Citrapac
Citrapak: 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: Citrapak
ATX code: N02BA71
Active ingredient: acetylsalicylic acid + caffeine + paracetamol + ascorbic acid (Acetylsalicylic acid + Caffeine + Paracetamol + Ascorbic acid)
Manufacturer: Pharmstandard-UfaVITA OJSC (Russia)
Description and photo update: 2020-07-04
Citrapac is a combined analgesic drug [non-steroidal anti-inflammatory drug (NSAID) + non-narcotic analgesic drug + psychostimulant drug + vitamin].
Release form and composition
Dosage form - tablets: from light brown to brown, flat-cylindrical, with white or brown inclusions, chamfer and risk, with the smell of cocoa (in a cardboard box, 2 cell contour packages containing 10 tablets each, and instructions for using Citrapak).
Active ingredients in 1 tablet:
- caffeine - 27.45 mg (in terms of caffeine monohydrate - 30 mg);
- ascorbic acid - 50 mg;
- paracetamol - 180 mg;
- acetylsalicylic acid (ASA) - 240 mg.
Auxiliary components: talc, povidone (polyvinylpyrrolidone), calcium stearate, potato starch, citric acid, cocoa bean powder.
Pharmacological properties
Pharmacodynamics
Citrapac is a combination drug containing NSAIDs, a vitamin, an analgesic and a non-narcotic substance. The drug has anti-inflammatory, antipyretic and analgesic properties.
The pharmacological actions of a medicinal product due to its active ingredients include:
- ASA: improving microcirculation in the inflammation focus; moderate inhibition of platelet aggregation and thrombus formation; easing pain (especially caused by the inflammatory process);
- paracetamol: inhibition of prostaglandin synthesis and a predominant effect on the center of thermoregulation in the hypothalamus;
- ascorbic acid: improving the tolerance of paracetamol and lengthening its action (associated with prolonging the half-life); a decrease in the need for folic and pantothenic acid, vitamins B 1, B 2, A and E; decrease in vascular permeability; increasing the body's resistance to infections; regulation of the synthesis of steroid hormones, tissue regeneration, blood clotting, carbohydrate metabolism and redox processes;
- caffeine: increasing mental and physical performance; elimination of drowsiness and fatigue; strengthening the effect of analgesics; stimulation of the psychomotor centers of the brain; analeptic action.
Pharmacokinetics
ASA after oral administration is rapidly and almost completely absorbed from the gastrointestinal tract (GIT). The metabolic process is partly affected during absorption. Bioavailability is approximately 70%, however, due to presystemic hydrolysis in the mucous membranes of the gastrointestinal tract and in the liver with the formation of salicylic acid under the action of enzymes, this indicator is characterized by significant individual variability. The bioavailability of salicylic acid ranges from 80 to 100%. The maximum plasma concentration of ASA after oral administration is reached after 10–20 minutes, salicylic acid - 18–120 minutes.
ASA and salicylic acid bind to plasma proteins to a high degree, and are quickly distributed in the body. The second has a non-linear degree of binding to plasma proteins, depending on the concentration: 400 μg per 1 ml - 75%. It crosses the placental barrier and is excreted in breast milk. It is mainly metabolized in the liver under the influence of enzymes with the formation of metabolites - salicyluric acid, salicylate glucuronide and phenyl salicylate, found in many body fluids and tissues. The metabolism of a substance in women is slower due to the lower activity of enzymes in the blood serum.
ACS, like its metabolites, is predominantly excreted by the kidneys. Its half-life from blood plasma is from 15 to 20 minutes, salicylic acid - from 120 to 180 minutes when taking ASA in low doses, and significantly increases when taking high doses. With normal renal function, 80 to 100% of a single dose of ASA is excreted by the kidneys for 1-3 days.
Paracetamol from the gastrointestinal tract is absorbed quickly and almost completely. The maximum plasma concentration is reached 10-60 minutes after oral administration. It is distributed in most body tissues, penetrates the placental barrier and is found in breast milk. In therapeutic doses, it slightly binds to blood plasma proteins, with an increase in the dose, binding increases. It undergoes primary metabolism in the liver, excreted mainly in the urine in the form of sulfates and glucuronides. Its half-life is 1 to 3 hours.
Ascorbic acid is rapidly and completely absorbed from the gastrointestinal tract. Binds to blood plasma proteins at a level of 25%. It is excreted in the urine as metabolites. In excessive doses, it is excreted in the urine quickly unchanged.
Caffeine entering the digestive tract is rapidly absorbed and distributed throughout the body. Its metabolism is almost entirely carried out in the liver through oxidation and demethylation in the form of metabolites excreted in the urine. The half-life varies from 4 to 9 hours.
Indications for use
Indications for Citrapak are:
- moderate or mild pain syndrome - dysmenorrhea, myalgia, neuralgia, headache / toothache, etc.;
- colds and other infectious and inflammatory diseases (to reduce fever).
Contraindications
Absolute:
- severe liver or kidney dysfunction;
- glaucoma;
- gastrointestinal bleeding;
- peptic ulcer of the stomach and duodenum;
- blood pathologies with a tendency to bleeding and hemorrhage;
- genetic absence of glucose-6-phosphate dehydrogenase;
- bronchial asthma;
- age up to 15 years;
- pregnancy;
- lactation period;
- established hypersensitivity to the components of the drug.
Relative (taking Citrapac requires special care and careful medical supervision):
- impaired renal / liver function;
- combined use with rifampicin, barbiturates, anticonvulsants;
- elderly age.
Citrapak, instructions for use: method and dosage
Citrapac tablets are intended for oral administration.
A single dose (1-2 tablets) should be taken after meals 2-3 times a day.
The maximum dose is 6 tablets per day. It is important to observe a break between doses of 6 hours (at least). Patients with impaired renal / hepatic function should observe a minimum interval between doses of 8 hours.
The duration of taking Citrapac as an antipyretic agent should not exceed 3 days, an anesthetic - 5 days. Other therapy regimens and dosages are determined by the doctor on an individual basis.
Side effects
During therapy with Citrapac, in rare cases, allergic skin reactions (urticaria, itching, rash), pain in the stomach, nausea, dizziness and palpitations develop. Long-term use of high doses of the drug can contribute to impaired liver and kidney function.
It is important to report any adverse events to your doctor.
Overdose
The main symptoms: stomach pain, nausea, sweating, vomiting, tachycardia, pallor of the skin.
Therapy: gastric lavage, the appointment of activated carbon.
If you suspect an overdose of Citrapac, it is important to seek immediate medical attention.
special instructions
Patients with chronic bronchitis, emphysema and bronchial asthma need medical advice regarding drug therapy.
If the manifestations of the disease persist for 5 days or are accompanied by severe fever for more than 3 days, persistent headache or rash, it is important to seek medical help.
The use of Citrapac in combination with other drugs is allowed only in consultation with a doctor.
Influence on the ability to drive vehicles and complex mechanisms
During the period of therapy with Citrapac, it is prohibited to drive vehicles, as well as perform other work related to increased attention, since drowsiness may appear.
Application during pregnancy and lactation
During pregnancy and during breastfeeding, Citrapac tablets are not used according to indications.
Pediatric use
The use of Citrapac in children under 15 years of age for the treatment of acute respiratory diseases caused by viral infections (acute respiratory viral infections, influenza) is contraindicated due to the risk of Reye's syndrome.
With impaired renal function
Renal dysfunction is a relative contraindication to the use of Citrapac, pronounced disorders are absolute.
For violations of liver function
- the use of Citrapac is contraindicated: severe liver dysfunction;
- use requires medical supervision: impaired liver function.
Use in the elderly
In elderly patients, treatment is recommended with caution.
Drug interactions
Combinations of the active substances of the drug with other drugs that are recommended to be taken into account:
- uricosuric drugs: paracetamol reduces their effectiveness;
- rifampicin, carbamazepine, phenytoin, barbiturates, other inducers of microsomal liver enzymes: increase the likelihood of developing the hepatotoxic effect of paracetamol;
- NSAIDs, non-narcotic analgesics, methotrexate, sulfonylurea derivatives, glucocorticosteroids, substances that reduce platelet aggregation and blood coagulation: Citrapac enhances the action of these drugs and their undesirable effects.
The drug should not be taken together with alcoholic beverages, rifampicin, anticonvulsants, and barbiturates.
Analogs
The analogues of Citrapac are: Citramarine, Parkocet, Excedrin, Citrapar, Citramon P Forte, Finrexin S-300, Migrenol Extra, Acifein, Askofen-P, Aquatsitramon, etc.
Terms and conditions of storage
Store at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews of Citrapak
Patients leave mostly positive reviews about Citrapac. The advantages most often include the budgetary cost of the drug, high efficiency and rapid development of therapeutic action.
The most significant drawbacks are considered negative side reactions and the presence of contraindications to its use, including for the treatment of viral infections in children under 15 years of age.
Price for Citrapac in pharmacies
The approximate price for Citrapak (20 tablets in a package) is 35 rubles.
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!
