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What kind of drug is Panadol, and what is it for?
Panadol- it is widespread antipyretic And analgesic a drug. The active substance of the medication is called paracetamol. Other commercial names include acetaminophen, mexalene, efferalgan, and others. Panadol has two main effects - antipyretic and analgesic, which explains its widespread and almost universal use. Contrary to popular belief, this drug has virtually no anti-inflammatory effect. The list of indications is very wide, and it can be divided into two main groups.
The first group of pathologies are diseases with severe pain.
Pathologies with severe pain syndrome for which Panadol is used include:
- arthralgia ( joint pain);
- pain during menstruation.
The second group of indications are various colds accompanied by fever. In this case, Panadol is prescribed as symptomatic treatment for influenza, pneumonia, bronchitis and fever unknown origin. The antipyretic effect is also associated with blockade of the enzyme cyclooxygenase and, as a consequence, prostaglandins. Inhibition of prostaglandins in the hypothalamic thermoregulation center leads to temporary elimination of fever. In addition, panadol increases heat transfer, which also leads to a decrease in temperature.
Thus, both effects of Panadol are due to the blockade of prostaglandin synthesis. The difference is the location. Inhibition of prostaglandins in the thermoregulatory center leads to a decrease in temperature, similar action in the center of pain is accompanied by an analgesic effect. Both centers are located in the hypothalamus.
Active ingredient: Panadol
The active ingredient in Panadol is paracetamol, also known worldwide as acetaminophen. Paracetamol is produced as an independent drug, but is most often included in anti-influenza medications. According to its chemical affiliation, it belongs to the group of anilides - compounds that are derivatives of aniline. Paracetamol differs from its other predecessors in its low toxicity. Thus, antipyretic drugs that preceded paracetamol ( acetanilide and phenacetin) had the ability to form methemoglobin. Methemoglobin is a form of hemoglobin in which iron ions have been oxidized. This, in turn, leads to blockage of oxygen transport. The result of methemoglobinemia is severe oxygen deficiency. Paracetamol ( and, accordingly, Panadol) is less able to form methemoglobin. However, in large doses it is still capable of having nephrotoxic and hepatotoxic effects.When taken orally, paracetamol is well absorbed from the gastrointestinal tract. After absorption through the mucous membrane, it penetrates into the blood, where it binds to plasma proteins by 15 percent. Paracetamol is transported through the bloodstream to the liver, where most of it is subject to conjugation ( tying) with glucuronic and sulfuric acid. As a result of this reaction, non-toxic to the body and easily excreted metabolites are formed. Subsequently, these metabolites ( glucuronide and sulfates) are excreted by the kidneys within 20–24 hours. If creatinine clearance is less than 20 milliliters per minute ( what is observed in renal failure), the elimination of the drug slows down several times.
The maximum concentration of paracetamol in the blood after a single dose is reached within an hour. So, when taking one tablet orally ( 500 milligrams) within an hour the concentration of panadol is 6 micrograms per kilogram of weight. The drug is quickly eliminated by the kidneys, so after 5 - 6 hours the concentration of Panadol is halved. The distribution of the drug occurs mainly in body fluids, with the exception of cerebrospinal fluid. About one percent of the drug passes into breast milk, which should, of course, be taken into account by nursing women.
Metabolism of the drug depends on general condition the body, namely on the functionality of the kidneys and liver. Thus, with cirrhosis of the liver and other diseases of this organ, the metabolism of Panadol slows down. As a result, the drug circulates in the body longer, which increases the risk of toxic effects.
The half-life of Panadol ranges from 2 to 4 hours, and in case of renal failure it increases to 6 hours. During this time, the concentration of the drug in the blood is halved, and half of Panadol is excreted from the body.
What does Panadol help with?
Panadol helps with mild to moderate pain of various origins, and also when high temperature. In the first case, it is used as an analgesic, that is, as a pain reliever. Availability and low risk of side effects have led to wide application panadol. So, as an anesthetic it is used for headaches, dental, muscle and joint pain. The mechanism of the analgesic effect is due to the blockade of the synthesis of prostaglandins, which play a major role in pain. The effectiveness of Panadol directly depends on the cause of the pain. Thus, the main analgesic mechanism is muscle relaxation and muscle wall vessels. If the pain is due to compression of a nerve or tissue, then Panadol is ineffective. No less important role The intensity of pain also plays a role. Panadol is powerless for very severe and unbearable pain.The main indication for the use of Panadol is fever in children and adults. The mechanism of antipyretic action is to influence the thermoregulation center, which is located in the hypothalamus. The indication for the use of Panadol is fever of various etiologies, and even fever of unknown origin.
It is important to know that Panadol does not have an anti-inflammatory effect. Therefore, it makes no sense to prescribe it for colds without fever. It is also not recommended to take Panadol for rheumatic diseases and connective tissue diseases.
How does Panadol work?
So, the main mechanism of action of panadol is the inhibition of biologically active substances in the hypothalamus. The hypothalamus is a brain structure that, together with the thalamus, is part of the diencephalon. This structure is part of the limbic system of the brain - the most ancient part of the brain, which, in turn, contains the main vital centers. Thus, the hypothalamus contains the respiratory center, the center of saturation and pleasure, as well as the center of pain and thermoregulation. Panadol works at the level of the last two.The mechanism of fever is due to an increase in the level of prostaglandins in the thermoregulatory center. The front part of this part of the brain receives information from thermoreceptors, while the back part ( heat production center) sends impulses back to muscles, skin vessels and other organs. Due to this, overall metabolism increases and thermoregulation processes in the muscles are activated. The heat transfer center is located in the nuclei of the anterior hypothalamus. Impulses coming from these areas lead to a decrease in heat production due to the expansion of blood vessels and increased heat release. In addition to prostaglandins, both reactions also involve hormones such as adrenaline, thyroxine and others. The constancy of temperature is due to the mutual regulation of the processes of heat production and heat transfer.
The activation of certain heat exchange mechanisms occurs depending on specific conditions. For example, when the temperature drops environment a mechanism such as trembling is activated, which increases heat transfer. In other words, the thermoregulation center is constantly tuned to maintain a certain body temperature - comfort temperature. To maintain this comfort, it is necessary that the air temperature in the room be no more than 25 degrees, and at the body level there would be no pyrogenic ( antipyretic) processes. Any change in these conditions leads to irritation of the corresponding receptors in the hypothalamus and a change in temperature.
The analgesic mechanism of action of panadol is similar to the antipyretic effect. A key link is also the blockade of the synthesis of prostaglandins - pain mediators. The blockade is carried out at the level of the cyclooxygenase enzyme.
The main role in the mechanism of pain syndrome is played by hypersensitivity nerve endings ( nociceptors) under the influence of substances, namely prostaglandins. In addition to prostaglandins, other mediators are involved in increasing sensitivity to pain - histamine, cytokines. As a rule, these are mediators from the inflammatory group that have many effects. Some increase vascular permeability and generate edema, others trigger allergic processes. In the occurrence of pain, the most significant are prostaglandins, namely prostaglandins of the E2 group, which most increase the sensitivity of receptors to pain.
Thus, a vicious circle is observed - tissue damage is accompanied by the release of chemical substances, which enhance both the processes of inflammation and pain syndrome. In its turn, pain symptoms affects the operation of many systems. That is why many experts recommend eliminating pain, since it is an important component of the treatment of many diseases.
To enhance the analgesic effect of Panadol, caffeine or other components are often added to combination drugs. Caffeine improves absorption ( suction) panadol and thereby enhances the analgesic effect.
How long does it take to work ( brings down the temperature) panadol?
The antipyretic effect of Panadol occurs within 30 to 60 minutes. The rate of development of the effect depends on the activity of liver enzymes, the condition of the gastric mucosa and, in general, on the characteristics of the body. Thus, when taken orally, panadol is absorbed through the mucous membrane gastrointestinal tract into the general bloodstream. After this, it penetrates the blood-brain barrier and reaches the hypothalamus, the center of thermoregulation and pain. With pronounced changes in the mucous membrane ( ulcers, atrophic gastritis) the absorption process is disrupted. As a result, the onset of the effect increases and can reach two hours. The speed of onset of the effect is also affected by the condition hematopoietic system. So, in order to penetrate the brain, Panadol needs to bind to blood proteins. If hypoproteinemia is observed at the body level ( low protein concentration), then the transport of panadol into the nervous system also slows down. After this, the drug is metabolized in the liver by combining with glucuronic acid and sulfate. This process occurs with the participation of mixed liver oxidases and cytochrome P450. With cirrhosis of the liver or with congenital genetic defects of enzymes, the conjugation process also slows down. However, this is already reflected in the duration of the effect of Panadol.How long does Panadol last?
Panadol lasts from 2 to 4 hours. However, options are possible here too. First of all, the duration of the effect of Panadol is influenced by the condition of the liver and kidneys. Thus, it is known that more than 95 percent of the drug is processed by liver enzymes. After this, the drug is excreted by the kidneys. In older people, whose metabolism is slower, the drug circulates in the body longer. The longer the medication stays in the body, the longer its effect. A similar process is observed in people with kidney and liver pathologies. In the first case, due to a broken renal filtration and excretion ( excretion) a drug for a long time is not excreted from the body and continues to circulate in the bloodstream. In the second case, due to impaired liver function, the process of inactivation of panadol by enzymes slows down. This leads not only to the fact that the medication remains active longer than prescribed, but also to the development of numerous side effects.The speed of effect and action of Panadol are also affected by physiological characteristics body. First of all, it is age. Thus, in children, due to the larger volume of circulating fluid and intensive metabolism, the effect occurs much faster - within 20 minutes. However, at the same time, it does not last long - up to one hour. In people over 60–65 years of age, the volume of circulating fluid decreases several times, as a result of which the metabolism of the drug slows down. Therefore, the effect occurs not after half an hour, but after an hour and a half. Due to decreased kidney function ( which naturally occurs with age) the rate of elimination of panadol is reduced, which also increases its circulation time. The consequence of this is a long-term analgesic and antipyretic effect.
Can children have Panadol?
Panadol is an antipyretic ( antipyretic drug ), which is very often prescribed to children. The daily and single dose of the drug, of course, depends on age. The maximum single dose for a child under 12 years of age is calculated based on 10 - 15 milligrams per kilogram of the child’s weight. The daily dose will be 60 milligrams per kilogram of the child’s weight. In this case, the daily dose must be divided into 3–4 doses. On average, a single dose for a child from 6 to 12 years old will be equal to 250 - 500 milligrams, for a child from 1 to 5 years old it is equal to 125 - 250 milligrams, for a child under one year old - up to 125 milligrams.In this case, in children, especially small ones, the rectal route of administration is preferable. In this case, the age dosage remains the same. The difference between the rectal route of administration is the rapid development of the effect. This is explained by the abundant blood supply to the rectum, which facilitates the absorption of the drug and, as a result, its faster action.
Panadol during pregnancy
Panadol, like most antipyretics, penetrates the placental barrier. This means that if a woman takes Panadol during pregnancy, then, regardless of the form of release, a certain concentration of the drug will be present in the fetus. However, despite this, experimental studies have not established the teratogenic and mutagenic effects of Panadol on the fetus. This means that, if necessary, the expected benefit of therapy for the mother should be weighed against the potential risk to the fetus. A similar situation is observed during breastfeeding, since panadol penetrates into breast milk.Panadol during breastfeeding
A small dose of Panadol also passes into breast milk. On average, 0.04 to 0.5 percent of the dose taken is excreted in breast milk. That is why Panadol is not contraindicated during lactation. However, there are clarifications here. If a nursing mother suffers from cirrhosis of the liver or chronic pathology kidneys, the effect of Panadol increases. At the same time, the toxicity of the drug and the risk of side effects increases. Therefore, before using Panadol, you should consult your doctor.Instructions for use of Panadol
The instructions for Panadol include the same provisions as for any other drug, namely, indications and contraindications, release forms, side effects. The instructions for the drug are in the box in which the drug is dispensed. In its absence, instructions can be found in any pharmacological reference book. Release forms, doses and composition of Panadol
Panadol is a widely used drug, the release form of which is not limited to tablet form.Panadol effervescent
Effervescent Panadol is a form of medication that must be dissolved in water before use. The commercial name of effervescent panadol is panadol soluble. Available in the form of tablets of 500 milligrams in a package of 12 pieces. Before use, one or two tablets are dissolved in 125 milliliters ( half a glass) water. The tablet is very fast ( almost instantly) dissolves regardless of water temperature. You can take no more than 8 tablets of Panadol Soluble per day.Panadol tablets
The main form of release is tablets. Doses vary from 250 ( Panadol for children) up to 500 milligrams ( for adults). The tablets are taken orally with a glass of water. Daily norm tablets depends on their dosage. So, given the daily allowable dose of 4 grams, 8 tablets of 500 milligrams are allowed. Taking the tablets should be divided into 4 doses with breaks of 6 hours.Panadol syrup
Panadol syrup is available in 100 ml bottles. 5 milliliters of syrup contains 120 milligrams active substance, that is, paracetamol. The syrup is equipped with a special measuring syringe, which makes dosing the drug easier. Also included with the drug is a dosage table. In addition, children's panadol syrup has a strawberry taste and smell.Candles and suppositories
Panadol in the form of suppositories is used for rectal administration. As a rule, this route of administration is recommended for children in order to reduce fever. This is explained by the fact that the effect of the drug when administered rectally occurs faster and lasts longer. After bowel movement, the suppository is inserted into the rectum.Children's Panadol suppositories are available in 125 and 250 milligrams. It is recommended to use 1 suppository 2 to 4 times a day every 6 hours. The duration of action of one candle is 6 hours.
Panadol extra
Panadol extra is the commercial name combination drug, which contains caffeine in addition to Panadol. Caffeine enhances the analgesic effect of Panadol, increasing its concentration in brain tissue. In addition, it stimulates the central nervous system, which also affects good effect drug. Indications for Panadol Extra are the same as for regular Panadol without caffeine.Indications for Panadol extra are:
- migraine;
- head and toothache;
- lumbar pain;
- muscle pain ( myalgia);
- painful menstruation;
- flu;
- fever.
Use of Panadol
As a rule, Panadol is prescribed orally. These can be regular or effervescent tablets, syrup or suspension. Panadol is recommended for children to use rectally ( candles). Very often Panadol ( aka paracetamol) is part of complex preparations. These can be powders for colds - Theraflu, Coldrex, Rinza tablets. In this case, they are also used internally, but the powders are first diluted in boiled water.It is recommended to swallow the tablets of the drug whole, without chewing or crushing, with a sufficient amount of water. Effervescent version of Panadol ( for example, Panadol Soluble) should be dissolved in a glass of water before use. The duration of treatment with Panadol, as well as its dose, are determined by the attending physician individually for each patient. However, on average the duration should not exceed 5 – 7 days. The daily dose for adults and adolescents over 12 years of age should not exceed 4 grams, and a single dose - 1 gram. As a rule, the doctor prescribes 500–1000 milligrams ( one - two tablets) 4 times a day. In this case, it is necessary to maintain an interval between taking the drug of at least 4 hours. For children aged 6 to 12 years, it is recommended to take 250–500 milligrams also 4 times a day with an interval of 4–6 hours.
Thus, acceptable daily dose for adults – 4000 milligrams ( 4 grams), and for children – 2000 milligrams. It is also important not to exceed the duration of taking the drug. If the expected effect does not occur within 3 days, then further use of the drug is not advisable.
The use of Panadol depends on the category of the patient ( child or adult), as well as from the readings. So, as a rule, Panadol is prescribed as an antipyretic.
Panadol for headaches and toothaches
Panadol is most often used as a pain reliever. In the general public, it is used for headaches or toothaches, less often for muscle pain or premenstrual syndrome. For this purpose, the drug is prescribed orally in the form of tablets, capsules or instant ( "fizzy") tablets. A single dose for headaches should not exceed one to two tablets, which is equivalent to 500 to 1000 milligrams.Panadol suspension for teething
Panadol is used as a pain reliever in children from 3 months. The main indications at such a young age are teething, ear pain or fever. In this case, as a rule, the doctor prescribes the drug in the form of a children's suspension. The dose of the drug is calculated based on the fact that a single dose is 15 milligrams per kilogram of weight. Calculated milligrams ( for example, 150 milligrams for a 10 kilogram child) are measured with a special syringe that comes in the package along with the drug. The drug begins to act within 15 - 20 minutes, and the effect lasts up to 4 hours. A second single dose can be repeated after 6 hours.Contraindications to taking Panadol
An absolute contraindication to Panadol is hypersensitivity to the drug. This hypersensitivity can lead to anaphylactic shock or another type of allergic reaction. However, it is worth noting that hypersensitivity to Panadol is relatively rare compared to hypersensitivity, for example, to aspirin. In general, Panadol has a narrow range of contraindications, and it is limited to chronic decompensated pathologies of the liver and kidneys.
Specific contraindications include the absence of the enzyme glucose-6-phosphate dehydrogenase and blood diseases. Panadol should be used with caution during pregnancy and breastfeeding.
Contraindications to the use of Panadol are:
- hypersensitivity to paracetamol;
- cirrhosis, hepatitis and other liver dysfunctions;
- chronic or acute renal failure;
- genetic deficiency of the enzyme glucose-6-phosphate dehydrogenase;
- blood pathologies;
- pregnancy;
- chronic alcoholism.
Liver dysfunction
As already mentioned, panadol is metabolized in the liver. This means that in the liver cells, with the help of special enzymes and oxidases, the drug is converted into an inactive substance. Thus, 80 percent of the total concentration of the drug is subject to binding to glucuronic acid. This process is also called conjugation. As a result, inactive metabolites drug. A metabolite is a substance into which a drug is converted under the influence of enzymes. In turn, the metabolite can be active or inactive. The active metabolite continues to act longer and stronger than the main substance. The inactive metabolite has no further effect. More than 80 percent of panadol is converted to an inactive form. The remaining part, with the help of enzymes, undergoes fusion with glutathione, resulting in the formation of an active metabolite, and this part of the drug continues to act on the body.Thus, the condition of the liver directly affects the activity of Panadol. If liver function is impaired, the process of formation of inactive metabolites slows down. This leads to prolonged circulation of the drug and prolongation of its action, and this, in turn, increases the risk of side effects.
Kidney failure
The main part of the drug is excreted by the kidneys. Therefore, the state of the urinary system directly affects the duration of the drug’s presence in the blood. Both acute and chronic renal failure interfere with the excretion of Panadol from the body. The consequence of this is that active and inactive metabolites continue to circulate in the blood for more than 4 to 6 hours. Thus, the rate of excretion of panadol metabolites ( glucuronide and sulfate) in patients with severe renal failure is 3 times lower than in healthy people. The main danger in in this case poses a high risk of bleeding. Since Panadol has weak antiplatelet properties, as the duration of its action increases, blood viscosity increases. If the patient has a history ( medical history) bleeding has already occurred, then renal failure is an absolute contraindication to the use of Panadol.Genetic deficiency of the enzyme glucose-6-phosphate dehydrogenase
Glucose-6-phosphate dehydrogenase is a cellular enzyme that takes part in many reactions. The main function is to maintain the level of glutathione in the cell and synthesize fatty acids. Deficiency of this enzyme will lead to a decrease in the energy potential in the cell and, as a consequence, to its hemolysis ( destruction). Genetic enzyme deficiency underlies hemolytic anemia, a disease that is accompanied by massive destruction of red blood cells.This disease is a contraindication to the use of Panadol, as it increases the risk of hemolysis of red blood cells several times.
Blood pathologies
Various blood diseases are also a contraindication to the use of Panadol. This is explained by several factors. Firstly, after absorption from the gastrointestinal tract, the medication enters the blood, where it binds to blood proteins. At various diseases this process is disrupted, which disrupts the metabolism of the drug. Secondly, Panadol itself increases blood viscosity, which in combination with existing diseases blood may lead to bleeding.Pregnancy and breastfeeding
Pregnancy and breastfeeding are not absolute contraindication to the use of Panadol. Less than one percent of the drug passes into breast milk, which does not pose a danger to the fetus or infant. However, all this is noted provided that the woman’s body is healthy and the drug is metabolized in the usual way. If a woman suffers from liver, kidney or blood disease, then the metabolism of Panadol may change. The circulation of the drug in the blood increases, which increases the risk of side effects.Chronic active alcoholism
In case of chronic alcoholism, you should use all medications with caution, and especially Panadol. This is explained by the fact that with this disease multiple disorders are recorded at almost the level of all body systems. Thus, in patients with alcoholism, vitamin and carbohydrate metabolism, also disruption of the normal pathway of glucose oxidation and its utilization by brain tissue. All such disorders are associated with the toxic effects of alcohol and a number of other factors. The latter primarily includes poor nutrition of patients. Protein metabolism disorders are most pronounced and increase very quickly. Thus, at this level, disorders of protein synthesis in neurons are recorded nervous system, which significantly affects its work. Clinically, this is manifested by memory and attention disorders and a decrease in the level of intelligence. However, the main danger is liver damage. No wonder alcohol is called a hepatotropic poison. Liver damage is observed in all patients with alcoholism. The reason for this is the accumulation of acetaldehyde, which kills liver cells ( hepatocytes). In this case, not only hepatocytes are destroyed, but also the liver enzyme system. This underlies the impaired metabolism of all medications that enter the liver. When Panadol penetrates the liver, its further transformation is disrupted. This leads to the fact that the medication takes longer than prescribed ( 24 hours) remains active, which in turn increases the risk of bleeding and other side effects.Side effects of Panadol
Panadol is a well-tolerated drug. The incidence of side effects is less than one percent. The most common side effects include gastrointestinal and allergic reactions. Increases the risk of side effects accompanying pathologies at the patient. For example, if a person taking Panadol suffers chronic gastritis or an ulcer, then the likelihood of nausea or vomiting increases several times.Side effects of Panadol
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Hepatobiliary system(liver and bile ducts) anti-inflammatory drugs ( NSAIDs). Liver damage and gastrointestinal symptoms are recorded in patients with pathologies of the corresponding systems. City Tablets, 500 milligrams, 12 pieces Soluble tablets, 500 milligrams, 12 pieces Syrup, 100 milliliters Rectal suppositories, 250 milligrams, 10 pieces Moscow
Saint Petersburg
Tver
Krasnoyarsk
Krasnodar
Nizhny Novgorod
Panadol is an analgesic-antipyretic. Release form and compositionDosage forms of Panadol:
The active ingredient of the drug is paracetamol. One tablet contains 500 mg, 5 ml of syrup - 120 mg, one suppository - 125 or 250 mg. Auxiliary components:
Indications for useIn accordance with the instructions for Panadol, the drug is intended for symptomatic therapy:
Panadol is prescribed to children in the form of a suspension and rectal suppositories:
ContraindicationsRegardless dosage form the use of Panadol is contraindicated in case of hypersensitivity to paracetamol or any auxiliary component of the drug. The drug should not be given in tablet form to children under 6 years of age. The medicine should be taken orally with caution by pregnant and breastfeeding women, the elderly, and patients with
Children's Panadol is contraindicated:
The drug is prescribed with caution to children who have been diagnosed with:
The simultaneous use of Panadol with other drugs that contain paracetamol is prohibited. Directions for use and dosageAccording to the instructions for Panadol, the drug is prescribed in tablet form:
The minimum interval between doses should be 4 hours. The children's suspension should be taken orally; the bottle should be shaken well before use. For dosing accuracy, the package includes a measuring syringe. The dose depends on the age and weight of the child. The drug is prescribed at the rate of 15 mg per kilogram of body weight, but not more than 60 mg/kg per day. The frequency of doses is 3-4 times a day with an interval of at least 4 hours. Average doses of Panadol, according to the instructions, are:
Suppositories are used rectally up to 3 times a day in the dose:
Paracetamol can be taken as a pain reliever for 5 days, and as an antipyretic drug for 3 days. An increase in the daily dose or duration of use of Panadol is possible only as prescribed by the attending physician and under his supervision. Side effectsIn rare cases, the following side effects of Panadol have been observed:
With prolonged use and/or in high doses, there is a risk of developing interstitial nephritis, nonspecific bacteriuria, renal colic and papillary necrosis. An overdose of paracetamol poses a risk of serious liver damage. Therefore, if you accidentally exceed the recommended dose of Panadol, you should immediately seek help. medical care, even if the person’s health is good. special instructionsIf long-term use of Panadol is necessary, especially in high doses, the blood picture should be monitored. During the treatment period medicine you must refrain from drinking alcoholic beverages. AnalogsAnalogues of Panadol active substance are the following drugs:
Terms and conditions of storagePanadol is sold in pharmacies over the counter. Regardless of the form of release, the drug should be stored at temperatures up to 25 ºС in a place inaccessible to sunlight. Best before date:
InstructionsTradenamePanadol® International nonproprietary nameParacetamol Dosage formFilm-coated tablets 500 mg CompoundOne tablet contains active substance - paracetamol 500 mg Excipients: corn starch, pregelatinized starch (soluble), povidone (K 25), potassium sorbate, talc, stearic acid, purified water. Film shell composition: hydroxypropyl methylcellulose 15 CPS, triacetin. DescriptionFilm-coated tablets white, capsule-shaped, with flat edges, marked with a triangular logo on one side and a notch on the other. Pharmacotherapeutic groupAnalgesics. Other analgesics and antipyretics. Anilides. Paracetamol ATX code N02BE01 Pharmacological propertiesPharmacokinetics Paracetamol is quickly and almost completely absorbed from the gastrointestinal tract. The maximum concentration in blood plasma is reached after 30-60 minutes. The half-life is 1-4 hours when taken in therapeutic doses. Evenly distributed in all body fluids. Plasma protein binding is variable, with 20 to 30% of the drug bound in cases of acute intoxication. When taken in therapeutic doses, 90-100% of the drug is excreted in the urine during the first day. The main amount of paracetamol is excreted after conjugation in the liver, 5% - unchanged. Pharmacodynamics Paracetamol is an analgesic-antipyretic. It has an analgesic and antipyretic effect by suppressing the synthesis of prostaglandins in the hypothalamus. The absence of a blocking effect on the synthesis of prostaglandins in peripheral tissues determines the absence of a negative effect on the mucous membrane of the gastrointestinal tract. In this regard, the use of paracetamol is especially advisable in patients for whom suppression of prostaglandin synthesis in peripheral tissues is undesirable, for example, if there is a history of gastrointestinal bleeding or in elderly patients. Indications for use- headache, migraine, toothache, pain after tooth extraction or other dental procedures, joint and muscle pain, fever and pain after vaccination, sore throat, painful menstruation, pain due to osteoarthritis, reduction of fever. Directions for use and dosesAdults (including seniors) and children 12 years and older: 500-1000 mg (1-2 tablets) every 4-6 hours as needed. The interval between doses is at least 4 hours. The maximum daily dose is 4000 mg (8 tablets). Children (6-11 years old): 250-500 mg (½ - 1 tablet) every 4-6 hours as needed. The interval between doses is at least 4 hours. The maximum daily dose is 60 mg/kg of the child's body weight, divided into single doses of 10-15 mg/kg over 24 hours. Single dose can be taken no more than 4 times within 24 hours. The maximum duration of use without prescription and medical supervision is 3 days. If symptoms persist, you should consult a doctor. Do not exceed the indicated dose. Do not take simultaneously with other paracetamol-containing drugs. Side effect Very rarely (<1/10 000) Anaphylaxis, hypersensitivity reactions including skin rash, angioedema, Stevens-Johnson syndrome Thrombocytopenia Bronchospasm in patients with hypersensitivity to acetylsalicylic acid and other NSAIDs (Do not take the drug if breathing problems have previously been observed when taking acetylsalicylic acid or non-steroidal anti-inflammatory drugs) Liver dysfunction You should immediately stop taking the drug and consult a doctor if the above adverse reactions occur, as well as if peeling of the skin, formation of ulcers in the mouth, difficulty breathing, swelling of the lips, tongue, throat and face, bruises, bleeding or any other undesirable reaction to a drug. ContraindicationsHypersensitivity to paracetamol or any other ingredient of the drug Children under 6 years old Drug interactionsThe drug, when taken for a long time, enhances the effect of indirect anticoagulants (warfarin and other coumarins), which increases the risk of bleeding; single doses do not have a significant effect. special instructionsBefore taking the drug, you should consult your doctor: Patients with chronic liver disease (concomitant liver disease increases the risk of liver damage when taking paracetamol) For patients with chronic kidney disease Patients taking warfarin or other blood thinners If the headache becomes constant Patients with conditions that are accompanied by a decrease in glutathione levels (for example, with severe infections such as sepsis), which may increase the risk of metabolic acidosis. Symptoms of metabolic acidosis include deep, rapid or labored breathing, nausea, vomiting, and loss of appetite. You should consult a doctor immediately if these symptoms occur. The risk of overdose is more likely in patients with non-cirrhotic alcoholic liver disease. Pregnancy and lactation Epidemiological data on the use of paracetamol during pregnancy show no negative effects when taken in recommended doses, however, you should consult your doctor before taking the drug. Paracetamol crosses the placental barrier and enters breast milk, but in clinically insignificant quantities. Available published data do not contain contraindications for taking the drug during breastfeeding. Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms There are no restrictions on driving a car or operating machinery. OverdoseLiver damage in adults is possible when taking 10 grams or more of paracetamol. Taking 5 grams or more of paracetamol may cause liver damage in patients with the following risk factors: Long-term treatment with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John's wort preparations, or other drugs that stimulate liver enzymes; Regular alcohol abuse; Conditions accompanied by a decrease in glutathione levels (eating disorders, cystic fibrosis, HIV infection, starvation, exhaustion). Symptoms Acute paracetamol poisoning in the first 24 hours includes nausea, vomiting, stomach pain, sweating, and pale skin. Liver damage is determined 12-48 hours after an overdose. Impaired glucose metabolism and metabolic acidosis may occur. In severe poisoning, liver failure may progress to encephalopathy, hemorrhage, hypoglycemia, cerebral edema and death. Acute renal failure with acute tubular necrosis can manifest as severe lumbar pain, hematuria, proteinuria and develop even in the absence of severe liver damage. Cardiac arrhythmia and pancreatitis were also noted. Treatment: In case of overdose, immediate medical attention is required. The patient should be taken to hospital immediately, even if there are no early symptoms of overdose. Symptoms may be limited to nausea and vomiting or may not reflect the severity of overdose or the risk of organ damage. Treatment with activated charcoal is advisable in cases where an excessive dose of paracetamol has been taken within 1 hour. The concentration of paracetamol in the blood plasma should be determined no earlier than 4 hours and even later after taking the drug (earlier determination of the concentration is not reliable). Treatment with N-acetylcysteine can be carried out within 24 hours after taking paracetamol, however, the maximum effect of this antidote can be obtained if it is used within 8 hours after administration. The effectiveness of the antidote decreases sharply after this time. If necessary, N-acetylcysteine is administered to the patient intravenously according to the recommended doses. In the absence of vomiting, oral methionine may be used as an alternative if it is not possible to urgently transport the patient to the hospital. Release form and packagingCost from 29.00 rub. (excluding drug release forms) Packaging Effervescent tablets pharmachologic effect Has analgesic and antipyretic properties; the latter manifest themselves in conditions of febrile syndrome of any origin. List of analogues of "Panadol"* - the list and cost are formed without taking into account the forms of release of the drug Indications for use
Release form
Pharmacodynamics of the drug A non-narcotic analgesic, it blocks COX1 and COX2 mainly in the central nervous system, affecting the centers of pain and thermoregulation. In inflamed tissues, cellular peroxidases neutralize the effect of paracetamol on COX, which explains the almost complete absence of anti-inflammatory effect. The absence of a blocking effect on the synthesis of Pg in peripheral tissues determines the absence of a negative effect on water-salt metabolism (retention of Na+ and water) and the mucous membrane of the gastrointestinal tract. Pharmacokinetics of the drug Quickly and almost completely absorbed from the gastrointestinal tract. Concentration in plasma reaches a peak after 30–60 minutes, T1/2 plasma - 1–4 hours. Metabolized in the liver. Excreted in the urine, mainly in the form of esters with glucuronic and sulfuric acids; less than 5% is excreted unchanged. Use during pregnancy Carefully. Contraindications for use
Side effects From the skin: itching, rash on the skin and mucous membranes (usually erythematous, urticaria), angioedema, exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome). From the side of the central nervous system (usually develops when taking high doses): dizziness, psychomotor agitation and disorientation. From the digestive system: nausea, epigastric pain, increased activity of liver enzymes, usually without the development of jaundice, hepatonecrosis (dose-dependent effect). From the endocrine system: hypoglycemia, up to hypoglycemic coma. From the hematopoietic organs: anemia, sulfhemoglobinemia and methemoglobinemia (cyanosis, shortness of breath, heart pain), hemolytic anemia (especially for patients with glucose-6-phosphate dehydrogenase deficiency). With long-term use in large doses - aplastic anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia. From the urinary system: (when taking large doses) - nephrotoxicity (renal colic, interstitial nephritis, papillary necrosis). Dosage Inside, adults - 2 tablets. up to 4 times a day with an interval between doses of at least 4 hours (maximum daily dose - 8 tablets), children from 6 to 12 years old - 1/2–1 tablet. up to 4 times a day with an interval between doses of at least 4 hours (maximum daily dose - 4 tablets). Soluble tablets are dissolved in 1/2 glass of water before use. Overdose Symptoms (acute overdose develops 6-14 hours after taking paracetamol, chronic - 2-4 days after exceeding the dose) of acute overdose: dysfunction of the gastrointestinal tract (diarrhea, loss of appetite, nausea and vomiting, abdominal discomfort and/or pain in the abdomen), increased sweating. Symptoms of chronic overdose: a hepatotoxic effect develops, characterized by general symptoms (pain, weakness, adynamia, increased sweating) and specific ones characterizing liver damage. As a result, hepatonecrosis may develop. The hepatotoxic effect of paracetamol may be complicated by the development of hepatic encephalopathy (thought disturbances, central nervous system depression, stupor), convulsions, respiratory depression, coma, cerebral edema, hypocoagulation, development of disseminated intravascular coagulation syndrome, hypoglycemia, metabolic acidosis, arrhythmia, collapse. Rarely, liver dysfunction develops suddenly and can be complicated by renal failure (renal tubular necrosis). Treatment: administration of SH-group donors and precursors of glutathione synthesis - methionine 8-9 hours after an overdose and N-acetylcysteine - after 12 hours. The need for additional therapeutic measures (further administration of methionine, intravenous administration of N-acetylcysteine) is determined in depending on the concentration of paracetamol in the blood, as well as on the time elapsed after its administration. Interactions with other drugs Reduces the effectiveness of uricosuric drugs. Concomitant use of paracetamol in high doses increases the effect of anticoagulant drugs (decreased synthesis of procoagulant factors in the liver). Inducers of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, which makes it possible to develop severe intoxications even with a slight overdose. Long-term use of barbiturates reduces the effectiveness of paracetamol. Ethanol contributes to the development of acute pancreatitis. Inhibitors of microsomal oxidation (incl. including cimetidine) reduce the risk of hepatotoxicity. Precautions for use It is not recommended to combine it with other medications that contain paracetamol or give it to children under 6 years of age. Caution should be exercised in severely impaired liver or kidney function. During treatment it is necessary to avoid drinking alcohol. Special instructions for use If the febrile syndrome continues during the use of paracetamol for more than 3 days and pain syndrome for more than 5 days, a doctor’s consultation is required. The risk of developing liver damage increases in patients with alcoholic hepatosis. Distorts laboratory test results in the quantitative determination of glucose and uric acid in plasma. During long-term treatment, monitoring of the peripheral blood picture and the functional state of the liver is necessary. Storage conditions At a temperature not exceeding 25 °C. Shelf life: 60 months. Disease classesATC classifierNervous system pharmachologic effectAntipyretic Description Antipyretic effect is aimed at reducing elevated body temperature. The mechanism of action is associated with inhibition of cyclooxygenase activity, decreased formation of prostaglandins, endoperoxides, bradykinins, free radicals and other pro-inflammatory biologically active substances. The concentration of prostaglandins in the thermoregulation center of the hypothalamus also decreases and heat transfer increases. Drugs that have an antipyretic effect are used to treat increased body temperature due to influenza, colds and other infectious and inflammatory diseases. Pharmacological groupAnilides Active ingredientsParacetamol Description White or white with a cream or pink tint crystalline powder. Easily soluble in alcohol, insoluble in water. The data provided is for informational purposes only. Panadol: instructions for use and reviews Panadol is a drug that has an analgesic and antipyretic effect. Release form and compositionDosage forms of Panadol:
Each pack also contains instructions for using Panadol. Composition of 1 dispersible tablet:
Composition of 1 film-coated tablet:
Pharmacological propertiesPharmacodynamicsPanadol is an analgesic-antipyretic. Has antipyretic and analgesic effects. By affecting the centers of thermoregulation and pain, it blocks COX-1 and COX-2 (cyclooxygenase-1 and -2), mainly in the central nervous system. It has virtually no anti-inflammatory properties. Does not lead to irritation of the gastric/intestinal mucosa. It has no effect on the synthesis of prostaglandins in peripheral tissues, and therefore does not affect water-salt metabolism. PharmacokineticsParacetamol has a high absorption, C max (maximum concentration of the substance) is 0.005–0.02 mg/ml, the time to reach it is 30–120 minutes. Binds to plasma proteins at a level of 15%. The substance penetrates the blood-brain barrier. Up to 1% of the dose of paracetamol taken by a nursing mother is found in breast milk. The therapeutically effective plasma concentration of the substance is achieved when it is used at a dose of 10–15 mg/kg. Metabolism occurs in the liver (90 to 95%): 80% of the dose enters into conjugation reactions with glucuronic acid and sulfates, followed by the formation of inactive metabolites; 17% of the dose undergoes hydroxylation, resulting in the formation of 8 active metabolites, which are further conjugated with glutathione to form inactive metabolites. In case of glutathione deficiency, these metabolites can lead to blockade of hepatocyte enzyme systems and their necrosis. The CYP 2E1 isoenzyme also takes part in the metabolism of the drug. T1/2 (half-life) is 1–4 hours. Excretion is carried out by the kidneys in the form of metabolites, mainly conjugates; only 3% of the dose is excreted unchanged. In elderly patients, the clearance of the drug decreases, while an increase in T1/2 is noted. Indications for usePanadol tablets are prescribed for the symptomatic treatment of the following conditions/diseases:
The drug is intended to reduce the severity of pain at the time of use; it has no effect on the progression of the disease. ContraindicationsAbsolute:
Relative (prescribing Panadol requires caution in the presence of the following conditions/diseases):
Panadol, instructions for use: method and dosagePanadol should be taken orally. Dispersible tablets must be dissolved in water before use (volume - at least 100 ml); Film-coated tablets are washed down with water.
The duration of the course of taking Panadol without medical supervision for pain relief should not exceed 5 days, as an antipyretic - 3 days. Any changes to the recommended dosage regimen should be agreed with your doctor. Side effectsPossible side effects:
OverdoseThe drug should be taken only in the doses recommended in the instructions. If you exceed the dosage of Panadol, even if you do not feel worse, you should immediately seek medical help, as there is a high probability of serious delayed liver damage. In adults, liver damage may occur when taking a dose of 10 g of paracetamol. Use of the drug in a dose of 5 g or more may cause liver damage in patients with additional risk factors, which include:
Acute poisoning is manifested by symptoms such as stomach pain, vomiting, nausea, pale skin, and sweating. 1–2 days after an overdose, signs of liver damage are determined (in the form of pain in the liver area, increased activity of liver enzymes). In severe cases, liver failure occurs, acute renal failure with tubular necrosis (possibly in the absence of severe liver damage), encephalopathy, pancreatitis, arrhythmia and coma may occur. The development of a hepatotoxic effect in adults occurs when taking paracetamol in a dose exceeding 10 g. Therapy: discontinuation of Panadol. You should seek medical help immediately. Gastric lavage and the use of enterosorbents (polyphepane, activated carbon) are indicated. SH-group donors and precursors for glutathione synthesis are administered: 8–9 hours after the overdose - methionine, 12 hours later - N-acetylcysteine. Depending on the concentration of the substance in the blood, as well as on the time that has passed after taking the drug, the need for additional therapeutic measures is determined (continued administration of methionine, intravenous administration of N-acetylcysteine). In case of serious impairment of liver function, 24 hours after taking paracetamol, therapy should be carried out together with specialists from a specialized department of liver diseases or a toxicology center. special instructionsWhen prescribing a long course in high doses, the blood picture should be monitored. Panadol is prescribed only under medical supervision and with caution for kidney or liver diseases, simultaneously with antiemetic drugs (metoclopramide, domperidone), as well as with drugs that lower blood cholesterol (cholestyramine). To avoid toxic liver damage, you should not combine the use of Panadol and alcoholic beverages. In cases where there is a need for daily painkillers, paracetamol, when used in combination with anticoagulants, can be taken only occasionally. The doctor must be warned about taking Panadol in cases of testing to determine the level of glucose and uric acid in the blood. Use during pregnancy and lactationPanadol should be used with caution during pregnancy/lactation. Use in childhoodPanadol therapy is contraindicated in patients under 6 years of age. For impaired renal functionIn case of renal failure, therapy should be carried out under medical supervision. For liver dysfunctionIn case of liver failure, therapy should be carried out under medical supervision. Use in old agePanadol tablets are prescribed to elderly patients with caution. Drug interactionsSimultaneous long-term use of paracetamol with certain drugs can lead to the development of the following effects:
When Panadol is used in combination with certain substances/drugs, the following effects may be observed:
AnalogsAnalogs of Panadol are: Paracetamol, Paracetamol MS, Panadol Active, Strimol, Efferalgan, Prohodol, Perfalgan, Tsefekon D. Terms and conditions of storageStore out of the reach of children at temperatures up to 25 °C. Best before date:
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Panadol is not a rare drug in Russian pharmacies. It is in great demand especially in the autumn-winter period. Prices for the drug vary depending on the region. 
