Citramon Maxi tablets 20 pcs

Active ingredients: paracetamol, caffeine, acetylsalicylic acid.

One tablet contains paracetamol 250 mg, caffeine 65 mg, acetylsalicylic acid 250 mg.

Excipients: low-substituted hydroxypropyl cellulose, citric acid, corn starch, microcrystalline cellulose, stearic acid.

Hypersensitivity to the components of the drug, hypersensitivity to other xanthine derivatives, other salicylates.

Bronchial asthma, urticaria or rhinitis caused by the use of salicylates or other NSAIDs in the anamnesis

Congenital hyperbilirubinemia, pronounced renal failure or liver failure, Gilbert’s syndrome, congenital deficiency of glucose-6-phosphate dehydrogenase;

Blood diseases, hemophilia, hemorrhagic diathesis, hypoprothrombinemia, anemia, leukopenia, increased tendency to bleeding, thrombosis, thrombophlebitis, hemorrhagic diseases;

Acute gastrointestinal ulcers, gastrointestinal bleeding, surgical interventions accompanied by significant bleeding;

Severe cardiovascular diseases, including rhythm disturbances, paroxysmal tachycardia, severe atherosclerosis, severe form of ischemic heart disease, severe heart failure, acute myocardial infarction, severe arterial hypertension, portal hypertension, tendency to vasospasm.

States of increased excitement, sleep disorders, old age, alcoholism, glaucoma, hyperthyroidism, acute pancreatitis, hypertrophy of the prostate gland, severe forms of diabetes.

Use simultaneously with MAO inhibitors, as well as within 2 weeks after stopping their use.

Combination with methotrexate at a dose of 15 mg per week or more.

Contraindicated in patients using tricyclic antidepressants or β-blockers.

For a headache: the usual recommended dose is 1 tablet, in addition, it is allowed to take 1 more tablet with an interval between doses of 4-6 hours.

In case of more intense pain, you can take 2 tablets.

For headache therapy, the duration of therapy should be up to 4 days.

With migraine: when symptoms appear, take 2 tablets, if necessary, it is allowed to take 2 additional tablets with an interval between doses of 4-6 hours.

When treating migraines, the duration of therapy should be up to 3 days.

For both headache and migraine, the maximum daily dose of the drug is 6 tablets.

Each dose of the medicine should be washed down with a full glass of water.

Do not take together with other medicines containing paracetamol.

It should be used with caution in elderly patients, especially those with reduced body weight.

Children

The drug should not be used in children due to the risk of developing Reye’s syndrome, hyperpyrexia, metabolic acidosis, disorders of the nervous system and psyche, vomiting, impaired liver function, and hyperthermia against the background of viral diseases.

pregnant

The drug should not be used during pregnancy and breastfeeding.

Acetylsalicylic acid has a teratogenic effect, when used during pregnancy in the first trimester leads to malformation, cleft palate, in the third trimester – to inhibition of labor, closure of the ductus arteriosus in the fetus, which causes hyperplasia of pulmonary vessels and hypertension in the vessels of the small blood circulation , impaired kidney function with possible further development of renal failure with oligohydroamniosis, prolongation of bleeding time, antiplatelet effect that can occur even after the use of very low doses.

Caffeine increases the risk of spontaneous abortion.

The drug penetrates into breast milk, which increases the risk of bleeding in children due to impaired platelet function.

Drivers

As adverse reactions from the nervous system may occur, when using the drug, you should avoid driving a car and work that requires increased attention and quick reaction.

Liver damage is possible in adults who have taken more than 10 g of paracetamol, and in children who have taken more than 150 mg/kg of body weight.

Taking 5g or more of paracetamol can cause liver damage.

Overdose symptoms in the first 24 hours: pallor, nausea, vomiting, anorexia and abdominal pain, liver damage may become apparent 12-48 hours after overdose, impaired glucose metabolism and metabolic acidosis may occur, in severe poisoning, liver failure may progress to encephalopathy , hemorrhages, hypoglycemia, coma and have a fatal outcome, acute renal failure with acute tubular necrosis can be manifested by severe lumbar pain, hematuria, proteinuria and develop even in the absence of severe kidney damage, as well as cardiac arrhythmia and pancreatitis.

With long-term use of the drug in large doses, aplastic anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia may develop on the part of hematopoietic organs.

When taking large doses, dizziness, psychomotor agitation and disorientation may occur from the side of the central nervous system; on the part of the urinary system, nephrotoxicity.

On the part of hearing and vestibular apparatus: disorientation.

From the respiratory system, organs of the chest and mediastinum: rhinitis, nasal congestion, shortness of breath, bronchial asthma, bronchospasm in patients sensitive to acetylsalicylic acid and other NSAIDs.

From the gastrointestinal tract: dyspeptic disorders, including nausea, vomiting, discomfort and pain in the epigastrium, heartburn, abdominal pain; inflammation of the gastrointestinal tract, erosive-ulcerative lesions of the gastrointestinal tract, which can in some cases cause gastrointestinal bleeding and perforation with corresponding laboratory and clinical manifestations, ulcers on the mucous membrane of the oral cavity.

From the side of the liver and biliary tract: increase in the activity of liver enzymes, as a rule, without the development of jaundice, hepatonecrosis, transient liver failure with an increase in the level of liver transaminases.

From the kidneys and urinary system: nephrotoxicity, renal colic, interstitial nephritis, papillary necrosis.

From the endocrine system: hypoglycemia, up to hypoglycemic coma.

From the side of the nervous system: headache, nervousness, restlessness, dizziness, tremors, paresthesias, tinnitus, visual disturbances, which may indicate an overdose: insomnia, sleep disturbances, increased excitability, disorientation, irritability.

On the part of the psyche: a feeling of fear, anxiety, anxiety.

From the side of the cardiovascular system: tachycardia, palpitations, arterial hypertension, arterial hypotension, arrhythmia.

From the blood and lymphatic system: anemia, sulfate hemoglobinemia and methemoglobinemia, hemolytic anemia, bruising or bleeding, with long-term use in large doses, aplastic anemia, pancytopenia, neutropenia, thrombocytopenia, agranulocytosis, such bleeding as intraoperative hemorrhages, hematomas, bleeding from the urogenital organs were observed system, epistaxis, gum bleeding, gastrointestinal bleeding, and cerebral hemorrhage, which were rarely life-threatening.

From the immune system: hypersensitivity reactions, including anaphylaxis, anaphylactic shock.

In patients with individual hypersensitivity to salicylates, the development of allergic skin reactions is possible, including such symptoms as skin hyperemia, a feeling of heat, rash, urticaria, swelling, itching, angioedema, rhinitis, nasal congestion. In patients with bronchial asthma, an increase in the frequency of bronchospasm is possible; allergic reactions from minor to moderate degree, which can affect the skin, respiratory tract, digestive tract, cardiovascular system and manifest in the form of rashes, urticaria, swelling, itching.

From the side of the skin and subcutaneous tissue: itching, rashes on the skin and mucous membranes, angioneurotic edema, erythema multiforme.

The shelf life is 2 years.

Store in the original packaging at a temperature not higher than 25 °C, in a place inaccessible to children.