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Аскорбиновая кислота — донор электронов (восстановитель и оксидант), и, возможно, все ее биохимические и молекулярные свойства могут быть обусловлены данной функцией."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВсасывание и распределение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Парацетамол быстро и практически полностью всасывается из желудочно-кишечного тракта. Связь с белками плазмы крови является минимальной при применении в терапевтических концентрациях."}},{"type":"paragraph","data":{"text":"Фенилэфрина гидрохлорид неравномерно всасывается из желудочно-кишечного тракта. Данные о распределении фенилэфрина отсутствуют."}},{"type":"paragraph","data":{"text":"Аскорбиновая кислота быстро всасывается из желудочно-кишечного тракта и распределяется по всему организму. Связь с белками плазмы крови составляет 25 %."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Парацетамол метаболизируется преимущественно в печени."}},{"type":"paragraph","data":{"text":"Фенилэфрина гидрохлорид подвергается первичному метаболизму моноаминооксидазами в кишечнике и печени. Таким образом, при пероральном применении биодоступность фенилэфрина снижается."}},{"type":"paragraph","data":{"text":"Данные о метаболизме аскорбиновой кислоты отсутствуют."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Парацетамол выводится почками в виде метаболитов, преимущественно, глюкуронидных и сульфатных конъюгатов, менее 5 % принятой дозы выделяется в неизмененном виде."}},{"type":"paragraph","data":{"text":"Фенилэфрина гидрохлорид выводится почками практически полностью в виде сульфатных конъюгатов."}},{"type":"paragraph","data":{"text":"При применении в дозах, превышающих потребности организма в аскорбиновой кислоте, аскорбиновая кислота выводится почками в виде метаболитов."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Препарат Колдрекс МаксГрипп применяют у взрослых в качестве временного средства для устранения симптомов «простуды» и гриппа, включая:"}},{"type":"list","data":{"style":"ordered","items":["повышенную температуру;","головную боль;","озноб;","боли в суставах и мышцах;","боли в пазухах носа и заложенность носа;","боли в горле."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Препарат Колдрекс МаксГрипп не рекомендуется принимать пациентам при:"}},{"type":"list","data":{"style":"ordered","items":["повышенной чувствительности к парацетамолу, фенилэфрину, аскорбиновой кислоте (витамину С) или любому другому компоненту препарата;","нарушениях функции печени и почек тяжелой степени;","артериальной гипертензии;","гиперфункции щитовидной железы (в т.ч. при тиреотоксикозе);","заболеваниях системы крови;","заболеваниях сердца (при выраженном стенозе устья аорты, остром инфаркте миокарда, тахиаритмии);","гиперплазии предстательной железы;","сахарном диабете и заболеваниях, связанных с наследственным нарушением всасывания сахара (каждый пакетик содержит около 4 г сахарозы);","генетическом отсутствии глюкозо-6-фосфат дегидрогеназы;","дефиците сахаразы/изомальтазы, при редком наследственном нарушении в виде непереносимости фруктозы, глюкозо-галактозной мальабсорбции, т.к. в состав препарата входит сахароза;","закрытоугольной глаукоме;","одновременном приеме трициклических антидепрессантов, бета-адрсноблокаторов, ингибиторов моноаминоксидазы (МАО), в том числе в период до 14 дней после их отмены;","одновременном приеме других парацетамолсодержащих лекарственных средств, деконгестантов, ненаркотических анальгетиков, нестероидных противовоспалительных препаратов, лекарственных препаратов для облегчения симптомов «простуды», гриппа и заложенности носа, препаратов, регулирующих аппетит, амфетаминподобных психостимуляторов, барбитуратов, противоэпилептических препаратов, рифампицина, хлорамфеникола (см. раздел «Взаимодействие с другими лекарственными средствами»);","одновременном приеме этанолсодержащих напитков и лекарственных препаратов;","хроническом алкоголизме;","беременности и в период грудного вскармливания;","возрасте до 18 лет."]}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Если у Вас одно из перечисленных заболеваний / состояний / факторов риска, перед приемом препарата обязательно проконсультируйтесь с врачом:"}},{"type":"list","data":{"style":"ordered","items":["доброкачественные гипербилирубинемии;","нарушения функции печени и почек легкой и средней степени тяжести;","алкогольная болезнь печени;","сердечно-сосудистые заболевания, включая повышенное артериальное давление, облитерирующие заболевания сосудов (синдром Рейно);","феохромоцитома;","наличие тяжелых инфекций, т.к. прием препарата может увеличить риск метаболического ацидоза;","дефицит глутатиона (в частности, у крайне истощенных пациентов, страдающих анорексией, хроническим алкоголизмом или пациентов с низким индексом массы тела);","одновременный прием гипотензивных средств, дигоксина и сердечных гликозидов, алкалоидов спорыньи (например, эрготамина и метисергида)."]}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Адекватные и строго контролируемые исследования применения препарата во время беременности и в период грудного вскармливания не проводились. В исследованиях у животных на поздних сроках беременности фенилэфрин вызывал задержку роста плода и стимулировал раннее начало родов. Фенилэфрин может проникать в грудное молоко. Отсутствуют данные о применении препаратов, содержащих фенилэфрин, в период грудного вскармливания. Применение препарата при беременности и в период грудного вскармливания противопоказано."}},{"type":"paragraph","data":{"text":"При необходимости применения препарата в период лактации грудное вскармливание следует прекратить."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Для приема внутрь."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНе превышайте рекомендованную дозу!\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСледует применять наименьшую дозу, необходимую для достижения эффекта, в течение максимально короткого срока лечения!\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eМинимальный интервал между приемами препарата Колдрекс МаксГрипп должен составлять 4 ч.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Содержимое 1 пакетика высыпать в кружку, налить половину кружки горячей воды и тщательно перемешать. При необходимости добавить холодной воды и сахар."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВзрослые\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"По 1 пакетику каждые 4-6 ч, но не более 4 пакетиков в сутки. Максимальная суточная доза не должна превышать 4 пакетиков. Максимальная длительность применения препарата без консультации с врачом — не более 5 дней."}},{"type":"paragraph","data":{"text":"Не принимать одновременно с другими парацетамолсодержащими средствами, деконгестантами и средствами для облегчения симптомов «простуды» и гриппа, а также с этанолсодержащими средствами и напитками."}},{"type":"paragraph","data":{"text":"Если при приеме препарата симптомы заболевания сохраняются, необходимо обратиться к врачу."}},{"type":"paragraph","data":{"text":"\u003cb\u003eПри превышении рекомендованной дозы препарата незамедлительно обратитесь за медицинской помощью, даже если Вы чувствуете себя хорошо. Передозировка парацетамола может вызвать печеночную и почечную недостаточность.\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eОсобые группы пациентов\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции почек\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Перед применением препарата Колдрекс МаксГрипп пациентам с нарушением функции почек необходимо предварительно проконсультироваться с врачом. Ограничения, связанные с применением препаратов, содержащих такую комбинацию действующих веществ, у пациентов с нарушением функции почек, преимущественно связаны с содержанием парацетамола в лекарственном препарате."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции печени\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Перед применением препарата Колдрекс МаксГрипп пациентам с нарушением функции печени необходимо предварительно проконсультироваться с врачом. Ограничения, связанные с применением препаратов, содержащих данную комбинацию действующих веществ, у пациентов с нарушением функции печени, преимущественно связаны с содержанием парацетамола в лекарственном препарате."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"В рекомендованных дозах препарат обычно хорошо переносится."}},{"type":"paragraph","data":{"text":"Нижеперечисленные нежелательные реакции выявлены спонтанно в ходе пострегистрационного применения препарата."}},{"type":"paragraph","data":{"text":"Нежелательные реакции классифицированы по системам организма и в соответствии с частотой развития. Частота развития нежелательных реакций определяется следующим образом: \u003ci\u003eочень часто\u003c/i\u003e (≥ 1/10), \u003ci\u003eчасто\u003c/i\u003e (≥ 1/100 и <1/10), \u003ci\u003eнечасто\u003c/i\u003e (≥1/1000 и <1/100), редко (≥ 1/10 000 и <1/1000), \u003ci\u003eочень редко\u003c/i\u003e (<10 000), \u003ci\u003eчастота неизвестна\u003c/i\u003e (частота не может быть оценена, исходя из имеющихся данных)."}},{"type":"paragraph","data":{"text":"\u003cb\u003eПарацетамол\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Парацетамол редко оказывает побочное действие."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны крови и лимфатической системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень редко: тромбоцитопения, лейкопения, агранулоцитоз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень редко: анафилактический шок, кожные реакции гиперчувствительности, включая среди прочих, кожную сыпь, крапивницу, ангионевротический отек (отек Квинке), синдром Стивенса-Джонсона, токсический эпидермальный некролиз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны дыхательной системы, органов грудной клетки и средостения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень редко: бронхоспазм у пациентов с повышенной чувствительностью к ацетилсалициловой кислоте и другим нестероидным противовоспалительным препаратам."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны печени и желчевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень редко: нарушения функции печени."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны почек и мочевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При длительном применении препарата в дозах, превышающих рекомендованную, повышается вероятность нефротоксического действия."}},{"type":"paragraph","data":{"text":"\u003cb\u003eФенилэфрин\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Редко: реакции гиперчувствительности, крапивница, аллергический дерматит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения психики\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто: нервозность."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны нервной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто: головная боль, головокружение, бессонница."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны органа зрения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Редко: мидриаз, острый приступ глаукомы, в большинстве случаев у пациентов с закрытоугольной глаукомой."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны сердечно-сосудистой системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто: повышение артериального давления."}},{"type":"paragraph","data":{"text":"Редко: тахикардия, ощущение сердцебиения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто: тошнота, рвота."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны кожи и подкожных тканей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень редко: сыпь."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны почек и мочевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Редко: дизурия, задержка мочеиспускания у пациентов с обструкцией выходного отверстия мочевого пузыря при гипертрофии предстательной железы."}},{"type":"paragraph","data":{"text":"\u003cb\u003eАскорбиновая кислота\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны крови и лимфатической системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна: тромбоцитоз, гиперпротромбинемия, эритропения, нейтрофильный лейкоцитоз, гипокалиемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна: аллергические реакции (кожная сыпь, гиперемия кожи)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна: раздражение слизистой оболочки желудочно-кишечного тракта. При приеме аскорбиновой кислоты более 600 мг/сут возможна умеренная поллакиурия."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПри возникновении любой из перечисленных нежелательных реакций немедленно прекратите прием препарата и как можно скорее обратитесь к врачу.\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Если любые из указанных в инструкции нежелательных реакций усугубляются или Вы заметили другие нежелательные реакции, не указанные в инструкции, сообщите об этом врачу."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003cb\u003eПрепарат следует принимать только в рекомендуемых дозах!\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"При подозрении на передозировку, даже при хорошем самочувствии, необходимо прекратить применение препарата и немедленно обратиться к врачу, т.к. существует риск отсроченного серьезного поражения печени и может потребоваться госпитализация."}},{"type":"paragraph","data":{"text":"Передозировка обусловлена, как правило, парацетамолом."}},{"type":"paragraph","data":{"text":"\u003cb\u003eПарацетамол\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПри передозировке парацетамола возможно развитие печеночной недостаточности, которая может привести к необходимости трансплантации печени или смерти.\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"В течение 24 ч возможны: бледность кожных покровов, снижение аппетита, тошнота, рвота, боль в животе. Клинические признаки поражения печени развиваются, как правило, через 24-48 ч и достигают максимума через 4-6 суток. Могут проявляться признаки нарушения метаболизма глюкозы и метаболического ацидоза. Токсическое действие у взрослых возможно после приема свыше 10г парацетамола. Наблюдался острый панкреатит, обычно с нарушением функции печени и токсическим воздействием на печень. Острая почечная недостаточность с острым некрозом канальцев, которая диагностируется по сильной боли в поясничной области, гематурии и протеинурии, может развиться и без тяжелого нарушения функции печени. Имеются сообщения о случаях аритмии сердца при передозировке парацетамола."}},{"type":"paragraph","data":{"text":"Прием 5г и более парацетамола может привести к поражению печени у пациентов, имеющих следующие факторы риска:"}},{"type":"list","data":{"style":"ordered","items":["продолжительное лечение карбамазепином, фенобарбиталом, фенитоином, примидоном, рифампицином, препаратами зверобоя продырявленного, или другими препаратами, стимулирующими ферменты печени;","регулярное употребление алкоголя в избыточных количествах;","дефицит глутатиона (вследствие нарушения питания, муковисцидоза, ВИЧ- инфекции, голодания, истощения)."]}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПри первых признаках передозировки необходимо срочно обратиться к врачу, даже при отсутствии отчетливых симптомов отравления.\u003c/i\u003e\u003c/b\u003e В ранний период симптоматика может быть ограничена только тошнотой и рвотой и может не отражать степени тяжести передозировки или степени риска поражения внутренних органов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В течение первого часа после предполагаемой передозировки целесообразно назначение активированного угля внутрь. Через четыре или более часов после предполагаемой передозировки необходимо определение концентрации парацетамола в плазме крови (более раннее определение концентрации парацетамола может быть недостоверным). Лечение ацетилцистеином может проводиться вплоть до 24 ч после приема парацетамола, однако максимальный гепатопротекторный эффект может быть получен в первые 8 ч после передозировки. После этого эффективность антидота резко падает. В случае необходимости ацетилцистеин может вводиться внутривенно. При отсутствии рвоты альтернативным вариантом (при отсутствии возможности быстрого получения стационарной помощи) является назначение метионина внутрь. Лечение пациентов с серьезным нарушением функции печени через 24 ч после приема парацетамола должно проводиться совместно со специалистами токсикологического центра или специализированного отделения заболеваний печени."}},{"type":"paragraph","data":{"text":"\u003cb\u003eФенилэфрин\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Симптомы передозировки фенилэфрина сходны с проявлениями побочных эффектов. В дополнение: раздражительность, головная боль, головокружение, бессонница, повышенная возбудимость, повышение артериального давления, тошнота, рвота, рефлекторная брадикардия. В тяжелых случаях передозировки возможно развитие галлюцинаций, спутанности сознания, судорог, аритмии. Следует учитывать, что появление клинически значимых симптомов передозировки фенилэфрина при приеме препарата всегда связано с тяжелым поражением печени на фоне передозировки парацетамола."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Симптоматическая терапия, при тяжелой артериальной гипертензии применение альфа- адреноблокаторов, таких как фентоламин."}},{"type":"paragraph","data":{"text":"\u003cb\u003eАскорбиновая кислота\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Высокие дозы аскорбиновой кислоты (более 3000 мг) могут вызвать временную осмотическую диарею и нарушения работы желудочно-кишечного тракта, такие как тошнота, дискомфорт в области желудка. Следует учитывать, что появление клинически значимых симптомов передозировки аскорбиновой кислоты при приеме препарата всегда связано с тяжелым поражением печени на фоне передозировки парацетамола."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Симптоматическое, форсированный диурез."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Потенциально клинически значимые лекарственные взаимодействия представлены ниже (см. разделы «Противопоказания» и «Особые указания»)."}},{"type":"paragraph","data":{"text":"Парацетамол при регулярном приеме в течение длительного времени усиливает эффект варфарина и других кумаринов, что увеличивает риск кровотечений. Эпизодический прием разовой дозы препарата не оказывает значимого влияния на их действие."}},{"type":"paragraph","data":{"text":"Индукторы ферментов микросомального окисления в печени (барбитураты, дифенин, карбамазепин, рифампицин, зидовудин, фенитоин, этанол, флумецинол, фенилбутазон и трициклические антидепрессанты) повышают риск гепатотоксического действия при передозировках и одновременном приеме с парацетамолом."}},{"type":"paragraph","data":{"text":"Ингибиторы микросомального окисления (циметидин) снижают риск гепатотоксического действия."}},{"type":"paragraph","data":{"text":"Парацетамол снижает эффективность диуретических препаратов."}},{"type":"paragraph","data":{"text":"Метоклопрамид и домперидон увеличивают, а колестирамин снижает скорость всасывания парацетамола."}},{"type":"paragraph","data":{"text":"Парацетамол усиливает эффекты ингибиторов МАО, седативных препаратов, этанола. Одновременный прием препарата парацетамола и алкогольных напитков повышает риск развития поражения печени и острого панкреатита."}},{"type":"paragraph","data":{"text":"Фенилэфрин при приеме с ингибиторами МАО может приводить к повышению артериального давления."}},{"type":"paragraph","data":{"text":"Фенилэфрин может снижать эффективность действия бета-адреноблокаторов и других гипотензивных препаратов (включая такие препараты, как дебризохин, гуанетидин, резерпин, метилдопа), увеличивает риск развития гипертензии и нарушений со стороны сердечно-сосудистой системы."}},{"type":"paragraph","data":{"text":"Трициклические антидепрессанты усиливают симпатомиметическое действие фенилэфрина и могут увеличивать риск развития побочных эффектов со стороны сердечно-сосудистой системы."}},{"type":"paragraph","data":{"text":"Одновременное применение галотана с фенилэфрином повышает риск развития желудочковой аритмии. Фенилэфрин снижает гипотензивное действие гуанетидина, который, в свою очередь, усиливает альфа-адреностимулирующую активность фенилэфрина."}},{"type":"paragraph","data":{"text":"Антидепрессанты, противопаркинсонические средства, антипсихотические средства, фенотиазиновые производные повышают риск развития задержки мочи, сухости во рту, запоров."}},{"type":"paragraph","data":{"text":"Одновременное применение глюкокортикостероидов с фенилэфрином увеличивает риск развития глаукомы."}},{"type":"paragraph","data":{"text":"Одновременное применение дигоксина и других сердечных гликозидов может повышать риск развития нарушения сердечного ритма и сердечного приступа."}},{"type":"paragraph","data":{"text":"Одновременное применение фенилэфрина и алкалоидов спорыньи (например, эрготамин и метисергид) может повышать риск эрготизма."}},{"type":"paragraph","data":{"text":"Одновременное применение фенилэфрина с симпатомиметическими аминами может повышать риск развития побочных эффектов со стороны сердечно-сосудистой системы. Аскорбиновая кислота увеличивает риск развития кристаллурии при лечении салицилатами и сульфаниламидами короткого действия, замедляет выведение почками кислот, увеличивает выведение лекарственных средств, имеющих щелочную реакцию (в т.ч. алкалоидов), снижает концентрацию в крови пероральных контрацептивов. Этанол способствует развитию острого панкреатита."}},{"type":"paragraph","data":{"text":"Миелотоксичные лекарственные средства усиливают проявление гематотоксичности препарата."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Следует проконсультироваться с врачом в случае усугубления симптомов, их сохранения свыше 5 дней или при сопутствующем наличии высокой температуры, кожной сыпи или стойкой головной боли."}},{"type":"paragraph","data":{"text":"Препарат не следует принимать одновременно с другими парацетамолсодержащими препаратами, а также ненаркотическими анальгетиками, НПВС (метамизол натрия, ацетилсалициловая кислота, ибупрофен и т.п.), препаратами для устранения симптомов «простуды» и гриппа, симпатомиметиками (деконгестантами), препаратами, регулирующими аппетит, амфетаминподобными психостимуляторами, барбитуратами, противоэпилептическими лекарственными средствами, рифампицином, хлорамфениколом."}},{"type":"paragraph","data":{"text":"\u003cb\u003eВо избежание токсического поражения печени препарат не следует сочетать с этанолсодержащими препаратами и напитками, а также принимать людям, склонным к хроническому потреблению алкоголя.\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Сопутствующие заболевания печени повышают риск дальнейшего повреждения печени при приеме препарата. При приеме препарата у пациентов с неалкогольным циррозом печени существует высокий риск передозировки."}},{"type":"paragraph","data":{"text":"При проведении анализов на определение мочевой кислоты и уровня глюкозы в крови сообщите врачу о применении препарата Колдрекс МаксГрипп, так как препарат может искажать результаты лабораторных тестов, оценивающих концентрацию глюкозы и мочевой кислоты."}},{"type":"paragraph","data":{"text":"Пациенты с дефицитом глутатиона вследствие расстройства пищевого поведения, цистического фиброза, ВИЧ-инфекции, голодания, истощения, подвержены передозировке, поэтому необходимо соблюдать меры предосторожности и перед приемом препарата рекомендуется проконсультироваться с врачом. Зарегистрированы случаи развития печеночной недостаточности / нарушений функции печени при небольшой передозировке парацетамола (5 г и более) у пациентов с низким уровнем глутатиона, в частности, у крайне истощенных пациентов, страдающих анорексией, хроническим алкоголизмом, пациентов с низким индексом массы тела или сепсисом."}},{"type":"paragraph","data":{"text":"Применение препарата пациентами с низким уровнем глутатиона, например, при сепсисе, может повышать риск развития метаболического ацидоза, сопровождающегося симптомами учащенного, затрудненного дыхания (чувство нехватки воздуха, одышка), тошнотой, рвотой, потерей аппетита. При одновременном проявлении этих симптомов следует немедленно обратиться к врачу."}},{"type":"paragraph","data":{"text":"Перед приемом препарата Колдрекс МаксГрипп необходимо проконсультироваться с врачом, если Вы принимаете:"}},{"type":"list","data":{"style":"ordered","items":["варфарин или другие непрямые антикоагулянты для разжижения крови;","метоклопрамид, домперидон (применяемые для устранения тошноты и рвоты) или колестирамин, используемый для снижения уровня холестерина в крови."]}},{"type":"paragraph","data":{"text":"Каждый пакетик содержит 0,12 г натрия, это следует учитывать пациентам, соблюдающим гипонатриевую диету."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат может вызывать головокружение. При появлении головокружения не рекомендуется управлять транспортными средствами или работать с механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Порошок для приготовления раствора для приема внутрь (лимонный)."}},{"type":"paragraph","data":{"text":"По 6,427 г порошка в многослойные пакетики (бумага/алюминиевая фольга/полиэтилен)."}},{"type":"paragraph","data":{"text":"По 3, 5 или 10 пакетиков вместе с инструкцией по применению помещают в картонную пачку. На вторичной упаковке допускается наличие контроля первого вскрытия."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре не выше 25 °C."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять 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":"\n\nСмитКляйн Бичем С.А., Испания / SmithKline Beecham S.A., Ctra. de Ajalvir, Km. 2,500,"}},{"type":"paragraph","data":{"text":"Alcala de Henares, 28806 Madrid, Spain.\n\n"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"\n\nАО «ГлаксоСмитКляйн Хелскер», Российская Федерация"}},{"type":"paragraph","data":{"text":"123112, г. Москва, Пресненская набережная, д. 10."}},{"type":"paragraph","data":{"text":"Тел. +7 (495) 777 9850;"}},{"type":"paragraph","data":{"text":"факс+7 (495) 777 9851.\n\n"}}]}],"source":null},"description_toggle":false,"short_description":"Комбинированное средство, действие которого обусловлено входящими в его состав компонентами. Парацетамол является обезболивающим и жаропонижающим средством. Механизм его действия предположительно заключается в подавлении синтеза простагландинов, преимущественно в центральной нервной системе. Отсутствие подавления периферического синтеза простагландинов придает препарату значимые фармакологические свойства, такие как сохранение защитных простагландинов в желудочно-кишечном тракте. Данное свойство парацетамола делает препарат особо подходящим пациентам с заболеваниями желудочно-кишечного тракта в анамнезе (например, пациентам с желудочно-кишечными кровотечениями в анамнезе или пациентам пожилого возраста) или пациентам, принимающим сопутствующее медикаментозное лечение, при котором подавление синтеза периферических простагландинов может быть нежелательным. Фенилэфрина гидрохлорид — симпатомиметическое средство, действие которого направлено на стимуляцию адренорецепторов (преимущественно α-адренорецепторов), что приводит к уменьшению отека слизистой оболочки носа и облегчению носового дыхания. Аскорбиновая кислота (витамин С) восполняет повышенную потребность в витамине С при «простудных» заболеваниях и гриппе, особенно на начальных стадиях заболевания, поскольку запасы витамина С при данных состояниях могут истощаться, а аппетит снижается. 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