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Last reviewed: 23.04.2024
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Lemsip is an antipyretic and analgesic medication. Contains paracetamol with phenylephrine.
The principle of influence of paracetamol is based on the suppression of GHG binding within the central nervous system, and in addition to the effect on the thermoregulatory center inside the hypothalamus.
Phenylephrine is a sympathomimetic. Its activity is primarily associated with the direct stimulation of the activity of adrenoreceptors. Indirectly, its effect develops with the release of norepinephrine. The substance reduces the swelling of the nasal mucosa and facilitates respiratory processes. At the same time, it leads to a narrowing of the arterioles and an increase in the values of blood pressure and OPSS.
Indications Lemsipa
It is used to eliminate the signs of the disease in case of flu and acute respiratory infections - pains affecting the joints, throat and muscles, nasal congestion, headaches and an increase in temperature.
Release form
The release of the drug is implemented in the form of oral liquid - inside a 4.8 g sachet. Inside pack 5 or 10 sachets.
Pharmacokinetics
After oral administration, paracetamol is absorbed at high speed inside the gastrointestinal tract. Plasma indicators Cmax are noted after the expiration of the 0.5-1th hour. After the introduction of therapeutic portions, the term half-life equals 1-4 hours.
Paracetamol exchange processes take place inside the liver, mostly through conjugation. Taking into account the plasma values of the substance, it partially participates in hydroxylation and deacetylation.
Excreted mainly together with urine (by 90-100% for a 24-hour period) in the form of glucuronide conjugates (by 60%), as well as sulfates (by 35%) or cysteine (by 3%).
Phenylephrine hydrochloride is absorbed inside the gastrointestinal tract (absorption process has a variable speed); metabolic processes are performed inside the liver with intestines. After the use of drugs, the plasma level Cmax is recorded after 60-120 minutes.
The average half-life is 2-3 hours. Excretion in the form of sulfate conjugate is made with urine.
Dosing and administration
It is required to pour the powder from the 1st sachet into the cup, then pour it with hot boiled water. The mixture should be stirred until the powder is completely dissolved; if necessary, you can sweeten the liquid that is used warm.
It is necessary to accept on the 1st sachet, repeating a portion with 4-6-hour intervals, if required. But at the same time you can not use more than 4 sachets per day.
The therapeutic cycle should be a maximum of 3-5 days.
Contraindications
The main contraindications:
- severe intolerance due to the influence of the constituent elements of the drug;
- problems with the work of the kidneys or liver;
- hyperbilirubinemia with congenital character;
- lack of G6FD component;
- fructose malabsorption (a rare hereditary variety);
- glucose-galactose malabsorption;
- sucrose-isomaltose deficiency;
- blood pathologies, thrombosis, severe anemia, thrombophlebitis, and also leukopenia;
- sleep disorders, alcoholism and conditions of intense arousal;
- organic lesions of the cardiovascular system (atherosclerosis among them) and greatly increased blood pressure values;
- having decompensated form of heart failure, a tendency to the development of vascular spasms, disorder of intracardiac conduction and coronary artery disease;
- glaucoma;
- prostatic hypertrophy;
- pancreatitis in the active phase;
- severe thyrotoxicosis or diabetes mellitus;
- epilepsy;
- use together with β-blockers or tricyclics or receiving IMAO during the last 14 days;
- use in combination with drugs that increase or suppress appetite, as well as amphetamine-like psychostimulants;
- phenylketonuria;
- tendency to thrombosis or increased blood clotting.
[5]
Side effects Lemsipa
Among the adverse events:
- lesions associated with the subcutaneous tissues or the epidermis: urticaria, SJS, erythroderma, rash, and in addition TEN, dermatitis of allergic origin, pruritus, erythema multiforme, purpura and hemorrhages;
- immune disorders: anaphylaxis, allergy symptoms (Quincke's edema among them);
- mental disorders: fear, anxiety, anxiety and irritability, agitation of a psychomotor or nervous nature, sleep or orientation disorder, depression, insomnia, hallucinations, a sedative state and confusion;
- neurological problems: tremor, headaches, paresthesias and dizziness;
- lesions affecting the vestibular apparatus and auditory organs: vertigo or ear noise;
- signs associated with visual organs: an increase in IOP, mydriasis and visual or accommodative disorder;
- lesions in the gastrointestinal tract: ulcers affecting the oral mucosa, pain and discomfort in the abdomen, nausea, heartburn, hypersalivation, vomiting, and in addition diarrhea, dry oral mucous membranes, weakening appetite and hemorrhage;
- problems with hepatobiliary function: hepatonecrosis, liver dysfunction, jaundice, increased activity of intrahepatic enzymes and liver failure;
- disorders affecting the blood system and lymph: leuco-, thrombocyto-, pancyto- or neutropenia, anemia (also hemolytic), agranulocytosis, sulfa- and methemoglobinemia;
- urinary and renal disorders: delay (usually in individuals with prostatic hypertrophy) or urinary impairment, colic in the kidney area, oliguria and nephrotoxic reaction;
- signs of the cardiovascular system: palpitations, swelling, dyspnea, increased blood pressure, reflex bradycardia or tachycardia, arrhythmia, and heart pain;
- problems affecting the respiratory function and the work of the mediastinal and sternum organs: bronchial spasms in people with intolerance to aspirin or other NSAIDs;
- Others: fever, glycosuria, systemic weakness, hyper- or hypoglycemia and hyperhidrosis.
Overdose
In case of poisoning with paracetamol, liver failure may develop. Hepatic damage develops after ingestion of 10+ g of paracetamol (in an adult) and 0.15+ g / kg (in a child).
Signs of intoxication with paracetamol (or phenylephrine) appearing on the first day: pallor, hyperhidrosis, headaches, agitation of a psychomotor nature, or suppression of the central nervous system, tachycardia, tremor, dizziness, extrasystole, and in addition insomnia, hyperreflexia, heart rhythm disorders, reflex, heart reflex, and, anorexia, nausea, anxiety, vomiting, abdominal pain and irritability.
In severe overdose, convulsions, hallucinations, arrhythmias and disorders of consciousness appear.
Manifestations of liver damage can develop after 12-48 hours after the poisoning. Perhaps the appearance of acidosis of the metabolic form and disorders of metabolic processes of sugar. Acute intoxication causes toxic encephalopathy with a disorder of consciousness and a comatose state, which sometimes leads to death.
The introduction of large doses can cause urinary disorders - the development of nephrotoxicity (necrotic papillitis, colic in the kidneys and tubulointerstitial nephritis). OPN, accompanied by tubulonecrosis, can appear without liver damage. There is information about the development of arrhythmias with pancreatitis.
Prolonged reception of large portions causes pancyto-, thrombocyto-, leuko- or neutropenia, aplastic anemia of the species or agranulocytosis.
It is believed that the additional amount of toxic metabolic elements during intoxication is irreversibly synthesized with intrahepatic tissues.
In case of poisoning with paracetamol, it is necessary to immediately provide the patient with medical assistance, even in the absence of overdose signs. To provide the required care and treatment, a person who has taken more than 7.5 g of paracetamol must be hospitalized. Symptomatic actions are also required. Within 48 hours from the moment of intoxication, paracetamol antidote (methionine or N-acetylcysteine) can be taken orally.
In case of intoxication with phenylephrine, it is required to take activated carbon, flush the stomach and carry out symptomatic actions; in the case of a strong increase in blood pressure using α-blockers (for example, phentolamine).
[12]
Interactions with other drugs
Combined use with tricyclics, MAOI or methyldopa can lead to a strong increase in the values of blood pressure, hyperthermia, tachycardia and the breakdown of important organs for life, which can result in death.
The drug potentiates the activity of anticonvulsants, ethanol and ethanol-containing substances, as well as sedative drugs.
Combination with antihypertensive drugs weakens their drug effects.
The introduction together with anticonvulsants, rifampicin, separate sleeping pills, ethyl alcohol and barbiturates leads to the fact that non-toxic portions of paracetamol cause hepatic damage. In addition, barbiturates weaken the antipyretic activity of paracetamol.
The combination of paracetamol and azidothymidine can cause neutropenia.
The combination of paracetamol with chloramphenicol potentiates the hepatotoxic effect of the latter.
Paracetamol enhances the activity of indirect type anticoagulants.
Paracetamol absorption rate increases with domperidone or metoclopramide, and also decreases with cholestyramine.
Phenylephrine combined with IMAO leads to the development of hypertensive activity.
Use with tricyclics (for example, amitriptyline) increases the likelihood of cardiovascular negative symptoms.
Introduction in combination with SG and digoxin causes myocardial infarction or a heartbeat disorder.
Combining phenylephrine and other sympathomimetics increases the likelihood of developing negative symptoms associated with cardiovascular disease.
Phenylephrine is able to weaken the therapeutic effect of β-blockers and other antihypertensives (methyldopa with reserpine), increasing the likelihood of hypertension and other negative symptoms associated with CVS.
It is impossible to prescribe Lemsip to persons who use MAOIs or have completed treatment with their use less than 14 days ago.
Storage conditions
Lemsip should be kept in a place closed to the penetration of small children. The temperature level is maximum 25 ° С.
[16]
Shelf life
Lemsip can be used for a 3-year term from the date of sale of the drug substance.
Attention!
To simplify the perception of information, this instruction for use of the drug "Pen" 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.