Tamipul

Pain syndrome of varying intensity:

• dysmenorrhea and menstrual pain;
• headache;
• neuralgia;
• myalgia
• arthralgia
• toothache.

Increased temperature (fever with flu and colds).

In the complex treatment of postoperative pain, relieving symptoms of rheumatoid arthritis and osteoarthritis.

Adults and adolescents over the age of 16 take 1–2 capsules every 4–6 hours, depending on the intensity of the pain syndrome and the recommendation of the doctor. The daily dose should not exceed 6 capsules. Children aged 12 to 16 years: 1 capsule 1-2 times a day. The capsule should be taken without chewing, drinking plenty of liquids (a glass of water). Typically, the duration of treatment is 3-7 days. If there is no improvement during this time, treatment should be reviewed.

The maximum period of use for children without consulting a doctor is 3 days.

The interval between doses is at least 4 hours.

Do not exceed the recommended dose.

The lowest effective dose should be used for the shortest time necessary to relieve symptoms.

Hypersensitivity to paracetamol, ibuprofen, caffeine or any other component of the drug, current or history of gastric ulcer (two or more clear episodes of exacerbation of ulcer or bleeding); history of upper gastrointestinal bleeding or perforation associated with previous treatment with nonsteroidal anti-inflammatory drugs; acute pancreatitis, severe liver and/or kidney dysfunction, congenital hyperbilirubinemia, glucose-6-phosphate dehydrogenase deficiency, alcoholism, blood diseases, severe anemia, leukopenia, thrombosis, thrombophlebitis, states of increased excitement; sleep disorders; severe arterial hypertension; organic diseases of the cardiovascular system; angle-closure glaucoma; epilepsy, hyperthyroidism, decompensated heart failure, cardiac conduction disorders, severe atherosclerosis, tendency to vasospasm, coronary heart disease, prostatic hypertrophy, severe forms of diabetes mellitus, allergic reaction (e.g., bronchial asthma, rhinitis, Quincke's edema) after using acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs, use of the drug simultaneously with nonsteroidal anti-inflammatory drugs, elderly patient.

Do not use together with monoamine oxidase (MAO) inhibitors, cyclooxygenase-2 and within 2 weeks after stopping their use; contraindicated in patients taking tricyclic antidepressants or beta-blockers. Gilbert's syndrome. Patient age up to 12 years. Pregnancy or breastfeeding.

Interaction with other medicinal products and other types of interactions

With simultaneous use of paracetamol with metoclopramide and domperidone, the absorption of paracetamol may be increased, with cholesterolamine - a decrease in absorption.

In the case of long-term continuous use of paracetamol, the anticoagulant effect of warfarin and other coumarins may be enhanced, and the risk of bleeding may increase.

Non-steroidal anti-inflammatory drugs may enhance the effect of anticoagulants, such as warfarin, and weaken the effect of drugs that lower blood pressure or diuretics.

Simultaneous use of other non-steroidal anti-inflammatory drugs may lead to increased side effects.

Corticosteroids may increase the risk of side effects from the gastrointestinal tract.

Taking the drug may lead to an increase in the concentration of lithium in the blood serum.

Simultaneous use with methotrexate may lead to poisoning.

Barbiturates reduce the antipyretic effect of paracetamol.

Anticonvulsants (including phenytoin, barbiturates, carbamazepine), which stimulate the activity of liver microsomal enzymes, can enhance the toxic effect of paracetamol on the liver due to an increase in the degree of conversion of the drug to hepatotoxic metabolites. With the simultaneous use of paracetamol with hepatotoxic drugs, the toxic effect of drugs on the liver increases. The simultaneous use of large doses of paracetamol with isoniazid increases the risk of developing hepatotoxic syndrome. Paracetamol reduces the effectiveness of diuretics. Do not use simultaneously with alcohol.

Caution should be exercised when using paracetamol with flucloxacillin, since simultaneous administration is associated with metabolic acidosis with a high anion gap, especially in patients with risk factors (see the section "Special instructions for use" in the instructions for medical use of the drug).

Simultaneous use of caffeine with MAO inhibitors can cause a dangerous increase in blood pressure. Caffeine enhances the effect (improves bioavailability) of analgesics-antipyretics, potentiates the effects of xanthine derivatives, alpha- and beta-adrenomimetics, psychostimulants.

Cimetidine, hormonal contraceptives, isoniazid enhance the effect of caffeine. Caffeine reduces the effect of opioid analgesics, anxiolytics, hypnotics and sedatives, is an antagonist of anesthetics and other drugs that depress the central nervous system, a competitive antagonist of adenosine drugs, ATP. With simultaneous use of caffeine with ergotamine, the absorption of ergotamine from the gastrointestinal tract improves, with thyroid-stimulating drugs - the thyroid effect increases. Caffeine reduces the concentration of lithium in the blood.

Features of use

In patients with impaired liver function, as well as in those who take paracetamol for a long time, it is recommended to regularly perform liver function tests. If the patient uses warfarin or similar drugs that have an anticoagulant effect, a doctor should be consulted before using the drug. Patients who take daily analgesics for mild arthritis should consult a doctor before using the drug. (for more details, see the instructions for medical use of the drug).
Use during pregnancy or breastfeeding.

Do not use during pregnancy or breastfeeding.

Starting from the 20th week of pregnancy, the use of ibuprofen may cause oligohydramnios due to fetal renal dysfunction. In case of exposure to ibuprofen for several days, starting from the 20th week of pregnancy, prenatal monitoring of oligohydramnios should be considered.

Children

The drug should not be used in children under 12 years of age.

Ability to influence the reaction rate when driving vehicles or using other mechanisms

If adverse reactions from the nervous system are observed during treatment with the drug, you should refrain from driving vehicles and working with other mechanisms.

Overdose

With long-term use of high doses, aplastic anemia, thrombocytopenia, pancytopenia, agranulocytosis, neutropenia, leukopenia are possible. When taking high doses, central nervous system (CNS) disorders may occur (dizziness, psychomotor agitation, impaired orientation and attention, insomnia, tremor, nervousness, anxiety), and urinary system - nephrotoxicity (renal colic, interstitial nephritis, papillary necrosis).

In case of overdose, increased sweating, psychomotor agitation or CNS depression, drowsiness, impaired consciousness, cardiac arrhythmias, tachycardia, extrasystole, tremor, hyperreflexia, convulsions may be observed.

Adverse reactions

The following adverse drug reactions are classified according to MedDRA terminology.

Immune system: hypersensitivity in the form of urticaria and itching; severe hypersensitivity reactions with manifestations such as swelling of the face, tongue and larynx, shortness of breath, tachycardia, arrhythmia, decrease or increase in blood pressure, anaphylaxis, Quincke's edema, hepatorenal syndrome, exacerbation of bronchial asthma and bronchospasm.

Nervous system: headache, dizziness, irritability, nervousness, depression, drowsiness, insomnia, anxiety, psychomotor agitation, emotional instability, convulsions, paresthesias, aseptic meningitis, some symptoms of which (rigidity of the occipital muscles, headache, nausea, vomiting, fever or disorientation) may occur in patients with existing autoimmune diseases such as systemic lupus erythematosus, mixed connective tissue disease.

From the side of the blood and lymphatic system: disorders of the hematopoietic system, agranulocytosis, anemia (including hemolytic and aplastic), decreased hematocrit and hemoglobin levels, sulfhemoglobinemia and methemoglobinemia (cyanosis, shortness of breath, heart pain), leukopenia, neutropenia, pancytopenia, thrombocytopenia. The first signs are: high fever, sore throat, mouth ulcers, flu symptoms, severe exhaustion, unexplained bleeding and bruising.

Gastrointestinal disorders: abdominal pain, heartburn, ulcerative stomatitis, dyspepsia and nausea, diarrhea, flatulence, constipation and vomiting, pancreatitis, duodenitis, esophagitis, gastritis, peptic ulcer, perforation or gastrointestinal bleeding, which can in some cases lead to death, especially in the elderly; exacerbation of ulcerative colitis and Crohn's disease.

From the urinary system: acute renal failure; renal colic; papillonecrosis, especially with prolonged use, associated with increased serum urea and edema; cystitis; hematuria; interstitial nephritis; nephrotic syndrome; oliguria; polyuria; tubular necrosis; glomerulonephritis; aseptic pyuria.

From the sensory organs: hearing impairment, hearing loss, tinnitus or noise in the ears, blurred vision, change in color perception, toxic amblyopia.

From the respiratory system: bronchospasm in patients sensitive to aspirin and other nonsteroidal anti-inflammatory drugs.

From the heart: heart failure, edema.

From the vascular system: arterial thrombosis (myocardial infarction or stroke).

Endocrine system and metabolic changes: hypoglycemia, up to hypoglycemic coma; decreased appetite; dry mucous membranes of the eyes and mouth; rhinitis.

Liver: liver disorders, increased activity of liver enzymes, hepatonecrosis (dose-dependent effect), liver failure, with prolonged treatment hepatitis and jaundice may occur.

Skin and subcutaneous tissue: allergic skin reactions, rash, purpura, skin peeling, itching, alopecia, photosensitivity; angioedema, severe skin reactions such as erythema multiforme (including Stevens-Johnson syndrome), epidermal necrolysis and a red, scaly, widespread rash with bumps under the skin and blisters, mainly localized in the skin folds, trunk and upper limbs, accompanied by fever at the beginning of treatment (acute generalized exanthematous pustulosis). If these symptoms occur, you should stop using Tamiflu® and consult a doctor immediately.

General disorders: malaise and fatigue.

Laboratory tests: decreased hemoglobin.

Simultaneous administration of the drug in recommended doses with products containing caffeine may increase side effects caused by caffeine, such as:

• mental disorders: headache, dizziness, increased excitability, anxiety, irritability, rapid heartbeat, restlessness, insomnia due to stimulation of the central nervous system;
• from the gastrointestinal tract: nausea caused by irritation of the gastrointestinal tract.

1 capsule contains:

• active ingredients: paracetamol 325 mg, ibuprofen 200 mg, caffeine 30 mg;
• excipients: talc, colloidal silicon dioxide, sodium lauryl sulfate, gelatin, kandurin (silver luster), patented blue V (E 131), azorubine, carmoisin (E 122).

Capsules.

Store in original packaging at a temperature not exceeding 25 ° C in an inaccessible place for children.

JSC "Grindex", Latvia

Dragenopharm Apotheker Püschl GmbH.