Combined product has analgesic, nandrolone phenylpropionate dosage anti-inflammatory and antispasmodic action. It suppresses the synthesis of prostaglandins (Pg). The product contains a nonsteroidal anti-inflammatory drug ibuprofen, myotropic antispasmodic pitofenone hydrochloride and m-anticholinergic agent of the central and peripheral actions fenpiveriniya bromide.
Ibuprofen is a phenylpropionic acid derivative. It has analgesic, anti-inflammatory and antipyretic activity. The main mechanism of action – inhibition of prostaglandin biosynthesis – modulators of pain sensitivity and thermoregulation inflammation in the central nervous system and peripheral tissues. In women with primary dysmenorrhea reduces the elevated levels of prostaglandins in the myometrium, thereby reducing the intrauterine pressure and the frequency of uterine contractions.
Pitofenone hydrochloride , like papaverine, has a direct effect on myotropic smooth muscles of internal organs and causes it to relax.
Fenpiveriniya bromide by m-anticholinergic action exerts additional relaxing effect on smooth muscle.
The combination of the three components of the drug leads to mutual reinforcement of their pharmacological action.
Novigan drug well absorbed in the gastrointestinal tract. The peak plasma concentration is reached approximately 1-2 hours after ingestion. The main component of the drug ibuprofen, 99% bound to plasma proteins, may accumulate in the synovial fluid, it is metabolized in liver and excreted 90% in urine as metabolites and conjugates. A small portion of the drug is excreted in the bile. The half-life of plasma is 2 hour.
Indications for use
– Mild to moderate pain with spasms of smooth muscles of internal organs: renal and biliary colic, biliary dyskinesia, intestinal colic.
– Gynecological diseases: dysmenorrhea.
– Headache, including migraine character.
– Short-term symptomatic treatment of joint pains, neuralgia, sciatica, myalgia.
Precautions for use
Advanced age, congestive heart failure, cerebrovascular disease, hypertension, coronary heart disease, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, nephrotic syndrome, creatinine clearance less than 30-60 mL / min, hyperbilirubinemia, gastric ulcer and duodenal ulcer ( history), an infection of Helicobacter pylori , gastritis, enteritis, colitis, prolonged use of NSAIDs, blood disease of unknown etiology (leukopenia, anemia), smoking, frequent use of alcohol (alcoholism), severe somatic diseases, concomitant therapy following medications: anticoagulants (eg warfarin), antiplatelet agents (for example, acetylsalicylic acid, clopidogrel), oral steroids (e.g., prednisone), selective serotonin reuptake inhibitor (such as citalopram, fluoxetine, paroxetine, sertraline).
Dosing and dosing regimen
Inside for 1 hour before or three hours after a meal. In order to avoid irritating the stomach, you can take the medication immediately after a meal or drink milk.
In the absence of specific instructions, the doctor advised to take spastic pains on 1 tablet up to 3 times a day. The maximum daily dose – 3 tablets. Do not exceed this dose!
The course of treatment , without consulting a doctor, should not exceed 5 days. Longer use is possible under the supervision of a physician with the control of peripheral blood and functional state of the liver.
Overdose symptoms, relief measures in overdose
Do not exceed this dose. If you exceed the dose, call your doctor or the nearest medical facility. Bring a package product.
Symptoms : abdominal pain, nausea, vomiting, lethargy, sleepiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, decreased blood pressure, bradycardia, tachycardia, atrial fibrillation, respiratory arrest.
Treatment : gastric lavage (only for an hour after ingestion), activated carbon, alkaline water, forced diuresis, symptomatic therapy (correction of acid-base status, blood pressure). No specific antidote.
Possible side effects when using the drug
At recommended doses, the drug nandrolone phenylpropionate dosagedoes not cause side effects.
From the gastrointestinal tract : NSAID gastropathy (abdominal pain, nausea, vomiting, heartburn, loss of appetite, diarrhea, flatulence, constipation, ulceration of the mucous membrane of the gastrointestinal tract, which, in some cases, complicated by perforation and bleeding, irritation or dry mucous membranes of the mouth, pain in the mouth, ulceration of the mucous membrane of the gums, aphthous stomatitis, pancreatitis.
On the part of the hepatobiliary system : hepatitis.
The respiratory system : dyspnea, bronchospasm.
From the senses : hearing loss: hearing loss, ringing or noise in the ears; impaired vision: toxic damage of the optic nerve, blurred vision, scotoma, dryness and irritation of the eyes, swelling of the conjunctiva and eyelids (allergic genesis), paresis of accommodation.
On the part of the central and peripheral nervous system : headache, dizziness, insomnia, anxiety, nervousness and irritability, agitation, drowsiness, depression, confusion, hallucinations, aseptic meningitis (usually in patients with autoimmune diseases).
Cardio-vascular system : congestive heart failure, tachycardia, increased blood pressure.
From the urinary system : acute renal failure, allergic nephritis, nephrotic syndrome (edema), oliguria, anuria, polyuria, proteinuria, cystitis, urine staining in red.
Allergic reactions : skin rash (usually erythematous or urticaria), itching, angioedema, anaphylactoid reactions, anaphylactic shock, bronchospasm or dyspnoea, fever, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome ), eosinophilia, allergic rhinitis.
From the side of blood : anemia (including hemolytic, aplastic), thrombocytopenia and thrombocytopenic purpura, agranulocytosis, leukopenia.
Other : increased or decreased sweating.
From the laboratory parameters: bleeding time (can be increased), the glucose concentration in the serum (may be reduced), creatinine clearance (may decrease), hematocrit or hemoglobin (may be reduced), serum creatinine concentration (can be increased), the activity of “liver” transaminases ( can be increased).
If the drug caused a change in your normal state, stop taking it and contact your doctor immediately.
Interaction with other drugs and (or) food
At therapeutic doses, the drug Novigan Ò does not enter into meaningful interactions with commonly used medications.
Inducers of enzymes of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, flumetsinol, rifampin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, increasing the risk of severe intoxication.
Inhibitors of microsomal oxidation reduce the risk of hepatotoxicity.
Reduces hypotensive activity vasodilator and natriuretic effect of furosemide and hydrochlorothiazide.
Reduces the effectiveness of uricosuric drugs. It enhances the effect of anticoagulants, antiplatelet agents, fibrinolytic (which increases the risk of bleeding).
Increases side effects mineralokortikosteroidov, glucocorticoids (increased risk of gastrointestinal bleeding), estrogens, ethanol; It enhances the hypoglycemic effect of sulfonylureas.
Antacids and cholestyramine reduce the absorption of ibuprofen.
It increases the blood concentration of digoxin, drugs lithium and methotrexate.
It enhances the effect of M-anticholinergics, the H1-histamine blockers, butyrophenones phenothiazines, amantadine and quinidine.
Co-administration of other NSAIDs increases the incidence of side effects.
Caffeine increases the analgesic (anesthetic) effect.
When concomitant administration of anti-inflammatory and reduces the antiplatelet effect of acetylsalicylic acid (may increase the incidence of acute coronary insufficiency in patients receiving antiplatelet agents as low-dose acetylsalicylic acid, after starting the drug Novigan Ò ).
Cefamandole, ceftazidime, tsefotetan, valproic acid, plikamitsin increase the incidence of gipoprotrombinemii while the appointment.
Myelotoxic drugs increase the expression gematotoksichnosti drug.
Cyclosporine and gold preparations boost the effect of ibuprofen on prostaglandin synthesis in the nandrolone phenylpropionate dosage kidneys, which is manifested by increased nephrotoxicity. Ibuprofen increases the plasma concentration of cyclosporin and the likelihood of its hepatotoxic effects.
Drugs that block tubular secretion, reduce excretion and increase plasma concentration of ibuprofen.
With prolonged use is necessary to monitor patterns of peripheral blood and functional state of the liver and kidneys.
To reduce the risk of adverse effects from the gastrointestinal tract should use the minimum effective dose. When symptoms of gastropathy shows careful control, including holding esophagogastroduodenoscopy, blood analysis with determination of hemoglobin and hematocrit, fecal occult blood.
If necessary, the definition of 17-keto steroids, the drug should be discontinued 48 hours prior to the study.
During the period of treatment should refrain from drinking alcohol.
Effects on ability to drive vehicles, machinery
During treatment, the patient should refrain from activities potentially hazardous activities that require high concentration and speed of psychomotor reactions tritren