Arstifen effervescent tablets 4 tubes of 20 pcs.

• active ingredients: citric acid anhydrous, sodium citrate anhydrous, potassium bicarbonate;
• 1 tablet contains: citric acid anhydrous 1197 mg, sodium citrate anhydrous 835.5 mg, potassium bicarbonate 967.5 mg;
• excipients: lactose monohydrate, mannitol (E 421), sodium saccharin, “Powdarome Lemon Premium” flavoring, adipic acid, polyethylene glycol.

Hypersensitivity to the components of the drug.

Kidney failure.

Urinary tract infections caused by bacteria that break down urea (risk of struvite stone formation).

Metabolic alkalosis.

Episodic hereditary adynamia.

In case of individual intolerance to any of the components of the drug, hypersensitivity reactions are possible. In some cases, taking the tablets may cause gastrointestinal disorders in susceptible patients. There have been reports of belching, heartburn, abdominal pain, flatulence, diarrhea, nausea, vomiting.

The optimal daily dose of Arstifen is determined individually by determining the urine pH.

For alkalizing urine in patients with uric acid (urate) stones.

To prevent recurrence, the pH of fresh urine should be in the range of 6.2 to 6.8. The required daily dose of Arstifen is individual for different patients. Usually the daily dose is 3 effervescent tablets. The daily dose is divided into three equal single doses taken during the day. If the pH of urine is below 6.2, the dose should be increased. Such correction should be made by increasing the evening dose to 2, and in exceptional cases – to 3 effervescent tablets. If the pH value exceeds 6.8, the dose should be reduced. It is advisable to adjust the dosage at the expense of the evening dose.

To dissolve (hemolitholysis) uric acid (urate) stones, the pH value of urine should be between 7.0 and 7.2.

For metaphylaxis of calcium stones and alkalinization of urine in patients with uric acid stones, in the presence of concomitant calcium stones.

The pH of fresh urine should be adjusted to 6.8 – 7.4. The dose should be determined in each individual case to achieve this pH range. Usually this is 3 effervescent tablets. If necessary, the dose can be increased, but in most cases 5 effervescent tablets are sufficient to achieve results in the specified pH range.

The daily dose of 3 effervescent tablets can be taken as a single evening dose or divided into three individual doses taken throughout the day. For higher doses, it is advisable to take 1 effervescent tablet in the morning, 1 at lunchtime and 2-3 tablets in the evening.

Arstifen is contraindicated in children under 18 years of age.

Effervescent tablets of the drug Arstifen should be dissolved in a glass of water, stirred and drunk immediately.

The liquid may be slightly cloudy and have some undissolved particles on the surface.

The effectiveness is usually monitored 3 times a day by measuring the pH of the urine. This is done using standard indicator strips included in each package. The indicator area of ​​the test strip should be briefly immersed in the urine. The colour of the test strip is then compared to the colour scale for 2 minutes, the pH value is read and recorded in the control calendar.

Use during pregnancy or breastfeeding

When using the drug according to the instructions, no negative effects were observed during pregnancy or breastfeeding.

Children

The efficacy and safety of the drug in children have not been sufficiently studied, therefore it is not recommended to prescribe Arstifen to children (under 18 years of age).

Ability to influence reaction speed when driving vehicles or other mechanisms

No effect.

With normal kidney function, the undesirable effect of the drug on changing the physiological parameters of metabolism is not observed either at the usual recommended dose or at a higher one, since the excretion of excess alkalis by the kidneys is a natural mechanism for regulating the acid-base balance in the body.

The upper limit of the urine pH range mentioned above should not be exceeded for several days, as there is a correspondingly increased risk of phosphate crystallization due to the increased pH (pH factor >7.8); moreover, a pronounced alkaline metabolic status is not a long-term problem.

Possible overdose can be corrected by reducing the dose of the drug. If necessary, measures can be taken to treat metabolic alkalosis.

Interaction studies have been performed only in adults. The simultaneous administration of substances containing citrate and aluminum may cause increased aluminum resorption, therefore it is recommended to observe a two-hour interval between taking such drugs and Arstifen.

The drug enhances the therapeutic effect of allopurinol.

Some drugs intended to lower blood pressure (aldosterone antagonists and other low-potassium diuretics such as triamterenes, spironolactones and amilorides), ACE inhibitors, sartans, as well as analgesic and anti-inflammatory drugs (non-steroidal anti-inflammatory drugs and peripheral analgesics) may reduce potassium excretion, which should be taken into account when prescribing them simultaneously with Arstifen (the risk of hyperkalemia increases). An increase in the extracellular potassium concentration reduces the effectiveness of cardiac glycosides, while its decrease increases the effect of arrhythmogenic cardiac glycosides.

With long-term use of the drug Arstifen, accumulation of quinidine in the body is possible in the event of its simultaneous administration, as well as a decrease in the effectiveness of nitrofurantoin (alkaline reaction of the environment), salicylates and lithium preparations (accelerated elimination).

Store in the original packaging at a temperature not exceeding 25 °C.

Keep out of reach of children.