Баралгин М Раствор, ампулы, 5 шт, 5 мл, 500 мг/мл, для инъекций

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В терапевтических дозах проникает в грудное молоко."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"\n\nТяжелый острый или хронический болевой синдром при травмах ипослеоперационном болевом синдроме при коликах при онкологическихзаболеваниях и других состояниях где противопоказаны другие терапевтические меры."}},{"type":"paragraph","data":{"text":"Лихорадка устойчивая к другим методам лечения.\n\n"}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"- Повышенная чувствительность к метамизолу натрия и другим компонентам препарата а также другим пиразолонам (феназон пропифеназон) или к пиразолидинам (фенилбутазон оксифенбутазон) включая например указания анамнеза на развитие агранулоцитоза при приеме одного из этих препаратов."}},{"type":"paragraph","data":{"text":"- Нарушения костномозгового кроветворения (например после лечения цитостатиками) или заболевания гематопоэтической системы."}},{"type":"paragraph","data":{"text":"- Указания анамнеза на бронхоспазм или другие анафилактические реакции (например крапивницу ринит ангионевротический отек) при приеме анальгезирующих препаратов таких как салицилаты парацетамол диклофенак ибупрофен индометацин напроксен."}},{"type":"paragraph","data":{"text":"- Врожденная недостаточность глюкозо-6-фосфат-дегидрогеназы (риск развития гемолиза)."}},{"type":"paragraph","data":{"text":"- Беременность (первый и третий триместр)."}},{"type":"paragraph","data":{"text":"- Период лактации"}},{"type":"paragraph","data":{"text":"- Острая интермиттирующая печеночная порфирия (риск развития приступов порфирии)."}},{"type":"paragraph","data":{"text":"- Новорожденные в возрасте до 3-х месяцев или при массе тела менее 5 кг"}},{"type":"paragraph","data":{"text":"- Грудные дети в возрасте от 3 до 12 месяцев (противопоказание только для внутривенного введения)."}},{"type":"paragraph","data":{"text":"- Артериальная гипотензия нестабильность гемодинамики (противопоказание только для внутривенного введения)."}}]},{"id":14,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- Артериальная гипотензия (систолическое артериальное давление ниже 100 мм рт. ст.) нестабильность гемодинамики (инфаркт миокарда множественная травма начинающийся шок) снижение объема циркулирующей крови начинающаяся сердечная недостаточность высокая лихорадка (повышенный риск резкого снижения артериального давления)."}},{"type":"paragraph","data":{"text":"- Заболевания при которых значительное снижение артериального давления может представлять повышенную опасность (пациенты с тяжелой ишемической болезнью сердца и выраженным стенозом артерий головного мозга)."}},{"type":"paragraph","data":{"text":"- Алкоголизм."}},{"type":"paragraph","data":{"text":"- Бронхиальная астма особенно в сочетании с сопутствующим полипозным риносинуситом; хроническая крапивница и другие виды атопии (аллергических заболеваний в развитии которых значительная роль принадлежит наследственной предрасположенности к сенсибилизации: поллинозы аллергический ринит и т. п.) (повышенный риск развития анафилактических/анафилактоидных реакций)."}},{"type":"paragraph","data":{"text":"- Непереносимость алкоголя (реакция даже на незначительные количества определенных алкогольных напитков с такими симптомами как зуд слезотечение и выраженное покраснение лица) (повышенный риск развития анафилактических/анафилактоидных реакций)."}},{"type":"paragraph","data":{"text":"- Непереносимость красителей (например тартразина) или консервантов (например бензоатов) (повышенный риск развития анафилактических/анафилактоидных реакций)."}},{"type":"paragraph","data":{"text":"- Выраженные нарушения функции печени и почек (рекомендуется применение низких доз в связи с возможностью замедления выведения метамизола натрия)."}},{"type":"paragraph","data":{"text":"- Беременность (второй триместр)."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Беременность"}},{"type":"paragraph","data":{"text":"Нет достаточных клинических данных применения метамизола натрия у беременных женщин поэтому применение при беременности не рекомендуется. Метамизол натрия проникает через плаценту."}},{"type":"paragraph","data":{"text":"В течение первого триместра беременности применение метамизола натрия противопоказано."}},{"type":"paragraph","data":{"text":"Во втором триместре беременности лечение метамизолом натрия должно"}},{"type":"paragraph","data":{"text":"осуществляться по строгим медицинским показаниям если ожидаемая польза для матери превышает потенциальный риск для плода. Применение метамизола натрия в третьем триместре беременности также противопоказано: нельзя исключить возможность преждевременного закрытия артериального (боталлова) протока и перинатальных осложнений вследствие влияния на способность тромбоцитов матери и плода к агрегации (так как метамизол натрия является ингибитором циклооксигеназы хотя и слабым)."}},{"type":"paragraph","data":{"text":"Период грудного вскармливания"}},{"type":"paragraph","data":{"text":"Метаболиты метамизола натрия выделяются с грудным молоком. В случае применения препарата в период грудного вскармливания кормление грудью должно быть прекращено как минимум на 48 ч."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Парентеральное введение препарата Баралгин М показано только при невозможности его приема внутрь."}},{"type":"paragraph","data":{"text":"Перед введением раствор рекомендуется нагреть до температуры тела."}},{"type":"paragraph","data":{"text":"Взрослые и подростки 15 лет и старше: в качестве разовой дозы рекомендуется 1-2 мл 50% (500 мг/мл) раствора Баралгин М (в/м или в/в) максимальная суточная доза - 4 мл инъекционного раствора (не более 2 г) разделенная на 2-3 приема. Максимальная разовая доза может составлять 1 г (2 мл 50% раствора)."}},{"type":"paragraph","data":{"text":"Дети и новорожденные: Баралгин М для парентерального применения нельзя назначать новорожденным в возрасте до 3-х месяцев или при массе тела менее 5 кг. Детям Баралгин М назначается в дозе 50-100 мг на 10 кг массы тела (01 - 02 мл 50% раствора). Разовая доза может быть назначена 2-3 раза в сутки."}},{"type":"paragraph","data":{"text":"Для детей в возрасте 3-12 месяцев введение осуществляется только внутримышечно (масса тела ребенка от 5 до 9 кг)."}},{"type":"paragraph","data":{"text":"Внутривенное введение должно осуществляться медленно: скорость введения не более 1 мл (500 мг метамизола натрия) в минуту в положении лежа при контроле за артериальным давлением пульсом и частотой дыхания для того чтобы при первых признаках развития анафилактической/анафилактоидной реакции прекратить введение препарата а также для минимизации риска снижения артериального давления. Так как возможный гипотензивный эффект является дозозависимым Баралгин М в больших дозах (более 2 мл -1 г) должен вводиться с особой осторожностью."}},{"type":"paragraph","data":{"text":"При слишком быстром введении препарата может наблюдаться очень резкое снижение артериального давления и шок."}},{"type":"paragraph","data":{"text":"Продолжительность лечения"}},{"type":"paragraph","data":{"text":"При применении при болевом синдроме продолжительность лечения 1-5 дней."}},{"type":"paragraph","data":{"text":"При применении при лихорадочном синдроме продолжительность лечения 1-3 дня."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Побочные эффекты были классифицированы соответственно рекомендациям Всемирной"}},{"type":"paragraph","data":{"text":"Организации Здравоохранения: очень часто (>10%); часто (>1 % <10%);"}},{"type":"paragraph","data":{"text":"нечасто (>01 % <1 %); редко (>001 % <01 %); очень редко (<001 %); частота неизвестна (по имеющимся данным невозможно оценить частоту развития побочных эффектов)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны сердца"}},{"type":"paragraph","data":{"text":"Частота неизвестна: синдром Коуниса (аллергическая стенокардия или аллергический инфаркт миокарда)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны иммунной системы"}},{"type":"paragraph","data":{"text":"Редко: метамизол натрия может вызывать анафилактические или анафилактоидные реакции которые могут быть тяжелыми и угрожающими жизни; в некоторых случаях анафилактические реакции могут привести к летальному исходу."}},{"type":"paragraph","data":{"text":"В случае развития анафилактических/анафилактоидных реакций необходимо немедленно прекратить введение препарата провести мероприятия по оказанию пациентам неотложной медицинской помощи провести развернутый клинический анализ крови."}},{"type":"paragraph","data":{"text":"Эти реакции могут возникать даже в случае если ранее препарат применялся много раз без каких-либо осложнений."}},{"type":"paragraph","data":{"text":"Такие лекарственные реакции могут развиться во время инъекции метамизола натрия или через несколько часов после его введения однако обычно они наблюдаются в течение одного часа после введения препарата."}},{"type":"paragraph","data":{"text":"Обычно более мягко протекающие анафилактические и анафилактоидные реакции проявляются в виде кожных симптомов и симптомов со стороны слизистых оболочек (зуд жжение гиперемия крапивница отек) одышки или жалоб со стороны желудочно-кишечного тракта."}},{"type":"paragraph","data":{"text":"Более легкие реакции могут прогрессировать до тяжелых форм с генерализованной крапивницей тяжелым ангионевротическим отеком (особенно с вовлечением гортани) тяжелым бронхоспазмом нарушениями ритма сердца резким снижением артериального давления"}},{"type":"paragraph","data":{"text":"(которому иногда предшествует повышение артериального давления) и развитием циркуляторного шока."}},{"type":"paragraph","data":{"text":"Очень редко: у пациентов с полным или неполным сочетанием бронхиальной астмы рецидивирующего полипоза носа и околоносовых пазух и непереносимости ацетилсалициловой кислоты или других нестероидных противовоспалительных препаратов (в том числе в анамнезе) реакции непереносимости обычно проявляются в виде приступов бронхиальной астмы."}},{"type":"paragraph","data":{"text":"Частота неизвестна: анафилактический шок."}},{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и под кожных тканей"}},{"type":"paragraph","data":{"text":"Нечасто: кроме проявлений анафилактических/анафилактоидных реакций на коже и слизистых оболочках перечисленных выше нечасто может возникать фиксированная лекарственная сыпь."}},{"type":"paragraph","data":{"text":"Редко: возможно возникновение сыпи."}},{"type":"paragraph","data":{"text":"Очень редко: возможно развитие синдрома Стивенса-Джонсона или синдрома Лайелла (токсического эпидермального некролиза)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны крови и лимфатической системы"}},{"type":"paragraph","data":{"text":"Редко: лейкопения."}},{"type":"paragraph","data":{"text":"Очень редко: агранулоцитоз (включая случаи с летальным исходом) тромбоцитопения."}},{"type":"paragraph","data":{"text":"Частота неизвестна: апластическая анемия панцитопения включая случаи с летальным исходом. Эти реакции являются иммунологическими по своей природе. Они могут возникать даже в случае если ранее препарат применялся много раз без каких-либо осложнений."}},{"type":"paragraph","data":{"text":"Типичными симптомами агранулоцитоза являются поражения слизистых оболочек (полости рта и глотки аноректальной области и половых органов) боль в горле лихорадка. Следует учитывать что если пациент получает антибиотикотерапию то типичные проявления агранулоцитоза могут быть минимально выраженными."}},{"type":"paragraph","data":{"text":"Скорость оседания эритроцитов значительно увеличивается в то время как увеличение лимфоузлов является слабовыраженным или отсутствует."}},{"type":"paragraph","data":{"text":"Типичными симптомами тромбоцитопении являются повышенная склонность к кровотечению и возникновение петехий на коже и слизистых оболочках."}},{"type":"paragraph","data":{"text":"В случае развития вышеперечисленных нарушений со стороны крови и лимфатической системы необходимо прекратить применение препарата и провести развернутый клинический анализ крови (см. раздел \"Особые указания\")."}},{"type":"paragraph","data":{"text":"Нарушения со стороны сосудов"}},{"type":"paragraph","data":{"text":"Изолированные гипотонические реакции"}},{"type":"paragraph","data":{"text":"Нечасто: во время или после введения препарата возможно изолированное транзиторное снижение артериального давления (возможно фармакологически"}},{"type":"paragraph","data":{"text":"обусловленное и не сопровождающееся другими проявлениями анафилактических/анафилактоидных реакций)."}},{"type":"paragraph","data":{"text":"Редко: снижение артериального давления может быть очень резко выраженным. Быстрое внутривенное введение может увеличить риск развития такой гипотензивной реакции."}},{"type":"paragraph","data":{"text":"Общие расстройства и нарушения в месте введения"}},{"type":"paragraph","data":{"text":"Нечасто: в месте инъекции возможна болезненность и местные реакции (гиперемия)."}},{"type":"paragraph","data":{"text":"Очень редко: флебит."}},{"type":"paragraph","data":{"text":"Нарушения со стороны почек и мочевыводящих путей"}},{"type":"paragraph","data":{"text":"Нечасто: возможно окрашивание мочи в красный цвет вследствие присутствия в моче метаболита - рубазоновой кислоты."}},{"type":"paragraph","data":{"text":"Очень редко: возможно острое ухудшение функции почек (острая почечная недостаточность) особенно у пациентов с заболеваниями почек в некоторых случаях с олигурией анурией или протеинурией; в отдельных случаях может возникать"}},{"type":"paragraph","data":{"text":"острый интерстициальный нефрит."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы"}},{"type":"paragraph","data":{"text":"При передозировке возможно появление следующих симптомов: тошнота рвота боли в животе снижение функции почек/острая почечная недостаточность с олигурией (например вследствие развития интерстициального нефрита) более редко симптомы со стороны центральной нервной системы (головокружение сонливость шум в ушах бред нарушение сознания кома судороги) и резкое снижение артериального давления (иногда прогрессирующее до шока) а также нарушения сердечного ритма (тахикардия) гипотермия одышка острый агранулоцитоз геморрагический синдром острая печеночная недостаточность паралич дыхательных мышц. После приема высоких доз выведение через почки нетоксичного метаболита (рубазоновой кислоты) может вызывать красное окрашивание мочи."}},{"type":"paragraph","data":{"text":"Лечение"}},{"type":"paragraph","data":{"text":"Если после приема препарата прошло не более 1-2 часов то можно вызвать рвоту провести промывание желудка через зонд; дать солевые слабительные активированный уголь. При передозировке показан форсированный диурез. Главный метаболит (4-N-метиламиноантипирин) может выводиться с помощью гемодиализа гемофильтрации гемоперфузии или фильтрации плазмы. При развитии судорожного синдрома - внутривенное введение диазепама и быстродействующих барбитуратов."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"С циклоспорином"}},{"type":"paragraph","data":{"text":"Метамизол натрия может снижать концентрацию циклоспорина в сыворотке крови поэтому при их совместном применении следует контролировать концентрации циклоспорина."}},{"type":"paragraph","data":{"text":"С другими ненаркотическими анальгезирующими средствами"}},{"type":"paragraph","data":{"text":"Одновременное применение метамизола натрия с другими ненаркотическими анальгезирующими средствами может привести к взаимному усилению токсических эффектов."}},{"type":"paragraph","data":{"text":"С трициклическими антидепрессантами пероральными контрацептивами аллопуринолом"}},{"type":"paragraph","data":{"text":"Трициклические антидепрессанты пероральные контрацептивы аллопуринол нарушают метаболизм метамизола натрия в печени и повышают его токсичность."}},{"type":"paragraph","data":{"text":"С барбитуратами фенилбутазоном и другими индукторами микросомальных ферментов печени Барбитураты фенилбутазон и другие индукторы микросомальных ферментов печени ослабляют действие метамизола натрия С седативными средствами и транквилизаторами Седативные средства и транквилизаторы усиливают обезболивающее действие метамизола натрия. При одновременном применении метамизола натрия и хлорпромазина может развиться тяжелая гипотермия."}},{"type":"paragraph","data":{"text":"С лекарственными средствами имеющими высокую связь с белками плазмы (пероральные гипогликемические средства непрямые антикоагулянты глюкокортикостероиды и индометацин)"}},{"type":"paragraph","data":{"text":"Метамизол натрия вытесняя из связи с белками плазмы пероральные"}},{"type":"paragraph","data":{"text":"гипогликемические средства непрямые антикоагулянты глюкокортикостероиды и индометацин усиливает их действие."}},{"type":"paragraph","data":{"text":"С миелотоксичными лекарственными средствами"}},{"type":"paragraph","data":{"text":"Миелотоксичные лекарственные средства усиливают проявление гематотоксичности метамизола натрия."}},{"type":"paragraph","data":{"text":"С метотрексатом"}},{"type":"paragraph","data":{"text":"Добавление метамизола натрия к лечению метотрексатом может усиливать гематотоксическое действие метотрексата особенно у пациентов пожилого возраста."}},{"type":"paragraph","data":{"text":"Поэтому данной комбинации следует избегать."}},{"type":"paragraph","data":{"text":"С тиамазолом и сарколизином"}},{"type":"paragraph","data":{"text":"Тиамазол и сарколизин повышают риск развития лейкопении."}},{"type":"paragraph","data":{"text":"С кодеином блокаторами Н2-гистаминовых рецепторов и пропранололом"}},{"type":"paragraph","data":{"text":"Кодеин блокаторы Н\u003csub\u003e2\u003c/sub\u003e-гистаминовых рецепторов и пропранолол усиливают эффекты метамизола натрия"}},{"type":"paragraph","data":{"text":"С рентгенокотрастными веществами коллоидными кровезаменителями и пенициллином"}},{"type":"paragraph","data":{"text":"Рентгеноконтрастные вещества коллоидные кровезаменители и пенициллин не должны применяться во время лечения метамизолом натрия (повышенный риск развития анафилактических/анафилактоидных реакций)."}},{"type":"paragraph","data":{"text":"С ацетилсалициловой кислотой"}},{"type":"paragraph","data":{"text":"При совместном применении метамизол натрия может уменьшать влияние ацетилсалициловой кислоты на агрегацию тромбоцитов. Поэтому данную комбинацию следует применять с осторожностью при лечении пациентов принимающих низкие дозы ацетилсалициловой кислоты для кардиопротекции (профилактики тромбообразования)."}},{"type":"paragraph","data":{"text":"С бупропионом"}},{"type":"paragraph","data":{"text":"Метамизол натрия может снижать концентрацию бупропиона в крови что следует принимать во внимание при одновременном применении метамизола натрия и бупропиона.\n\n"}}]},{"id":9,"name":"Особые указания","slug":"","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При лечении пациентов получающих цитостатические средства и детей до 5 лет лечение метамизолом натрия должно проводиться только под наблюдением врача."}},{"type":"paragraph","data":{"text":"Анафилактические/ анафилактоидные реакции"}},{"type":"paragraph","data":{"text":"При выборе способа введения препарата следует учитывать что парентеральное применение связано с более высоким риском возникновения анафилактических/анафилактоидных реакций."}},{"type":"paragraph","data":{"text":"Повышенный риск развития реакций гиперчувствительности на метамизол натрия обуславливают следующие состояния:"}},{"type":"paragraph","data":{"text":"- полное или неполное сочетание бронхиальной астмы рецидивирующего полипоза носа и околоносовых пазух и непереносимости ацетилсалициловой кислоты или других нестероидных противовоспалительных препаратов (в том числе в анамнезе);"}},{"type":"paragraph","data":{"text":"- хроническая крапивница; непереносимость алкоголя"}},{"type":"paragraph","data":{"text":"(повышенная чувствительность к алкоголю) на фоне которой даже при приеме незначительного количества некоторых алкогольных напитков у пациентов возникают чихание слезотечение и выраженное покраснение лица. Непереносимость алкоголя может свидетельствовать о ранее неустановленном синдроме аспириновой астмы;"}},{"type":"paragraph","data":{"text":"- непереносимость или повышенная чувствительность к красителям (например к тартразину) или к консервантам (например к бензоатам)."}},{"type":"paragraph","data":{"text":"Перед применением метамизола натрия необходимо провести тщательный опрос пациента. В случае выявления риска развития анафилактоидной реакции прием может быть возможен только после определения соотношения риск/польза."}},{"type":"paragraph","data":{"text":"В случае применения метамизола натрия у таких пациентов необходим строгий медицинский контроль их состояния и необходимо иметь средства для оказания им неотложной помощи в случае развития анафилактических/анафилактоидных реакций."}},{"type":"paragraph","data":{"text":"Агранулоцитоз"}},{"type":"paragraph","data":{"text":"При длительном применении необходимо контролировать картину периферической крови. В любое время на фоне лечения метамизолом натрия возможно развитие агранулоцитоза. Он возникает очень редко длится не менее недели не зависит от дозы может быть тяжелым угрожать жизни и даже привести к летальному исходу."}},{"type":"paragraph","data":{"text":"В связи с этим при появлении симптомов возможно связанных с нейтропенией (лихорадки озноба боли в горле затрудненного глотания стоматита эрозивно- язвенных поражений ротовой полости вагинита или проктита снижения количества нейтрофилов в периферической крови менее 1500/мм\u003csup\u003e3\u003c/sup\u003e) необходимо прекратить лечение препаратом и обратиться к врачу."}},{"type":"paragraph","data":{"text":"Панцитопения"}},{"type":"paragraph","data":{"text":"В случае панцитопении лечение следует немедленно прекратить необходимо контролировать показатели развернутого анализа"}},{"type":"paragraph","data":{"text":"У предрасположенных пациентов может возникать анафилактический шок поэтому пациентам с астмой или атопией метамизол натрия следует назначать с осторожностью."}},{"type":"paragraph","data":{"text":"Тяжелые кожные реакции"}},{"type":"paragraph","data":{"text":"На фоне применения метамизола натрия были описаны угрожающие жизни кожные реакции такие как синдром Стивенса-Джонсона (ССД) и токсический эпидермальный некролиз (ТЭН). При появлении симптомов ССД или ТЭН (таких как прогрессирующая кожная сыпь часто с пузырями или поражением слизистой оболочки) лечение метамизолом натрия следует немедленно прекратить его не следует начинать повторно."}},{"type":"paragraph","data":{"text":"Пациенты должны быть осведомлены о симптомах данных заболеваний. У них следует тщательно контролировать кожные реакции особенно в течение первых недель лечения. крови вплоть до их нормализации. Все пациенты должны быть осведомлены о том что при появлении симптомов патологического изменения крови (например общего недомогания инфекций стойкой лихорадки образования гематом кровотечения бледности) на фоне приема метамизола натрия следует немедленно обратиться за медицинской помощью.Гипотензивные реакции Введение метамизола натрия может вызывать отдельные гипотензивные реакции. Данные реакции возможно зависят от дозы препарата и чаще возникают после парентерального введения. Во избежание развития тяжелых гипотензивных реакций необходимо придерживаться следующих рекомендаций:"}},{"type":"paragraph","data":{"text":"- внутривенное введение препарата следует осуществлять медленно; пациентам с имеющейся гипотензией снижением объема циркулирующей крови"}},{"type":"paragraph","data":{"text":"дегидратацией нестабильностью гемодинамики или с начальной стадией недостаточности кровообращения требуется нормализация гемодинамики;"}},{"type":"paragraph","data":{"text":"- при лечении пациентов с высокой температурой тела следует соблюдать осторожность."}},{"type":"paragraph","data":{"text":"У данных пациентов показание к применению метамизола натрия следует выбирать особенно осторожно."}},{"type":"paragraph","data":{"text":"При введении препарата Баралгин М в подобных условиях необходимо пристальное медицинское наблюдение. Для снижения риска гипотензивных реакций может потребоваться осуществление профилактических мероприятий (стабилизация гемодинамики). Метамизол натрия следует использовать только при тщательном контроле гемодинамики пациентов у которых следует избегать снижения артериального давления например пациентов с тяжелой ишемической болезнью сердца или стенозом сосудов которые кровоснабжают головной мозг."}},{"type":"paragraph","data":{"text":"Острая боль в животе"}},{"type":"paragraph","data":{"text":"Недопустимо использование препарата для снятия острых болей в животе (до выяснения их причины). Нарушение функции печени и почек"}},{"type":"paragraph","data":{"text":"У пациентов с нарушением функции печени и почек рекомендуется избегать приема метамизола натрия в высоких дозах из-за снижения скорости выведения препарата."}},{"type":"paragraph","data":{"text":"При внутримышечном введении необходимо использовать иглу для внутримышечного введения."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"При приеме рекомендованных доз не было отмечено нежелательного воздействия на концентрацию внимания и реакционную способность. Тем не менее при использовании высоких доз следует учитывать возможное нарушение концентрации внимания и реакционной способности что представляет риск при выполнении манипуляций особой важности (например управлении транспортным средством или машинным оборудованием) особенно после приема алкоголя."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для внутривенного и внутримышечного введения 500 мг/мл."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в защищенном от света месте при температуре от 8 °С до 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"4 года."}},{"type":"paragraph","data":{"text":"Не использовать препарат по истечении срока годности указанного на упаковке."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Санофи Индия Лимитед, AT & Post Dabhasa, Tal - Padra, Dabhasa - 391 440, Vadodara, Gujarat State, India, Индия"}}]},{"id":22,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Санофи Индия Лимитед"}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Анальгезирующее ненаркотическое средство производное пиразолона неселективно блокирует циклооксигеназу и снижает образование простагландинов из арахидоновой кислоты. Препятствует проведению болевых экстра- и проприоцептивных импульсов по пучкам Голля и Бурхарда повышает порог возбудимости таламических центров болевой чувствительности увеличивает теплоотдачу. Отличительной чертой является незначительная выраженность противовоспалительного эффекта обусловливающая слабое влияние на водно-солевой обмен (задержка ионов натрия и воды) и слизистую оболочку желудочно-кишечного тракта. Оказывает анальгезирующее жаропонижающее и некоторое спазмолитическое (в отношении гладкой мускулатуры мочевыводящих и желчевыводящих путей) действие. После внутривенного введения период полувыведения для метамизола натрия составляет 14 минут. Примерно 96% выводится с мочой в виде метаболитов. Главный метаболит (4- N-метиламиноантипирин). При введении высоких доз через почки может выделяться нетоксичный метаболит (рубазоновая кислота) способная окрашивать мочу в красный цвет. Связь активного метаболита с белками плазмы крови - 50-60%. Преимущественно выводится почками. 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