Caffetin Cold tablets: composition, instructions for use, price

Composition of Caffetin Cold

Caffetin Cold contains the following active substances in each tablet:

500-555 mg of paracetomol (in the form of granules, which consist of 90% paracetomol , as well as excipients: 8.4% gelatinized starch, 0.6% povidone, 1% stearic acid);
30 mg pseudoephedrine hydrochloride ;
15 mg dextromethorphan hydrobromide ;
60-62 mg of ascorbic acid (using granulate that contains 97% ascorbic acid and 3% hydroxypropyl methylcellulose).

Colloidal silicon dioxide, magnesium stearate, croscarmellose sodium, microcellulose and talc are used as excipients in Caffetin Cold.

The film shell is made of blue Opadry II (E132 - indigo carmine), macrogol, polyvinyl alcohol (partially hydrolyzed), titanium dioxide (E171) and talc.

Composition of Caffetina

of paracetamol , 210 mg of propyphenazone , 50 mg of caffeine and 10 mg of codeine sesquihydrate phosphate as active substances .
As excipients, Caffetin contains 6.3 mg of glyceryl dibehenate , 21.1 mg of calcium hydrogen phosphate dihydrate , 14.5 mg of sodium carboxymethyl starch , 2.5 mg of colloidal anhydrous silicon dioxide, 9.6 mg of croscarmellose sodium, 13.5 mg magnesium stearate, 1.5 mg sodium lauryl sulfate, 12.5 mg povidone and 28.5 mg microcellulose.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The effect of the drug is due to the total effect of the components of the drug:

Paracetamol causes analgesic and antipyretic effects. It blocks cyclooxygenase in the central nervous system, by affecting the centers of thermoregulation and pain. A distinctive feature of paracetamol from non-steroidal anti-inflammatory drugs is the almost complete absence of anti-inflammatory effect. It does not irritate the mucous membrane of the stomach and intestines and does not affect the course of water-salt metabolism , since it does not affect the synthesis of prostaglandins in the peripheral tissues of the body.
Pseudoephedrine has a constricting effect on the vessels located in the mucous membrane of the nasal cavity and pharynx, significantly reduces swelling , thereby reducing secretion in the nasal cavity and facilitating nasal breathing.
Dextromethorphan affects the cough center - it has an increasing effect on the cough threshold , thereby reducing dry cough , which is associated with irritation of the mucous membrane of the nose and pharynx during colds. Ascorbic acid - restores the lack of vitamin C, which is often observed during colds.

Pharmacokinetics

A significant part of paracetamol is absorbed in the small intestine, and the maximum concentration in the blood plasma is achieved in the period from half an hour to an hour and a half after taking the drug orally. Metabolism of paracetamol (about 90–95%) occurs in the liver: with 80% of the substance, inactive metabolites are formed due to the conjugation reaction with sulfates and glucuronic acid, 17% are hydroxylated and form 8 active metabolite substances, which then undergo a conjugation reaction with glutathione, in as a result of which inactive metabolites are formed.

In case of glutathione deficiency, the resulting metabolites can have a blocking effect on the enzyme systems of liver cells and provoke their death. The isoenzyme CYP2E1 also takes part in metabolism . The half-life from the body ranges from 1 to 4 hours. The drug is excreted by the kidneys as metabolites, mainly in the form of conjugates, of which only about 3% are excreted unchanged. In old age, the clearance of the drug and the half-life may increase.

Pseudoephedrine is rapidly absorbed after taking the tablets orally, the maximum concentration in the blood plasma is reached after 1.5–2 hours. The half-life from plasma is approximately 5.5 hours. Metabolism of pseudoephedrine partially occurs in the liver - an active metabolite is formed, which is then excreted from the body in the urine.

Absorption of dextromethorphan after it enters the body occurs quickly, and maximum concentration in the blood occurs approximately 2 hours after taking the tablets. Metabolism of dextromethorphan takes place in the liver. The metabolite is excreted in the urine unchanged and in the form of metabolites. Ascorbic acid is absorbed in the gastrointestinal tract and quickly distributed throughout the tissues of the body. It is oxidized to dehydroxyascorbic acid (reversibly), and part of the amount of ascorbic acid entering the body is metabolized into the substance ascorbate-2-sulfate . Ascorbic acid is excreted from the body along with urine.

Contraindications

Contraindications to the use of the drug Caffetin Cold include the presence of:

hypersensitivity to this drug or to any of its components;
diagnosis of arterial hypertension , coronary heart disease or angina pectoris ;
severe impairment of liver or kidney function, as well as hepatitis ;
simultaneous use of monoamine oxidase inhibitors , antidepressants , drugs used in antiparkinsonian therapy or use of monoamine oxidase inhibitors during the last 2 weeks before starting to take Caffetin Cold;
congenital deficiency of glucose-6-phosphate dehydrogenase;
pregnancy;
lactation period;
less than 12 years of age.

Caution should be exercised when taking the drug when:

benign hyperbilirubinemia (including Gilbert's syndrome );
viral hepatitis;
alcoholism;
arrhythmias;
prostatic hyperplasia (especially if there is urinary retention);
diabetes mellitus;
hyperthyroidism;
bronchial asthma;
chronic obstructive pulmonary disease;
general exhaustion.

Overdose

Each active substance included in the drug can cause specific symptoms.

Paracetamol : the first 24 hours after taking the drug - the skin turns pale, nausea, vomiting, and abdominal pain ; metabolic acidosis develops . Symptoms associated with liver dysfunction may appear 12–48 hours after taking the drug.
Caffeine : a state of anxiety may occur, tremors , headaches, confusion, and extrasystole .
Codeine : the appearance of cold sticky sweat, confusion, dizziness, drowsiness, decreased blood pressure , signs of nervousness, fatigue, development of bradycardia , severe weakness, slow difficulty breathing, hypothermia , anxiety , miosis , convulsions.

In case of overdose, the stomach is washed, activated charcoal , cardiac activity and blood pressure , and maintenance therapy is carried out. Naloxone, is administered intravenously . SH-group donors and precursors for the synthesis of the substance glutathione are also administered - Methionine for a period of time about 8-9 hours after administration and acetylcysteine - for 8 hours.

If you suspect poisoning, you should immediately contact a medical facility.

Side effects

Side effects of the drug can manifest as various symptoms from almost all body systems:

digestive system - nausea, dry mouth may occur, and pain in the epigastrium ; in cases of long-term use in large doses, the hepatotoxic effect of the drug is manifested;
central nervous system – side effects of the drug include drowsiness , irritability, agitation; in some cases - dizziness ;
allergic reactions may occur in the form of skin rash, itching , urticaria , angioedema ;
cardiovascular system - sometimes blood pressure tachycardia may occur ;
hematopoietic organs - the development of anemia, thrombocytopenia, agranulocytosis is occasionally observed, if the drug is taken for a long time and in large quantities, the likelihood of developing hemolytic anemia, aplastic anemia, pancytopenia ;
urinary system - with a long period of use of the drug in large quantities, Caffetin has a nephrotoxic effect , which can manifest itself as renal colic , the development of interstitial nephritis , papillary necrosis ).

Instructions for use (Method and dosage)

Caffetin Cold is intended for oral administration.

The dose of the drug intended for adults and children over 12 years of age is 1 tablet, repeated 4 times a day. It is allowed to take 2 tablets at a time. The interval between doses should not be less than 4 hours. A single dose should not be more than 2 tablets, the dose per day should not be more than 8 tablets.

If the temperature is elevated for more than 3 days from the moment you started taking the medicine, and the cough does not go away within 5 days, you should seek medical help.

Caffetine price, where to buy

You can buy Caffetin in Moscow at almost any pharmacy. The price of Caffetin (pack of 12 tablets) is approximately 115 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine

ZdravCity

Caffetin Light tablets 12 pcs. Alkaloid AO
RUB 147.00 order
Caffetin Cold tablets p.p.o. 10pcs Alkaloid AO
RUB 224 order

Pharmacy Dialogue

Caffetin Light (tab. No. 12) Alkaloida
135 rub. order

Pharmacy24

Caffetin Lady 200 mg No. 10 tablets Alkoloid AD-Skop є, Republic of Macedonia
98 UAH.order

Interaction

The simultaneous use of paracetamol in large doses enhances the effect of anticoagulant drugs.

Taking drugs related to inducers of microsomal oxidation , which occurs in the liver ( phenytoin , ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants ) and hepatotoxic drugs increases the formation of hydroxylated active metabolic products of paracetamol, and this makes the likelihood of severe intoxication even when taken small dose of the drug.

Long-term use of barbiturates reduces the effect of taking paracetamol .

The combination of taking paracetamol in large quantities and salicylates (especially cases of long-term simultaneous use) increases the likelihood of developing cancer of the kidneys or bladder.

Long-term combined use of paracetamol and non-steroidal anti-inflammatory drugs increases the risk of analgesic nephropathy or renal papillary necrosis , significantly advancing the onset of the terminal stage of renal failure .

Taking diflunisal , which has the property of increasing plasma concentrations by half, leads to an increased risk of developing the hepatotoxic effect of the drug.

The simultaneous use of pseudoephedrine and other sympathomimetic drugs may have an additive effect and contribute to the development of toxic effects. The combination of pseudoephedrine with monoamine oxidase inhibitors can lead to the development of a hypertensive crisis . Therefore, the use of the drug is permitted no earlier than two weeks after monoamine oxidase inhibitors .

Concomitant use of propranolol may enhance the pressor effect of pseudoephedrine . Also, when using pseudoephedrine, it is possible to reduce the hypotensive effect of drugs such as Eserpine , Methyldopa, Mecamylamine and hellebore alkaloids .

The drugs Fluoxetine , Amiodarone and Quinidine inhibit the cytochrome P450 system , thereby creating conditions for increasing the concentration of dextromethorphan in the circulating blood.

Caffetin®

Caffeine

: with the combined use of caffeine and barbiturates, anticonvulsants (drugs), it is possible to increase metabolism and increase the clearance of caffeine; cimetidine, oral contraceptive drugs, disulfiram, ciprofloxacin, norfloxacin - decreased metabolism of caffeine in the liver.

Reduces the effect of narcotic and sleeping pills.

Concomitant use of caffeine with beta-blockers may lead to mutual suppression of therapeutic effects; with adrenergic bronchodilators - to additional stimulation of the central nervous system and other additive toxic effects.

Caffeine accelerates the absorption of ergotamine.

The simultaneous use of the drug with drugs that stimulate the central nervous system, MAO inhibitors (furazolidone, procarbazine, selegiline) is not recommended - large doses of caffeine can cause the development of dangerous cardiac arrhythmias or a pronounced increase in blood pressure, as well as with drugs and drinks containing caffeine.

Caffeine may decrease the clearance of theophylline and possibly other xanthines, increasing the potential for additive pharmacodynamic and toxic effects.

Codeine

: with the simultaneous use of ethanol, muscle relaxants, as well as drugs that depress the central nervous system, increased sedation, suppression of the respiratory center and depression of the central nervous system are possible.

Concomitant use of opioids with sedatives, such as benzodiazepines or related drugs, increases the risk of sedation, respiratory depression, coma, and death due to additive CNS depressant effects. The dose and duration of simultaneous use should be limited (see Section "Special Instructions").

Drugs with anticholinergic activity, antidiarrheal drugs (including loperamide) increase the risk of constipation.

Reduces the effect of metoclopramide.

Paracetamol

: inducers of microsomal oxidation in the liver (anticonvulsants, 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.

Concomitant use of paracetamol in high doses can enhance the effect of indirect anticoagulants (derivatives of dicoumarin, warfarin, acenocoumarol), and simultaneous use with non-steroidal anti-inflammatory drugs can lead to adverse reactions from the gastrointestinal tract.

Reduces the effectiveness of uricosuric drugs.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

Under the influence of paracetamol, T1/2 of chloramphenicol increases 5 times.

Metoclopramide accelerates the absorption of paracetamol.

special instructions

While using the drug, it is necessary to monitor peripheral blood counts and the functional state of the liver.

During the treatment period, it is prohibited to consume ethanol (which can lead to the development of hepatotoxic effects of the drug) and caffeine-containing drugs and products.

The drug affects a person’s ability to drive vehicles and engage in any other types of activities that require concentration and high speed of psychomotor reactions.