Andipal Avexima
Andipal Avexima: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Andipal Avexima
ATX code: N02BB72
Active ingredient: metamizole sodium in combination with psycholeptics
Manufacturer: JSC "Avexima" (Russia); ASFARMA LLC (Russia); LLC "Anzhero-Sudzhensky chemical-pharmaceutical plant"
Description and photo update: 2018-22-10
Prices in pharmacies: from 35 rubles.
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Andipal Avexima is a non-narcotic analgesic and antispasmodic drug.
Release form and composition
Dosage form Andipal Avexim - tablets: beveled and scored, flat-cylindrical, white or white with a slight yellow tinge (10 pcs. In blisters, 1 or 2 packs in a cardboard box; 10 pcs. In blister-free blisters).
Composition for 1 tablet:
- active ingredients: metamizole sodium (analgin) - 250 mg; bendazole (dibazol) - 20 mg; phenobarbital - 20 mg; papaverine hydrochloride - 20 mg;
- auxiliary components: talc, potato starch, calcium stearate, stearic acid.
Pharmacological properties
Pharmacodynamics
According to the instructions, Andipal Avexima is a combined preparation containing active ingredients that have an antispasmodic effect and mutually reinforce the pharmacological action.
Pharmacodynamic characteristics of the active components of the medicinal product:
- metamizole sodium: an analgesic and antipyretic of the pyrazolone group, which has an analgesic, antispasmodic and antipyretic effect. Along with its active metabolite (4N-methylaminoantipyrine), it has both central and peripheral mechanisms of action. Non-selective inhibitor of cyclooxygenase, which reduces the formation of prostaglandins from arachidonic acid;
- bendazole (dibazol): a vasodilator with a vasodilator and spinal cord stimulating effect. Has an antispasmodic effect directly on the smooth muscles of the walls of blood vessels and internal organs, facilitates synaptic transmission in the spinal cord;
- papaverine hydrochloride: an antispasmodic that reduces tone and relaxes the smooth muscles of the walls of blood vessels and internal organs, which has a hypotensive effect;
- phenobarbital: a substance from the group of barbiturates that interacts with the barbiturate site of the benzodiazepine-gamma-aminobutyric acid (GABA) receptor complex. Inhibits the sensory areas of the cerebral cortex, reducing motor activity and inhibiting cerebral functions, including the respiratory center; reduces the tone of smooth muscles of the gastrointestinal tract (gastrointestinal tract). In small doses, it shows a sedative effect and enhances the effectiveness of other components.
Pharmacokinetics
- metamizole sodium: absorbed well and quickly in the gastrointestinal tract, hydrolyzed in the intestinal wall with the formation of an active metabolite; unchanged is absent in the blood (its insignificant concentration can be found in plasma after intravenous administration); the active metabolite binds to proteins by 50-60%; the analgesic is metabolized in the liver, and excreted in the urine by the kidneys; penetrates into breast milk in therapeutic doses;
- bendazole (dibazol): bioavailability ~ 80%; end products of biotransformation - conjugates formed in the process of carboethoxylation and methylation of the imino group of the imidazole ring of bendazole: 1-methyl-2-benzylbenzimidazole and 1-carboethoxy-2-benzylbenzimidazole; metabolites of bendazole are excreted in the urine;
- papaverine hydrochloride: the average bioavailability is ~ 54%, up to 90% of the substance binds to plasma proteins; the antispasmodic is well distributed and penetrates the internal (histohematological) barriers; the substance is metabolized in the liver, excreted in the form of metabolites by the kidneys and is completely excreted from the blood during hemodialysis; T 1/2 (half-life) is from 0.5 to 2 hours, but can be extended to 24 hours;
- phenobarbital: when administered orally, it is absorbed completely, but relatively slowly, the maximum concentration in the blood reaches 1–2 hours after administration; up to 50% of the substance binds to plasma proteins, is evenly distributed in various organs and tissues, but in the brain tissues it is found in a lower concentration. T 1/2 in adult patients is from 2 to 4 days, excreted from the body slowly, which is a prerequisite for cumulation; biotransformed by liver microsomal enzymes, excreted in the form of inactive metabolites by the kidneys, including unchanged from 25 to 50%.
Indications for use
- pain syndrome of mild or moderate severity, as a result of spasms of smooth muscles of internal organs: renal / biliary / intestinal colic; dyskinesia of the bile ducts; algodismenorrhea; PCES (postcholecystectomy syndrome); spasm of the bladder and ureters;
- cerebral vasospasm, migraine;
- pain syndrome after surgery and / or diagnostic procedures (as an adjunct drug).
Contraindications
Absolute:
- oppression of bone marrow hematopoiesis;
- tachyarrhythmias, spontaneous angina pectoris, unstable angina pectoris, stable exertional angina pectoris (III-IV functional class), heart failure in the stage of decompensation, collapse;
- prostate adenoma;
- angle-closure glaucoma;
- megacolon, intestinal obstruction;
- respiratory diseases that cause obstructive syndrome;
- bronchial asthma, provoked by the intake of ASA (acetylsalicylic acid), salicylates, as well as other NSAIDs (non-steroidal anti-inflammatory drugs);
- violation of atrioventricular (AV) conduction;
- diseases accompanied by muscle hypertonicity, myasthenia gravis, convulsive syndrome;
- porphyria (including data in anamnesis);
- severe liver / kidney dysfunction;
- deficiency of G6PD (glucose-6-phosphate dehydrogenase);
- the period of pregnancy and breastfeeding;
- children under 8 years old;
- elderly age;
- alcoholism, drug addiction;
- respiratory depression;
- coma;
- increased individual sensitivity to any component of the drug, as well as to pyrazolone derivatives.
Relative contraindications - Andipal Avexim is prescribed with caution in arterial hypotension, peripheral blood diseases and liver failure.
Instructions for the use of Andipal Avexim: method and dosage
Andipal Avexim tablets are taken orally.
Recommended dosage for children over 8 years old and adult patients: 1 pc. 2-3 times a day, but not more than 5 days.
You cannot take pills for more than 3 days without consulting a doctor.
Side effects
- central nervous system: drowsiness, decreased speed of psychomotor reactions;
- Gastrointestinal tract: nausea, constipation;
- cardiovascular system: arterial hypotension;
- immune system: allergic reactions.
In the case of prolonged use, it is possible to develop leukopenia, agranulocytosis, liver / kidney dysfunction.
Overdose
Symptoms of Andipal Avexim overdose are: dizziness, severe drowsiness, collaptoid state.
To treat the condition, the patient needs to take activated charcoal and rinse the stomach. Then, under medical supervision, measures are taken to maintain the vital functions of the body, relieve symptoms of intoxication and prevent serious complications.
special instructions
The use of Andipal Avexim for more than 7 days requires monitoring the functional state of the liver and the picture of peripheral blood.
If there is no effect of treatment within 3 days, you should stop taking the tablets and consult a doctor.
Influence on the ability to drive vehicles and complex mechanisms
During the period of therapy with Andipal Avexim, it is necessary to refuse to engage in potentially hazardous activities (including driving vehicles) that require speed of psychomotor reactions and increased concentration of attention.
Application during pregnancy and lactation
Data from studies of the effect on the course of pregnancy and the health of the mother and the fetus of the main active ingredient of Andipal Avexim - metamizole sodium (analgin) are limited. It is known that the substance penetrates the placental barrier, but its teratogenic effect was not found in preclinical observations. Despite the weak inhibition of sodium metamizole synthesis of prostaglandins, premature closure of the ductus arteriosus in the fetus and perinatal complications in the mother or newborn caused by impaired platelet aggregation cannot be ruled out. It is prohibited to use the drug during pregnancy.
Since metabolites of metamizole sodium are able to penetrate into breast milk, when taking Andipal Avexim, as well as within 48 hours after taking the last dose, breastfeeding should be abandoned.
Pediatric use
It is prohibited to use the drug for children under 8 years old. Children and adolescents from 8 to 18 years old can take Andipal Avexim only as directed by a doctor, no more than 1 tablet 2-3 times a day.
With impaired renal function
Patients with chronic kidney disease and impaired creatinine clearance require a dose reduction, since such conditions can lead to a decrease in the excretion of metamizole sodium metabolites.
For violations of liver function
The rate of elimination of the drug in patients with impaired liver function decreases, and therefore, repeated administration of high doses should be avoided. For a short course, dose adjustment of Andipal Avexim is not required. There is no experience of long-term use of the drug in this category of patients.
Use in the elderly
Since the elimination of metamizole sodium metabolites can be reduced in elderly patients, a dose reduction of Andipal Avexim is necessary.
Drug interactions
- nitrosorbide, nitroglycerin, sustak and other nitrates; corinfar, nifedipine, and other calcium channel blockers; anaprilin, talinolol, metoprolol and other β-blockers; pentamine and other ganglion blockers; furosemide, hypothiazide and other diuretics; dipyridamole, aminophylline and other myotropic antispasmodics: Andipal Avexima enhances their hypotensive effect;
- other non-narcotic analgesics: mutual intensification of the toxic effect is possible;
- adsorbents, astringents and coating agents: reduce the absorption of Andipal Avexim in the gastrointestinal tract.
Analogs
Analogs of Andipal Avexim are: Antipyrin, Nomigren, Reopirin, Papazol-UBF, Papazol, Urolesan, No-shpalgin, Unispaz, Teodibaverin, etc.
Terms and conditions of storage
Store in a dry place, protected from light, at a temperature not exceeding 25 ° C. Keep out of the reach of children.
The shelf life is 2.5 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Andipal Avexim
There are not very many reviews about Andipal Avexim, but among them there are practically no negative ones. In only one case, the patient expressed dissatisfaction with the fact that the drug does not stop and does not reduce very high blood pressure, but this may be a consequence of its use not according to indications. All patients who took pills as prescribed by a doctor speak of them as an effective remedy that relieves pain and spasm, well tolerated, with practically no negative side effects, and affordable.
Price for Andipal Avexima in pharmacies
The approximate price of Andipal Avexim is about 40 rubles. for 10 tablets per pack.
Andipal Avexima: prices in online pharmacies
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Drug name Price Pharmacy |
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Andipal Avexima tablets 10 pcs. 35 RUB Buy |
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Andipal Avexima tablets 10 pcs. RUB 48 Buy |
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Andipal Avexima tablets 20 pcs. RUB 69 Buy |
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Andipal Avexima tablets 20 pcs. 79 RUB Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
