Tablets "Flamidez ^® " are applied at the following indications: an acute pain (a miositis, myalgia, head, tooth, a radicular syndrome), at rheumatic defeat of soft tissues, a pseudorheumatism, an ankylosing spondylitis, an osteoarthrosis, a spondylarthritis, bad attacks of gout, primary dysmenorrhea, an adnexitis, a pharyngotonsillitis, otitis.

Structure

One tablet, coated, contains (active ingredients): paracetamol of 500 mg, diclofenac of potassium of 50 mg, a serratiopeptidaza in the form of granules with a kishechnorastvorimy covering which contain 15 mg of a serratiopeptidaza that is equivalent to fermental activity of 30000 PIECES on one tablet.

Excipients: microcrystalline cellulose; corn starch; povidone (K-30); lactose, monohydrate; gipromelloza; polyethyleneglycols (PEG 6000); titan dioxide (E 171); talc; polysorbates (80); tartrazine (E 102); opadray white 58901 (gipromelloza; lactose, monohydrate; titan dioxide (E 171); polyethyleneglycol; talc).

Excipients of granules of a serratiopeptidaza: sodium of a kroskarmelloz, magnesium stearate, silicon dioxide colloidal waterless, cellulose microcrystalline.

Contraindication

• hypersensitivity to medicine components;
• Quincke's disease;
to
• it is contraindicated to patients who in response to use of acetylsalicylic acid or other non-steroidal anti-inflammatory medicaments (NPVS) have attacks of bronchial asthma ("aspirinovy asthma"), urticaria or sharp rhinitis;
• stagnant heart failure (NYHA II-IV);
• coronary heart disease at patients with stenocardia, the postponed myocardial infarction;
• cerebrovascular diseases at patients who had a stroke or have episodes of the passing ischemic attacks;
• a disease of peripheral arteries;
• treatment of perioperatsionny pain at coronary shunting (or uses of the cardiopulmonary bypass);
• high risk of developing postoperative bleedings, fibrillation, violations of a hemostasis, hemopoietic violations or cerebrovascular bleedings;
• bleeding or the perforation digestive tract in the anamnesis connected with the previous treatment by non-steroidal anti-inflammatory medicaments (NPVS);
• an active form of a peptic ulcer / bleeding or a recurrent peptic ulcer / bleeding in the anamnesis (two or more separate episodes of the established ulcer or bleeding);
• inflammatory bowel diseases (Crohn's disease or ulcer colitis);
• heavy liver failure;
• heavy renal failure;
• a disease of blood;
• leukopenia;
• expressed anemia;
• congenital hyperbilirubinemia;
• deficiency glyukozo-6-fosfatdegidrogenazy;
• alcoholism.

Route of administration

If established intolerance of some sugars, it is necessary to consult with the doctor before taking this drug.

should use Drug in the most effective doses during the short span, considering problems of treatment at each certain patient.

Dose is defined by the doctor for each patient individually, depending on age, character and a course of the disease, shipping and medical efficiency of medicine.

Drug is taken inside after a meal, washing down with a small amount of liquid (200 ml).

Adult: one tablet 2-3 times a day depending on weight of the course of the disease.

to Children aged from 14 years: one tablet 1-2 times a day.

Maximum daily dose - 3 tablets.

Duration of treatment is defined by the doctor individually depending on dynamics of symptoms, and makes no more than 5-7 days.

Maximum term of application without consultation of the doctor - 3 days.

Feature of application

Pregnant women

do not use Drug during pregnancy or feeding by a breast.

Children

apply Medicine to children aged from 14 years.

Drivers

Drug "Flamidez ^® " can slow down psychomotor reactions therefore it is necessary to refrain from control of motor transport or work with difficult mechanisms during use of medicine.

Damage of a liver is possible

at adults who accepted 10 g and more paracetamol, and at children who accepted more than 150 mg/kg of body weight. At patients with risk factors (long-term treatment by carbamazepine, phenobarbital, Phenytoinum, Primidonum, rifampicin, a St. John's wort or other medicines which induce liver enzymes; regular use of excessive amounts of ethanol; the glutationovy cachexia (digestive disturbances, the Mucoviscidosis, HIV infection, hunger, a cachexia) can lead application of 5 or more paracetamol to damage of a liver.

overdose Symptoms in the first 24 hours: pallor, nausea, vomiting, anorexia and abdominal pain. Damage of a liver can be shown in 12-48 hours after overdose. There can be violations of metabolism of glucose and a metabolic acidosis. In a serious poisoning the liver failure can progress in encephalopathy, hemorrhages, a hypoglycemia, a coma and a lethal outcome. The acute renal failure with sharp necrosis of tubules can be shown by severe lumbar pain, a hamaturia, a proteinuria and to develop even in the absence of severe damage of a liver. In case of overdose the arterial hypotension, respiratory depression, spasms, gastrointestinal bleedings, sonitus, cardiac arrhythmia and pancreatitis can be also observed.

At prolonged use of medicine in high doses from bodies of blood formation the aplastic anemia, a pancytopenia, the Agranulocytosis, a neutropenia, a leukopenia, thrombocytopenia can develop. At reception of high doses from central nervous system - dizziness, psychomotor initiation and violation of orientation; from an urinary system - nephrotoxicity (renal colic, interstitial nephrite, capillary necrosis).

in case of overdose of diclofenac the arterial hypotension, respiratory depression, spasms, a renal failure, diarrhea, gastrointestinal bleedings, dizziness, a ring in ears can arise.

emergency medical service is necessary for

At overdose. The patient should be taken immediately to hospital even if there are no early symptoms of overdose. Symptoms can be limited to nausea and vomiting or can not reflect weights of overdose or risk of defeat of bodies. It is necessary to consider treatment by activated carbon if the overdose of paracetamol was accepted within the 1st hour. Concentration of paracetamol should be measured in blood plasma in 4 hours or later after reception (earlier concentration are not reliable). Treatment by N-Acetylcysteinum can be performed within 24 hours after intake of paracetamol, but the maximum protective effect occurs at its application within 8 hours after reception. The efficiency of antidote sharply decreases after this time. If necessary the patient intravenously should enter N-Acetylcysteinum, according to the established list of doses. In the absence of vomiting it is possible to apply methionine inside as the corresponding alternative in the remote areas out of hospital.

Supporting measures and symptomatic treatment are necessary for

for elimination of such complications as hypotension, a renal failure, spasms, gastrointestinal violations and respiratory depression.

Artificial diuresis, dialysis or hemoperfusion, cannot guarantee a conclusion of non-steroidal anti-inflammatory medicaments owing to their high linking with proteins of blood plasma and intensive metabolism.

Side effects

from the system of blood and lymphatic system: thrombocytopenia, a neutropenia, a leukopenia, anemia (including hemolytic and aplastic anemia (especially for patients with deficiency glyukozo-6-fosfatdegidrogenazy)), the Agranulocytosis, a pancytopenia, a sulfhemoglobinemia, a methemoglobinemia (cyanosis, short wind, heartaches).

from the immune system: reactions of hypersensitivity, including a skin itch, rash on skin and mucous membranes, anaphylactic/anaphylactoid reactions (including hypotension and an acute anaphylaxis), a Quincke's disease (including a face edema).

Mental disorders: disorientation, depression, sleep disorders, insomnia, nightmares, irritability, concern, sensation of fear, mental disorders, confusion of consciousness, psychomotor excitement, hallucinations.

from nervous system: headache, dizziness, drowsiness, paresthesia, violations of memory, spasm, uneasiness, tremor, aseptic meningitis, frustration of sense of taste, violations of cerebral circulation, violations of sensitivity.

from an organ of sight: disorder of vision, misting of sight, diplopia, optic neuritis.

from organs of hearing and a labyrinth of an ear: vertigo; a ring in ears, a hearing disorder.

Cardial violations: heartbeat strengthening, tachycardia, pain in heart, short wind, heart failure, a myocardial infarction.

Given clinical trials and epidemiological data confirm the increased risk of trombotichesky complications (for example a myocardial infarction or a stroke), connected with use of diclofenac, in particular in high therapeutic doses (150 mg a day) and at prolonged use.

Vascular frustration: arterial hypertension, arterial hypotension, vasculitis.

from the respiratory system, bodies of a thorax and mediastinum: asthma (including an asthma), a bronchospasm (especially at the patients sensitive to acetylsalicylic acid), a stethalgia, a pneumonitis, expectoration with blood impurity, acute eosinophilic pneumonia.

from digestive tract: nausea, vomiting, diarrhea, dyspepsia, pain in epigastriums, an abdominal pain, a meteorism, gastritis, intestinal bleedings, vomiting with blood impurity, hemorrhagic diarrhea, a melena, ulcer of stomach or intestines (with bleeding or without it, perforation), colitis (including hemorrhagic colitis and exacerbation of ulcer colitis or Crohn's disease), a lock, stomatitis, a glossitis, the pharyngeal frustration similar to a diaphragm of intestinal strictures, pancreatitis.

from digestive system: increase in level of Transaminases, hepatitis, jaundice, abnormal liver function; instant hepatitis, gepatonekroz (at reception of high doses), a liver failure.

from skin and hypodermic cellulose: rash (usually generalized rashes, erythematic, rash on mucous membranes), urticaria, an itch, bullous rashes, eczema, an erythema, an exudative multiformny erythema, Stephens-Johnson's syndrome, a toxic epidermal necrolysis (Lyell's disease), exfoliative dermatitis, loss of hair, reaction of photosensitivity, purple, allergic purple, naggers.

from an urinary system: sharp renal failure, hamaturia, proteinuria, nephrotic syndrome, interstitial nephrite, renal papillary necrosis.

from an endocrine system: a hypoglycemia (to a hypoglycemic coma).

from a reproductive system: impotence.

to Store

in original packing at a temperature not above 30 °C, out of children's reach.

Expiration date - 2.5 years.