ФармакодинамикаКомбинированный препарат, действие которого о... Инструкция
Показания к применению
Болевой синдром слабой и умеренной интенсивности
(зубная и головная боль, боли в
суставах, мышцах, невралгия, альгодисменорея), обусловленный, в том
числе и спазмами
гладкой мускулатуры внутренних органов (почечная колика, желчная
колика, дискинезия желчевыводящих путей
и желчного пузыря по гиперкинетическому...
Продолговатые таблетки
желтого цвета с риской с одной стороны.
Фармакотерапевтическая группа
Анальгезирующее средство комбинированное
(анальгезирующее ненаркотическое
средство + спазмолитическое средство).
Фармакологические свойства
Фармакодинамика
Комбинированный препарат, действие которого обусловлено входящим в
его состав компонентами.
Дротаверин – производное изохинолина, обладающее
спазмолитическим действием в отношении
гладкой мускулатуры (ингибирование фермента фосфодиэстеразы IV, увеличение концентрации цАМФ, который,
инактивируя фермент миозинкиназу,
приводит к расслаблению гладкой мускулатуры). Дротаверин также обладает
слабым ингибирующим действием на
кальмодулин-зависимые кальцевые каналы. Независимо от
типа вегетативной иннервации, дротаверин
эффективен при спазмах гладкой
мускулатуры. Он действует на гладкие мышцы, находящиеся в сосудистой,
желудочно кишечной, желчевыводящей и урогенитальной системах (содержание фосфодиэстеразы
IV в различных тканях различно).
Парацетамол оказывает анальгетическое и жаропонижающее действие
преимущественно путем ингибирования
синтеза простагландинов в центральной нервной системе. В воспаленных тканях клеточные пероксидазы
нейтрализуют действие парацетамола, что
объясняет практически полное отсутствие противовоспалительного эффекта.
Отсутствие блокирующего влияния на
синтез Pg в периферических тканях обуславливает отсутствие у парацетамола отрицательного влияния на
водно-солевой обмен (задержка натрия и воды)
и слизистую оболочку желудочно-кишечного тракта.
Фармакокинетика
Парацетамол быстро всасывается в желудочно-кишечном тракте и
распределяется в большенство органов и
тканей. Абсорбция – высокая, время достижения максимальной концентрации достигается через 0.5-2 ч;
максимальная концентрация – 5-20 мкг/мл. Связь
с белками плазмы – 15%. Проникает через гематоэнцефалический барьер.
Менее 1% от принятой кормящей матерью
дозы парацетамола проникает в грудное молоко.
Метаболизируется в печени (90-95%): 80% вступает в реакции конъюгации
с глюкуроновой кислотой и сульфатами м
образованием неактивных метаболитов. При
недостатке глутатиона эти метаболиты могут блокировать ферментные
системы гепатоцитов и вызывать их
некроз. В метаболизме препарата также участвует изофермент CYP2E1. Период полувыведения – 1-4 ч.
Выводится почками в виде метаболитов,
преимущественно конъюгатов, только 3% - в неизменном виде. У пожилых
больных снижается клиренс препарата и
увеличивается период полувыведения.
Дротаверин при приеме внутрь быстро и
практически полностью всасывается, абсорбция
– высокая, период полуабсорбции – 12 мин. Биодоступность – 100%.
Равномерно распределяется в тканях,
проникает в гладкомышечные клетки. Время достижения максимальной концентрации – 2 ч. Связь с
белками плазмы составляет 95-98%. Период
полувыведения – 1-4 ч. В основном выводится почками, в меньшей степени –
с желчью. Не проникает через
гематоэнцефалический барьер.
Показания к применению
Болевой синдром слабой и умеренной интенсивности
(зубная и головная боль, боли в
суставах, мышцах, невралгия, альгодисменорея), обусловленный, в том
числе и спазмами
гладкой мускулатуры внутренних органов (почечная колика, желчная
колика, дискинезия желчевыводящих путей
и желчного пузыря по гиперкинетическому типу, кишечная колика, спастические запоры, спастический
колит, тенезмы).
Противопоказания
Гиперчувствительность; тяжелая почечная и
печеночная недостаточность; тяжелая
хроническая сердечная недостаточность (III-IV функциональный класс по
классификации NYHA), атриовентрикулярная
блокада II-III степени, кардиогенный шок; дыхательная недостаточность, бронхиальная астма;
хронический алкоголизм; заболевания крови
(тромбоцитопения, лейкопения, агранулоцитоз); дефицит
глюкозо-6-фосфатдегидрогена зы; внутричерепная гипертензия; применение
одновременно других препаратов,
содержащих парацетамол; лечение ингибиторами моноаминооксидазы (и в
течение еще 14 дней после их отмены);
беременность и период лактации; детский возраст до 6 лет.
С осторожностью
С осторожностью назначают больным с
доброкачественной гипербилирубинемией
(синдром Жильбера), больным с атриовентрикулярной блокадой I степени, а
также лицам пожилого возраста.
Способ применения и дозы
Внутрь, с большим количеством жидкости через 1-2
часа после приема пищи (прием препарата
сразу после еды приводит к задержке наступления действия). Детям в
возрасте от 6 до 12 лет препарат
назначают в разовой дозе 1/2 таблетки. Повторное применение препарата возможно через 10-12 часов,
максимальная доза составляет 2 таблетки в сутки. Взрослым и подросткам старше 12 лет препарат
рекомендуется применять по 1-2 таблетки
за один прием, при необходимости прием можно повторить через 8 часов.
При коротком (не более 3 дней) курсе
лечения максимальная суточная доза составляет 6 таблеток, при более длительном курсе лечения она не должна
превышать 4 таблеток в день.
Пациентам пожилого возраста с нормальной функцией печени и почек
коррекции дозы препарата не требуется, у
пациентов с печеночной и/или почечной недостаточностью доза препарата должна быть снижена и установлена
индивидуально.
Максимальная
продолжительность лечения без консультации врача - 3 дня.
Побочное действие
Со стороны центральной
нервной системы (обычно развивается при приеме высоких доз): головокружение, головная боль, сонливость.
Со стороны
сердечно-сосудистой системы: артериальная гипотензия, аритмия, тахикардия, «приливы».
Со стороны
пищеварительной системы: тошнота, запоры, редко (при применении высоких доз) - токсическое поражение
печени.
Со стороны органов
кроветворения: при длительном применении в больших дозах - апластическая анемия,
агранулоцитоз, тромбоцитопения.
Аллергические реакции: кожная сыпь, очень редко
- бронхоспазм, отек слизистой оболочки
носа.
Передозировка
Симптомы обусловленные передозировкой парацетамола: в течение
первых 24 ч после приема - бледность
кожных покровов, тошнота, рвота, анорексия, абдоминальная боль; нарушение метаболизма глюкозы, мстаболический
ацидоз.
Симптомы нарушения функции печени могут
появиться через 12-48 ч после
передозировки. При тяжелой передозировке - печеночная недостаточность
с прогрессирующей энцефалопатией, кома;
острая почечная недостаточность с тубулярным
некрозом (в т.ч. при отсутствии тяжелого поражения печени); аритмия,
панкреатит. Гепатотоксический эффект у
взрослых проявляется при приеме 10 г и более.
Лечение: промывание желудка,
солевые слабительные, введение донаторов SH-групп и предшественников синтеза глутатиона -
метионина через 8-9 ч после передозировки и
N-ацетилцистеина - через 12 ч. Необходимость в проведении
дополнительных терапевтических
мероприятий (дальнейшее введение метионина, внутривенное введение N-ацетилцистеина) определяется в зависимости
от концентрации парацетамола в крови, а
также от времени, прошедшего после его приема. При тяжелом повреждении
центральной нервной системы может
понадобиться искусственная вентиляция легких,
кислородотерапия.
Взаимодействие с другими лекарственными средствами
Дротаверин снижает
действие леводопы (могут усиливаться тремор и ригидность).
При совместном применении парацетамола с хлорамфениколом
увеличивается период полувыведения
хлорамфеникола и усиливается его токсичность.
Одновременное применение парацетамола с
доксирубицином увеличивает риск развития
нарушений функции печени. Парацетамол снижает эффект урикозурических
препаратов. Метоклопрамид и домперидон
усиливают абсорбцию парацетамола, а колестирамин ее уменьшает. Сопутствующее применение
парацетамола в высоких дозах повышает эффект
антикоагулянтных лекарственных средств (снижение синтеза прокоагулянтных
факторов
в печени). Индукторы микросомального окисления в
печени (фенитоин, барбитураты,
рифампицин, фенилбутазон, трициклические антидепрессанты), этанол и
гепатотоксичес кие лекарственные средства увеличивают продукцию гидроксилированных
активных метаболитов, что обусловливает
возможность развития тяжелых интоксикаций даже при небольшой передозировке. Длительное
использование барбитуратов снижает
эффективность парацетамола, Этанол способствует развитию острого
панкреатита. Ингибиторы микросомального
окисления (в т.ч. циметидин) снижают риск
гепатотоксического действия. Длительное, совместное использование
парацетамола и других неспецифических
противовоспалительных препаратов повышает риск развития "анальгетической" нефропатии и
почечного папиллярного некроза, наступления
терминальной стадии почечной недостаточности. Одновременное длительное
назначение парацетамола в высоких дозах
и салицилатов повышает риск развития рака почки или мочевого пузыря. Дифлунисал
повышает плазменную концентрацию парацетамола на 50% - риск развития гепатотоксичности.
Миелотоксические лекарственные средства
усиливают проявления гематотоксичности парацетамола.
Особые указания
Риск развития повреждений печени возрастает у
больных алкогольным гепатозом. При
почечной и печеночной недостаточности легкой и средней степени тяжести
доза должна устанавливаться
индивидуально. При применении препарата свыше 3 дней и/или высоких доз необходим контроль картины периферической
крови (числа лейкоцитов, тромбоцитов) и
функционального состояния печени (активности «печеночных» ферментов). Клинические и лабораторные симптомы
гепатотоксического действия начинают
проявляться в течение 48-72 ч после приема больших доз препарата. В
период лечения необходимо воздерживаться
от вождения автотранспорта и занятий другими потенциально опасными видами
деятельности, требующими повышенной концентрации внимания и быстроты
психомоторных реакций.
Форма выпуска
Таблетки, 40 мг + 500 мг. По 6 таблеток в
блистер Алю/Алю. По 1, 2 или 4 блистера
вместе с инструкцией по применению в картонной пачке.
Условия хранения
Хранить в оригинальной упаковке (блистер в пачке) при температуре
не выше 25°C. Хранить в недоступном для
детей месте.
Срок годности
2 года.
Не использовать после истечения срока годности, указанного на упаковке.
Условия отпуска
без рецепта.
Производитель
ХИНОИН Завод Фармацевтических и Химических Продуктов ЗАО ул. Леваи, 5, 2112 Верешедьхаз, Венгрия.
Организация, принимающая претензии потребителей
125009, Москва, ул.
Тверская, 22.
Телефон: (495)
721-14-00.
Факс (495) 721-14-11.
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"}},{"type":"paragraph","data":{"text":"Дротаверин – производное изохинолина, обладающее\nспазмолитическим действием в отношении\nгладкой мускулатуры (ингибирование фермента фосфодиэстеразы IV, увеличение концентрации цАМФ, который,\nинактивируя фермент миозинкиназу, \nприводит к расслаблению гладкой мускулатуры). Дротаверин также обладает\nслабым ингибирующим действием на\nкальмодулин-зависимые кальцевые каналы. Независимо от "}},{"type":"paragraph","data":{"text":"типа вегетативной иннервации, дротаверин\nэффективен при спазмах гладкой \nмускулатуры. Он действует на гладкие мышцы, находящиеся в сосудистой,\nжелудочно кишечной, желчевыводящей и урогенитальной системах (содержание фосфодиэстеразы\nIV в различных тканях различно). "}},{"type":"paragraph","data":{"text":"Парацетамол оказывает анальгетическое и жаропонижающее действие\nпреимущественно путем ингибирования\nсинтеза простагландинов в центральной нервной системе. В воспаленных тканях клеточные пероксидазы\nнейтрализуют действие парацетамола, что \nобъясняет практически полное отсутствие противовоспалительного эффекта.\nОтсутствие блокирующего влияния на\nсинтез Pg в периферических тканях обуславливает отсутствие у парацетамола отрицательного влияния на\nводно-солевой обмен (задержка натрия и воды) \nи слизистую оболочку желудочно-кишечного тракта. "}},{"type":"paragraph","data":{"text":"\u003cb\u003eФармакокинетика \n\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Парацетамол быстро всасывается в желудочно-кишечном тракте и\nраспределяется в большенство органов и\nтканей. Абсорбция – высокая, время достижения максимальной концентрации достигается через 0.5-2 ч;\nмаксимальная концентрация – 5-20 мкг/мл. Связь \nс белками плазмы – 15%. Проникает через гематоэнцефалический барьер.\nМенее 1% от принятой кормящей матерью\nдозы парацетамола проникает в грудное молоко. \nМетаболизируется в печени (90-95%): 80% вступает в реакции конъюгации\nс глюкуроновой кислотой и сульфатами м\nобразованием неактивных метаболитов. При \nнедостатке глутатиона эти метаболиты могут блокировать ферментные\nсистемы гепатоцитов и вызывать их\nнекроз. В метаболизме препарата также участвует изофермент CYP2E1. Период полувыведения – 1-4 ч.\nВыводится почками в виде метаболитов, \nпреимущественно конъюгатов, только 3% - в неизменном виде. У пожилых\nбольных снижается клиренс препарата и\nувеличивается период полувыведения. "}},{"type":"paragraph","data":{"text":"Дротаверин при приеме внутрь быстро и\nпрактически полностью всасывается, абсорбция \n– высокая, период полуабсорбции – 12 мин. Биодоступность – 100%.\nРавномерно распределяется в тканях,\nпроникает в гладкомышечные клетки. Время достижения максимальной концентрации – 2 ч. Связь с\nбелками плазмы составляет 95-98%. Период \nполувыведения – 1-4 ч. В основном выводится почками, в меньшей степени –\nс желчью. Не проникает через\nгематоэнцефалический барьер. "}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Болевой синдром слабой и умеренной интенсивности\n(зубная и головная боль, боли в \nсуставах, мышцах, невралгия, альгодисменорея), обусловленный, в том\nчисле и спазмами "}},{"type":"paragraph","data":{"text":"гладкой мускулатуры внутренних органов (почечная колика, желчная\nколика, дискинезия желчевыводящих путей\nи желчного пузыря по гиперкинетическому типу, кишечная колика, спастические запоры, спастический\nколит, тенезмы). 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Взрослым и подросткам старше 12 лет препарат\nрекомендуется применять по 1-2 таблетки \nза один прием, при необходимости прием можно повторить через 8 часов.\nПри коротком (не более 3 дней) курсе\nлечения максимальная суточная доза составляет 6 таблеток, при более длительном курсе лечения она не должна\nпревышать 4 таблеток в день. "}},{"type":"paragraph","data":{"text":"Пациентам пожилого возраста с нормальной функцией печени и почек\nкоррекции дозы препарата не требуется, у\nпациентов с печеночной и/или почечной недостаточностью доза препарата должна быть снижена и установлена\nиндивидуально. "}},{"type":"paragraph","data":{"text":"Максимальная\nпродолжительность лечения без консультации врача - 3 дня. "}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны центральной\nнервной системы (обычно развивается при приеме высоких доз): \u003c/i\u003eголовокружение, головная боль, сонливость. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны\nсердечно-сосудистой системы: \u003c/i\u003eартериальная гипотензия, аритмия, тахикардия, «приливы». "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны\nпищеварительной системы: \u003c/i\u003eтошнота, запоры, редко (при применении высоких доз) - токсическое поражение\nпечени. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органов\nкроветворения: \u003c/i\u003eпри длительном применении в больших дозах - апластическая анемия,\nагранулоцитоз, тромбоцитопения. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции: \u003c/i\u003eкожная сыпь, очень редко\n- бронхоспазм, отек слизистой оболочки\nноса. "}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы обусловленные передозировкой парацетамола: в течение\nпервых 24 ч после приема - бледность\nкожных покровов, тошнота, рвота, анорексия, абдоминальная боль; нарушение метаболизма глюкозы, мстаболический\nацидоз. "}},{"type":"paragraph","data":{"text":"Симптомы нарушения функции печени могут\nпоявиться через 12-48 ч после \nпередозировки. При тяжелой передозировке - печеночная недостаточность\nс прогрессирующей энцефалопатией, кома;\nострая почечная недостаточность с тубулярным \nнекрозом (в т.ч. при отсутствии тяжелого поражения печени); аритмия,\nпанкреатит. Гепатотоксический эффект у\nвзрослых проявляется при приеме 10 г и более. \n"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение: \u003c/i\u003eпромывание желудка,\nсолевые слабительные, введение донаторов SH-групп и предшественников синтеза глутатиона -\nметионина через 8-9 ч после передозировки и \nN-ацетилцистеина - через 12 ч. Необходимость в проведении\nдополнительных терапевтических\nмероприятий (дальнейшее введение метионина, внутривенное введение N-ацетилцистеина) определяется в зависимости\nот концентрации парацетамола в крови, а \nтакже от времени, прошедшего после его приема. При тяжелом повреждении\nцентральной нервной системы может\nпонадобиться искусственная вентиляция легких, \nкислородотерапия. "}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Дротаверин снижает\nдействие леводопы (могут усиливаться тремор и ригидность). "}},{"type":"paragraph","data":{"text":"При совместном применении парацетамола с хлорамфениколом\nувеличивается период полувыведения\nхлорамфеникола и усиливается его токсичность. \n"}},{"type":"paragraph","data":{"text":"Одновременное применение парацетамола с\nдоксирубицином увеличивает риск развития \nнарушений функции печени. Парацетамол снижает эффект урикозурических\nпрепаратов. Метоклопрамид и домперидон\nусиливают абсорбцию парацетамола, а колестирамин ее уменьшает. Сопутствующее применение\nпарацетамола в высоких дозах повышает эффект \nантикоагулянтных лекарственных средств (снижение синтеза прокоагулянтных\nфакторов "}},{"type":"paragraph","data":{"text":"в печени). Индукторы микросомального окисления в\nпечени (фенитоин, барбитураты, \nрифампицин, фенилбутазон, трициклические антидепрессанты), этанол и\nгепатотоксичес кие лекарственные средства увеличивают продукцию гидроксилированных\nактивных метаболитов, что обусловливает\nвозможность развития тяжелых интоксикаций даже при небольшой передозировке. Длительное\nиспользование барбитуратов снижает \nэффективность парацетамола, Этанол способствует развитию острого\nпанкреатита. Ингибиторы микросомального\nокисления (в т.ч. циметидин) снижают риск \nгепатотоксического действия. Длительное, совместное использование\nпарацетамола и других неспецифических\nпротивовоспалительных препаратов повышает риск развития \"анальгетической\" нефропатии и\nпочечного папиллярного некроза, наступления \nтерминальной стадии почечной недостаточности. Одновременное длительное\nназначение парацетамола в высоких дозах\nи салицилатов повышает риск развития рака почки или мочевого пузыря. Дифлунисал\nповышает плазменную концентрацию парацетамола на 50% - риск развития гепатотоксичности.\nМиелотоксические лекарственные средства \nусиливают проявления гематотоксичности парацетамола. "}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Риск развития повреждений печени возрастает у\nбольных алкогольным гепатозом. При \nпочечной и печеночной недостаточности легкой и средней степени тяжести\nдоза должна устанавливаться\nиндивидуально. При применении препарата свыше 3 дней и/или высоких доз необходим контроль картины периферической\nкрови (числа лейкоцитов, тромбоцитов) и\nфункционального состояния печени (активности «печеночных» ферментов). Клинические и лабораторные симптомы\nгепатотоксического действия начинают \nпроявляться в течение 48-72 ч после приема больших доз препарата. В\nпериод лечения необходимо воздерживаться\nот вождения автотранспорта и занятий другими потенциально опасными видами\nдеятельности, требующими повышенной концентрации внимания и быстроты\nпсихомоторных реакций. "}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки, 40 мг + 500 мг. По 6 таблеток в\nблистер Алю/Алю. По 1, 2 или 4 блистера \nвместе с инструкцией по применению в картонной пачке. "}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в оригинальной упаковке (блистер в пачке) при температуре\nне выше 25°C. Хранить в недоступном для\nдетей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года."}},{"type":"paragraph","data":{"text":"Не использовать после истечения срока годности, указанного на упаковке. "}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"без рецепта."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ХИНОИН Завод Фармацевтических и Химических Продуктов ЗАО ул. Леваи, 5, 2112 Верешедьхаз, Венгрия. "}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"125009, Москва, ул.\nТверская, 22. "}},{"type":"paragraph","data":{"text":"Телефон: (495)\n721-14-00. "}},{"type":"paragraph","data":{"text":"Факс (495) 721-14-11. "}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаКомбинированный препарат, действие которого обусловлено входящим в его состав компонентами. Дротаверин – производное изохинолина, обладающее спазмолитическим действием в отношении гладкой мускулатуры (ингибирование фермента фосфодиэстеразы IV, увеличение концентрации цАМФ, который, инактивируя фермент миозинкиназу, приводит к расслаблению гладкой мускулатуры). Дротаверин также обладает слабым ингибирующим действием на кальмодулин-зависимые кальцевые каналы. Независимо от типа вегетативной иннервации, дротаверин эффективен при спазмах гладкой мускулатуры. Он действует на гладкие мышцы, находящиеся в сосудистой, желудочно кишечной, желчевыводящей и урогенитальной системах (содержание фосфодиэстеразы IV в различных тканях различно). Парацетамол оказывает анальгетическое и жаропонижающее действие преимущественно путем ингибирования синтеза простагландинов в центральной нервной системе. В воспаленных тканях клеточные пероксидазы нейтрализуют действие парацетамола, что объясняет практически полное отсутствие противовоспалительного эффекта. Отсутствие блокирующего влияния на синтез Pg в периферических тканях обуславливает отсутствие у парацетамола отрицательного влияния на водно-солевой обмен (задержка натрия и воды) и слизистую оболочку желудочно-кишечного тракта.ФармакокинетикаПарацетамол быстро всасывается в желудочно-кишечном тракте и распределяется в большенство органов и тканей. Абсорбция – высокая, время достижения максимальной концентрации достигается через 0.5-2 ч; максимальная концентрация – 5-20 мкг/мл. Связь с белками плазмы – 15%. Проникает через гематоэнцефалический барьер. Менее 1% от принятой кормящей матерью дозы парацетамола проникает в грудное молоко. Метаболизируется в печени (90-95%): 80% вступает в реакции конъюгации с глюкуроновой кислотой и сульфатами м образованием неактивных метаболитов. При недостатке глутатиона эти метаболиты могут блокировать ферментные системы гепатоцитов и вызывать их некроз. В метаболизме препарата также участвует изофермент CYP2E1. Период полувыведения – 1-4 ч. Выводится почками в виде метаболитов, преимущественно конъюгатов, только 3% - в неизменном виде. У пожилых больных снижается клиренс препарата и увеличивается период полувыведения. Дротаверин при приеме внутрь быстро и практически полностью всасывается, абсорбция – высокая, период полуабсорбции – 12 мин. Биодоступность – 100%. Равномерно распределяется в тканях, проникает в гладкомышечные клетки. Время достижения максимальной концентрации – 2 ч. Связь с белками плазмы составляет 95-98%. Период полувыведения – 1-4 ч. В основном выводится почками, в меньшей степени – с желчью. Не проникает через гематоэнцефалический барьер.","substance":[{"id":135,"title":"Дротаверин","title_latin":"Drotaverinum","slug":"drotaverin_135"},{"id":605,"title":"Парацетамол","title_latin":"Paracetamolum","slug":"paratsetamol_605"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":true,"comments":null,"image_alt":"Но-шпа Дуо - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/72671/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/72671/share_default/"}},"diseases":[],"other_packages":[],"other_product_forms":[],"related_products":{"title":"Похожие товары","type":"similar","products":[{"id":152053,"title":"ТераФлю","subtitle":{"full":"Порошок, пакеты, 10 шт, для раствора для приема внутрь, лимон","short":"Порошок, 10 шт","package":"10 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