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Paracetamol has analgesic and antipyretic activity. The drug blocks cyclooxygenase I and II predominantly in the central nervous system, affecting thermoregulation, and pain centers. In inflamed tissues cellular peroxidase neutralize the effect of paracetamol on cyclooxygenase, which explains the almost complete absence of his anti-inflammatory effect. The drug has no negative impact on the water-salt metabolism (sodium and water retention) and the digestive tract mucosa due to the lack of influence on the synthesis of prostaglandins in peripheral tissues. The possibility of formation of methemoglobin – is unlikely.

INDICATIONS
moderately or weakly expressed bituminous mix testosterone pain (headache, toothache, migraine pain, neuralgia, muscle pain, back pain, pain in trauma and burns, sore throat, painful menstruation).

Increased body temperature in cold and other infectious diseases -vospalitelnyh.

CONTRAINDICATIONS

  • Hypersensitivity to paracetamol or any other component of the formulation.
  • Children under 9 years of age (weight not less than 35 kg)

With care – renal and / or hepatic failure, congenital hyperbilirubinemia (Gilbert syndrome, Dubinin-Johnson and Rotor), viral hepatitis, alcoholic liver disease, alcoholism, lack of glucose-6-phosphate dehydrogenase, pregnancy, lactation, old age.

DOSAGE AND ADMINISTRATION
The tablet dissolved in a glass of water (200 ml) and drink after 1 -2 hours after a meal. Typically used 1-2 tablets 2-3 times a day at intervals of at least 4 hours.

The maximum single dose for adults and adolescents over 12 years is 2 tablets (1 g) daily – 8 tablets (4 g).

Children (9-12 years); 1 tablet up to 4 times a day, if necessary. The interval between doses – at least 4 hours, a single dose can be administered no more than 4 times (4 tablets) for 24 hours.

Patients with impaired hepatic or renal function and in elderly patients with an interval between doses of the drug should be at least 8 hours and the daily dose should be reduced.

The duration of intake of not more than 5 days in the appointment as an analgesic and 3 days as antipyretic. The increase in the daily dose bituminous mix testosterone or duration of treatment are possible only under medical supervision.

SIDE EFFECTS
The drug was well tolerated at recommended doses.

Sometimes there may be an allergic reaction in the form of a skin rash, itching, angioedema. Rarely – a violation of hematopoiesis (anemia, thrombocytopenia, methemoglobinemia).

With prolonged use at doses considerably higher than recommended, increasing the likelihood of human liver and kidneys, requires monitoring of peripheral blood picture.

Overdose
symptoms: pale skin, anorexia, nausea, vomiting; gepatonekroz (necrosis severity is directly dependent on the degree of overdose). The toxic effect of the drug in adults is possible after receiving more than 10-15 g of paracetamol: increased activity of “liver” transaminases, increased prothrombin time (after 12-48 hours); detailed clinical picture of liver damage manifests itself in 1-6 days. Rarely hepatic dysfunction develops lightning speed and can be complicated by renal insufficiency (tubular necrosis).

 

INTERACTION WITH OTHER DRUGS
Inductors microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which makes the possibility of severe intoxication with small overdoses. Ethanol contributes to the development of acute pancreatitis. Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxicity.

Paracetamol reduces the effectiveness of uricosuric drugs.

Cautions
With continued feverish syndrome, during treatment with paracetamol for more than 3 days, and pain syndrome – more than 5 days require a doctor’s consultation.

Distorts the performance of laboratory tests for the quantitative determination of uric acid in the plasma.

In order to prevent liver bituminous mix testosterone toxicity of paracetamol should not be combined with alcohol intake, and take people prone to chronic alcohol consumption.

The risk of liver damage increases in patients with alcoholic hepatosis.

Prolonged use of the drug is necessary to monitor patterns of peripheral blood and functional state of the liver.

Flyutabs contains 451 mg of sodium per tablet which should be taken into account in patients on a strict low-salt diet.

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We must carefully monitor patients while receiving rifabutin and fluconazole.  The four testosterone ester mix increases. Saquinavir clearance is reduced by about 50% due to the inhibition of hepatic metabolism isoenzyme . You may need dose adjustment of saquinavir. Sirolimus. Increasing the concentration of sirolimus in the plasma presumably due to the metabolism of sirolimus ingibirovainem through inhibition of isozyme  . This combination can be used with an appropriate dose of sirolimus adjusted depending on the effect / concentration.

Oral hypoglycemic agents.Fluconazole increases the plasma half-life of oral hypoglycemic agents – sulfonylureas (chlorpropamide, glibenclamide, glipizide, tolbutamide). The combined use of fluconazole and oral hypoglycemic agents may be, but the physician should bear in mind the possibility of hypoglycemia. Requires regular monitoring of blood glucose and, if necessary, correction sulfonylurea dose. Tacrolimus. Use of fluconazole and tacrolimus (oral) leads to increased serum levels of the last 5 times by inhibiting the metabolism of tacrolimus occurring in the intestines by isoenzyme . No significant changes in the pharmacokinetics of drugs are not mentioned in the application of tacrolimus intravenously. Cases of nephrotoxicity. Patients concurrently receiving fluconazole and tacrolimus inside, should be carefully monitored. Tacrolimus dose should be adjusted according to the degree of increase of its concentration in the blood.

Theophylline. When using fluconazole 200 mg for 14 days at the same time (or in combination) with the average speed of plasma theophylline klierensa tsofillina reduced by 18%. In the appointment of fluconazole patients receiving theophylline in high doses, or in patients with an increased risk of toxic effect of theophylline should be monitored for the appearance of symptoms of theophylline overdose and, if necessary, adjust the treatment accordingly. Vinca alkaloids. , Assumed Despite the lack of targeted research that fluconazole can increase the concentration of vinca alkaloids (e.g., vincristine and vinblastine) in blood plasma and, thus, lead to neurotoxicity, which may possibly be associated with inhibition of isozyme four testosterone ester mix.  It has been reported one case of undesirable side reactions central nervous system  as a pseudotumor of the brain, while the application is fully transretinoevoy acid and fluconazole, who disappeared after the abolition of fluconazole. The use of this combination is possible, but should be aware of the possibility of adverse reactions from the central nervous system.

In patients receiving the combination of fluconazole and zidovudine, there is increase   of zidovudine by 84% and 74%, respectively, which is caused by a decrease in the metabolism of the latter to its main metabolite. Before and after treatment with Fluconazole, 200 mg / day for 15 days in patients , a significant increase in  set zidovudine (20%). Patients receiving such a combination should be monitored in order to identify side effects of zidovudine.

Simultaneous voriconazole (400 mg, 2 times a day on the first day followed by 200 mg twice a day for 2.5 days) and fluconazole (400 mg on the first day followed by 200 mg daily for 4 days), increases concentration and voriconazole  and 79% respectively. It has been shown that this effect is maintained while reducing the dose and / or dosing frequency of any of the drugs. Concomitant use of voriconazole and fluconazole is not recommended. Tofacitinib: tofacitinib exposure is increased by combining it with drugs that are both moderate inhibitors of Cfour testosterone ester mixisoenzyme and potent inhibitors  (eg, fluconazole). May possibly need a dose tofacitinib correction. Studies of the interaction of oral formulations of fluconazole during its simultaneous administration with food, cimetidine, antacids, and after total body irradiation in preparation for bone marrow transplantation has shown that these factors do not have a clinically meaningful effect on the absorption of fluconazole. These interactions are installed with repeated application of fluconazole; Interactions with other drugs as a result of a single dose of fluconazole is not known. Doctors should take into account the interaction with other drugs not specifically been studied, but it is possible.

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It was shown that fluconazole significantly lengthens excretion of fentanyl. Note that increasing the concentration of fentanyl can lead to inhibition of respiratory function. Galofantina can increase the concentration in plasma due to the inhibition of isozyme testosterone mix 500 phoenix. While the use of fluconazole, as well as with other antifungals azole may develop arrhythmias of ventricular tahisistolicheskoy type “pirouette”, so the combined use of them is not recommended.

Inhibitors of MMC-CoA reductase. With the simultaneous use of fluconazole with inhibitors reductase, metabolized isoenzyme (such as atorvastatin and simvastatin) or isoenzyme (fluvastatin), the risk of myopathy and rhabdomyolysis is increased. If necessary, concurrent therapy these drugs, patients should be monitored masteron cycle in order to detect symptoms of myopathy and rhabdomyolysis. It is necessary to monitor the concentration of in the event of a significant increase in the concentration of or if diagnosed or suspected on the development of myopathy or rhabdomyolysis, therapy with inhibitors reductase inhibitors should be discontinued.

Losartan. Fluconazole inhibits the metabolism of losartan to its active metabolite, which responsible for most of the effects associated with antagonism of the angiotensin-II receptor. A regular control of blood pressure.Methadone. Fluconazole may increase the plasma concentrations of methadone. You may need correction of the dose of methadone. Nonsteroidal anti-inflammatory drugs . Of flurbiprofen increased 23% pa and 81%, respectively. Similarly, tof the pharmacologically active isomer were increased by 15% and 82% respectively, while the application of fluconazole with racemic ibuprofen (400mg). With simultaneous use of fluconazole in a dose of 200 mg / day of celecoxib in a dose of 200 mg celecoxib increased na 68% and 134%, respectively. This combination may reduce the dose of celecoxib twice. Despite the lack of dedicated research, fluconazole may increase the systemic exposure of other side effects of femara metabolized isoenzyme (naproxen, lornoxicam, meloxicam, diclofenac). You may need a dosage adjustment . With simultaneous use of testosterone mix 500 phoenix and fluconazole patients should be under close medical supervision in order to identify and monitor adverse events and toxicities associated with .

Oral contraceptives. In an application combining oral contraceptives with fluconazole at a dose of 50 mg significantly effect on hormone levels has been established. With a daily intake of 200 mg of fluconazole AUC of ethinyl estradiol and levonorgestrel increased by 40% and 24%, respectively. When receiving 300 mg fluconazole once weekly ethinyl estradiol and norethindrone increased by 24% and 13% respectively. Thus, repeated use of fluconazole in these doses is unlikely to affect the efficacy of combined oral contraceptive. Phenytoin. Simultaneous administration of fluconazole and phenytoin can lead to an increase in the plasma concentration of phenytoin to a clinically significant degree.Therefore, if necessary, the joint use of these drugs need to monitor the concentration of phenytoin with the dose adjusted to maintain drug levels within the therapeutic range.

Prednisone. There are reports on the development of acute adrenal insufficiency of the patient after liver transplantation to cancel background fluconazole after three months of therapy. Presumably, the termination of fluconazole therapy caused the increase of isoenzyme activity testosterone mix 500 phoenix, leading to increased metabolism of prednisone. Patients receiving combination therapy with prednisone and fluconazole should be under close medical supervision cytomel t3 at the abolition of receiving fluconazole for the purpose of assessing the state of the adrenal cortex. Rifabutin. There have been reports about the interaction of fluconazole and rifabutin, accompanied by an increase in serum concentrations of the latter up to 80%. With simultaneous use of fluconazole and rifabutin uveitis cases are described.

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Simultaneous multiple fluconazole and hydrochlorothiazide may lead to an increase in concentration of fluconazole in blood plasma by 40%. The effect of this severity does not require changes in dosage regimen of fluconazole in patients receiving concomitant diuretics, but a doctor should take this into account.

Rifampicin. The combination with rifampicin leads to Ap28 pancake mix gnc testosterone reduction (area under the curve “concentration-time”) by 25% and shortened the half-life of fluconazole of 20% plasma. Therefore, patients receiving concomitant rifampicin, the dose of fluconazole is expedient to increase. Fluconazole is a potent inhibitor of the and a moderate inhibitor of the isoenzyme . In addition to these further effects, there is a risk increase in plasma concentration and other drugs, mstaboliziruemyh isoenzymes while taking a flukoiazolom. Therefore, caution should be exercised with concomitant use of the following drugs steroids deca, and similar combinations of patients if necessary should be under close medical supervision. Note that the inhibiting effect of fluconazole persists 4-5 days after discontinuation of therapy due to the long half-life.

Alfentanil. There decrease in clearance and volume of distribution, the increase in half-life of alfentanil. This may be due to inhibition of CYP3A4 flukoiazolom. You may need a dosage adjustment alfentanil. Amitriptyline, nortriptyline. The effect of increasing. The concentration of 5-nortriptyline p28 pancake mix gnc testosterone may be measured at the start of combination therapy with fluconazole and one week after the start of treatment. If necessary to adjust the dose of amitriptyline / nortriptyline. Amphotericin B. In studies in mice (including immunosuppressed) were noted following results: a small additive antifungal effect in systemic infection caused by C. albicans, no interaction with intracranial infection caused Cryplococcus neoformans and antagonism in systemic infection by A. fimigatus. The clinical significance of these results phenylpropionate is not clear. In the application of fluconazole and other antifungals (azole derivatives) with warfarin increases protrombinovos time (an average of 12%). Perhaps bleeding (hematoma, bleeding from the nose and gastrointestinal tract, hematuria, melena). Patients receiving anticoagulants kumariiovye, you must constantly monitor the prothrombin time during treatment and within 8 days after the simultaneous application. You should also evaluate the feasibility of dose adjustment of warfarin. Azithromycin. In an application inside of fluconazole in a single dose of 800 mg of azithromycin in a single dose of 1200 mg expressed pharmacokinetic interaction between the two drugs is not established.

Benzodiazepines. (Short-acting). After oral administration of midazolam, fluconazole significantly increases the concentration of midazolam and psychomotor effects and this effect is more pronounced after receiving fluconazole inside than when used intravenously. If necessary, concomitant therapy with benzodiazepines in patients taking fluconazole be observed in order to assess the feasibility of the corresponding dose reduction benzodiazepine. When simultaneous administration of a single dose of triazolam, fluconazole triazolam AUC increases by approximately 50%, C max – 25-50% and elimination half-life at 25 50% due to the inhibition of metabolism of triazolam. You may need dose adjustment of triazolam. Carbamazepine. Fluconazole inhibits the metabolism of carbamazepine and increase proviron dosage its serum concentration by 30%. It is necessary to take into account the risk of developing carbamazepine toxicity. It will be appreciated the need carbamazepine dose adjustment depending on the concentration / effect. Calcium channel blockers. Certain calcium channel antagonists (nifedipine, isradipine, amlodipine, verapamil and felodipine) are metabolized isoenzyme p28 pancake mix gnc testosterone. Fluconazole increases the systemic exposure of calcium channel antagonists. Recommended control side effects. Cyclosporine.It is recommended to monitor the blood concentration of cyclosporine in patients receiving fluconazole as patients receiving a transplanted kidney Fluconazole, 200 mg / day results in a slow increase in the plasma concentration of cyclosporine. However, when multiple dose Fluconazole, 100 mg / day of cyclosporine concentration changes in bone marrow transplant recipients was observed.Cyclophosphamide. With simultaneous use of cyclophosphamide and fluconazole marked increase in serum bilirubin and creatinine concentrations. A combination of drugs is possible, taking into account the risk of data breaches. Fentanyl. There are reports of one death, possibly due to the simultaneous reception of fentanyl and fluconazole. It is assumed that the disturbances associated with fentanyl intoxication.

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Dryness of the oral mucosa, nausea, vomiting, diarrhea, constipation, bloating, abdominal pain. Liver and biliary tract: rarely – a violation of the liver (jaundice function, hepatitis, gepatonskroz, hyperbilirubinemia, increased alanine aminotransferase activity , aspartate aminotransferase, alkaline phosphatase), hepatotoxicity, in some cases fatal, cholestasis, hepatocellular damage.from the nervous system: headache, dizziness, change in taste, paraesthesia, insomnia, somnolence, tremor; . rare – cramps From the blood and lymphatic system: anemia; rarely – leukopenia, thrombocytopenia, neutropenia, agranulocytosis. Cardio-vascular system: prolongation of the testosterone compound testosteron mix – genesis interval; flicker, ventricular flutter, an arrhythmia ventricular tachysystolic type “pirouette» (torsade de pointes). For the skin: rash, alopecia, exfoliative skin lesions, including Stevens-Johnson and toxic epidermal necrolysis syndrome, acute generalized exanthematous pustulosis, increased sweating, drug rash. On the part of metabolism: increased cholesterol concentrations in plasma triglycerides, hypokalemia. From the musculoskeletal system: myalgia. Other: fatigue, asthenia, fatigue, fever, sweating, vertigo; rarely – renal dysfunction.

Overdose

Symptoms: hallucinations, paranoid behavior. Treatment: symptomatic, gastric lavage, forced diuresis. Haemodialysis for 3 hours reduces the plasma concentration of approximately 50%.

Interaction with other drugs

Single or multiple administration of fluconazole 50 mg do not affect the metabolism of phenazone (antipyrine) at the same time taking them.

Concomitant use of fluconazole with the following drugs is contraindicated Cisapride. With the simultaneous use of fluconazole and cisapride may be adverse reactions of the heart, in t. Ch. Ventricular fibrillation tachysystolic type “pirouette» (torsade de pointes). Testosterone compound testosteron mix – genesis time per day and cisapride at a dose of 20 mg four times a day resulting in a marked increase in plasma concentrations of cisapride and increase interval on the electrocardiogram. Terfenadine. With simultaneous use of azole antifungals and terfenadine may cause serious arrhythmias resulting increase the  interval. When receivingincreasing  interval is not established. However, the use of fluconazole in doses of 400 mg / day and above causes a significant increase in the concentration of terfenadine in the blood plasma. Simultaneous administration of fluconazole at doses of 400 mg / day or more with terfenadine is contraindicated (see. “Contraindications”). Treatment of fluconazole at doses less than 400 mg / day in combination with terfenadine should be carefully monitored.

Astemizole. Concomitant use of fluconazole with astemizole or other drugs, the metabolism of which the  system may be associated with an increase in serum concentrations of these agents.  Levels can lead to a lengthening of interval, and in some cases to the development of ventricular arrhythmias tachysystolic type “pirouette» (torsade de pointes). Concomitant use of fluconazole and astemizole is contraindicated. Pimozide. Despite the fact that no relevant studies conducted in vitro or in vivo, the simultaneous use of fluconazole and pimozide may result in inhibition of pimozide metabolism. In turn, the increase in plasma concentrations of pimozide may lead  prolongation, and in some cases the development of ventricular arrhythmias tahisistolicheskoy type “pirouette» (torsade de pointes). The simultaneous use of fluconazole and pimozide contraindicated.

Quinidine. Despite the fact that no relevant studies conducted in vitro or in vivo, simultaneous administration of fluconazole and quinidine can also lead to inhibition of quinidine metabolism.Application quinidine associated with testosterone compound testosteron mix – genesis interval prolongation, and in some cases with the development of ventricular arrhythmias tachysystolic type “pirouette» (torsade de pointes). Concomitant use of fluconazole and quinidine is contraindicated. Erythromycin. Concomitant use of fluconazole and erythromycin potentially leading to increased risk of cardiotoxicity (prolongation of the interval testosterone compound testosteron mix – genesis, torsade de pointes) and, therefore, sudden cardiac death. Concomitant use of fluconazole and erythromycin is contraindicated. stretch marks bodybuilding kalpa pharmaceuticals easy to follow bodybuilding diet