention, it is necessary to treat situations when you have to take two or more drugs at the same time. Sometimes it is quite difficult to predict how a particular substance behaves in the body of a particular patient, because each person is purely individual. But, nevertheless, certain patterns of the mutual influence of one chemical substance or element on another are still visible.

With the joint reception of Zaldiar with pentazocine, there is a "cancellation" syndrome, because, as antagonists, these drugs begin to compete with each other, suppressing the action of everyone. In this case, a complex combination of these drugs is not effective and even dangerous. A similar situation occurs when Zaldiar collaborates with such drugs as nalbuphine or buprenorphine.

Interactions Zal'diar with other drugs, the bioavailability of which extends to the receptors of the central nervous system, have a mutually reinforcing effect. And even more so when combined with any alcoholic beverage fortress, the side symptomatology inherent in an overdose of tramadol is more pronounced. These drugs include tranquilizers and sleeping pills.

There is a decrease in anti-bolide manifestations and duration of their action during Zaldiar's work in tandem with such drugs and substances as: tricyclic antidepressants, carbamazepine, ethanol, barbiturates and many others.

The long course of barbiturates acts depressingly on the active manifestations of paracetamol. The combination of Zaldiar with other non-steroidal anti-inflammatory medications can provoke the development of nephropathy, renal papillary necrosis, which invariably leads to the sometimes irreversible pathology of kidney function (kidney failure). The interaction of the drug in question with ethanol gives impetus to the progression of acute pancreatitis.

Long-term use of paracetamol in an overestimated dosage in combination with the introduction of salicylates into the body sharply increases the chances of cancerous growths to develop into the oncology of the bladder or kidney. Naloxone combined Zaldiara improves respiratory function and enhances the analgesic effect.

Increase the likelihood of hepatotoxicity in the patient can diflunisal, which, almost a half times increases the quantitative component of paracetamol in the patient's blood system. The use of Zaldiar in combination with drugs partially or completely blocking the impulse action on the neurons of the central nervous system to reduce the likelihood of epileptic seizures (such as antipsychotics, tricyclic antidepressants, selective inhibitors) often lead to reflex convulsions. The rapid absorption characteristics of Zaldiar can be improved by the parallel administration of medications such as domperidone or metoclopramide.

Erythromycin and ketoconazole by their characteristics are able to replace the metabolic processes of the active substance Zaldiar, so their joint use is not recommended in order to avoid an overdose of this chemical compound. The concomitant use of quinidine promotes an increase in the amount of tramadol and inhibits the quantitative index of the metabolite.

The complex reception of an anesthetic with indirect anticoagulants helps increase the probability of bleeding.

[11]

Storage conditions

Any medicine must be out of the reach of small children. Temperature storage conditions Zaldiar - the room should not be above 25 ° C.

[12], [13]

Shelf life

Do not use Zaldiar drug when the expiration date of the drug, which corresponds to three years, has expired.

[14], [15]