Ambene: why the combined drug is more effective for severe pain

Diseases of the musculoskeletal and peripheral nervous system are often accompanied by inflammation, fever, severe pain, loss of proper functionality and gradual loss of mobility. The drug Ambene is an ambulance for patients with such diseases. It is distinguished from other potent painkillers by its rapid, pronounced effect and the absence of a huge number of side effects. Available in ampoule form or in ready-made syringes intended for intramuscular injection. The instructions for the drug will tell you how Ambene works, what the therapeutic effect is based on and the rules for taking it.

Ambene drug in ampoules

Release form and composition

Ambien is produced in the form of a solution for intravenous (i.v.) and intramuscular (i.m.) administration/solution for i.v. administration: transparent colorless liquid [5 ml in an ampoule, in a blister pack (pallet) 5 ampoules, in a cardboard a pack of 2 contour packages (pallets) complete with or without an ampoule knife].

Composition of 1 ml solution:

• active ingredient: aminomethylbenzoic acid (Amben) – 10 mg;
• additional components: water for injection, sodium chloride.

Analogs

Ambien has no substitutes. Modern pharmacology does not produce drugs with identical composition. You can get as close as possible to a therapeutic effect similar to Ambene only by using several drugs.

Usually replace Ambene with one or more products from this list:

• Milgamma (manufactured in Germany) - includes B vitamins in combination with lidocaine;
• Movalis (manufactured in Spain) - injections containing the NSAID Meloxicam;
• Lidocaine (manufacturer Belarus) - anesthetic;
• Neurobion (manufactured in Germany) - contains B vitamins;
• Dexamethasone (manufactured in Slovenia) is a hormonal drug, a synthetic corticosteroid with an anti-inflammatory effect.

Pharmacological properties

Pharmacodynamics

Ambien is an inhibitor of fibrinolysis (the process of dissolving blood clots and blood clots), a synthetic analogue of lysine, with established effectiveness in the treatment of bleeding of various origins. The action of the active substance is similar to that of epsilon-aminocaproic acid, but Ambien demonstrates a much stronger effect. The specific hemostatic effect of the substance in bleeding caused by an increase in fibrinolytic activity is associated with blocking plasminogen activators and partial inhibition of the effect of plasmin.

Ambien suppresses fibrinolysis by competitively saturating lysine-binding receptors that ensure the connection of plasminogen (plasmin) with fibrinogen (fibrin). The drug also inhibits biogenic polypeptides-kinins.

Pharmacokinetics

Ambien increases the detoxifying effect of the liver and helps suppress antibody formation. When administered parenterally, the drug immediately reaches its maximum concentration in the blood and maintains this level for three hours. The drug is excreted from the body by the kidneys, unchanged - up to 60–80%. If the excretory function of the kidneys is impaired, the concentration of the active substance in the blood increases significantly.

Interaction

When used simultaneously with other anti-inflammatory drugs and drugs containing ethyl alcohol, the risk of bleeding from the gastrointestinal tract increases; with oral antidiabetic drugs (sulfonylurea derivatives) or insulin, hyper- or hypoglycemia is possible, with cardiac glycosides - slowing or accelerating the digitalization of patients, with diuretics - a decrease in diuresis and natriuresis with the development of hypo- or hyperkalemia. Weakens the effect of antihypertensive drugs, hormonal contraceptives, sulfinpyrazone and probenecid. Increases the toxicity of methotrexate. Anabolic steroids and methylphenidate enhance the effect; barbiturates, promethazine, rifampicin, hydantoin - weaken.

Indications for use

• conditions against which systemic hyperfibrinolysis occurs (including overdose of plasminogen activators: urokinase, streptokinase, etc.);
• violations of the platelet, procoagulant or vascular components of hemostasis (with a decrease in the ability to form a hemostatic thrombus);
• localized hemorrhages resulting from increased local fibrinolytic activity (during operations on the prostate, bladder, menorrhagia, after tonsillectomy);
• surgical operations and various pathological processes accompanied by an increase in fibrinolytic activity of the blood; operations on the brain (including for subarachnoid hemorrhages), operations on the heart, blood vessels, lungs, pancreas and thyroid glands; uterine bleeding, premature detachment of a normally located placenta, prolonged retention of a dead fetus in the uterine cavity; acute pancreatitis, liver disease; gastrointestinal, nosebleeds; condition after dental interventions;
• secondary hypofibrinogenemia with massive transfusions of canned blood (for prophylactic purposes).

How does Ambene work?

Due to the complex combined composition of Ambien and the ability of the active components to enhance the therapeutic effect of each other, it is considered a highly effective medicine with cumulative action. The result is achieved in much smaller doses than would be required when using individual medications - single drugs. Introduced into the body according to the instructions, the drug easily enters the systemic bloodstream. Ambene begins to act immediately - the therapeutic effect is achieved quickly, and due to the slow metabolism of the drug, it lasts for a long time. The long half-life is explained by the ability of phenylbutazone to bind to plasma proteins by more than 95%. The main mechanisms of action of Ambene include:

• reduction in the synthesis of prostaglandins by phenylbutazone and sodium acetate salicylamide due to inhibition of the activity of tissue enzyme COX types 1 and 2, which incl. helps restore normal activity of neurons in the thermoregulation center. As a result, the drug prevents the development of the inflammatory process, reduces pain and fever in febrile patients. Phenylbutazone is also capable of increasing the excretion of potassium and sodium salts precipitated in the urine, which leads to a decrease in the concentration of uric acid in the blood;
• the ability of dexamethasone to react with a receptor protein on the cell membrane and penetrating into the nucleus, affecting transcription and the formation of ribonucleic acid involved in protein biosynthesis. By reducing the level of proteins involved in inflammation, acute pain and high fever disappear for a long time, and all phases of the chronic inflammatory process are suppressed. Glucocorticoid hormone also has a positive effect on the central nervous system, the processes of development and metabolism of bone tissue;
• the active participation of cyanocobalamin in ensuring the vital activity of spinal cells, the formation of the myelin sheath, which covers all nerve fibers and helps transmit signals to the nerves. Thus, the drug prevents the development or progression of degenerative processes in tissues;
• long-lasting and strong (2-6 times stronger than Novocaine) anesthetic effect of Lidocaine. This is achieved by blocking sodium channels in the nerve fibers and endings, and, consequently, stopping the transmission of nerve impulses and loss of pain sensitivity.

Excipients are excreted slowly - they completely leave the body only after 7-8 hours. The instructions for Ambien say that this happens naturally - renal and intestinal excretion predominates: with feces, urine. Some components are able to pass through the placenta and enter breast milk - if a course of treatment with Ambene is necessary, breastfeeding is prohibited.

Contraindications

• predisposition to thrombosis and thromboembolic lesions;
• hypercoagulable phase of DIC syndrome (disseminated intravascular coagulation);
• severe forms of coronary heart disease (CHD) and cerebral ischemia;
• vitreous hemorrhage;
• kidney diseases leading to impaired kidney function;
• hypersensitivity to the components of the product.

Ambien injections should be prescribed with extreme caution in the presence of cerebral circulatory disorders.

Instructions for use of Ambien: method and dosage

Ambien is administered in doses of 50–100 mg (1–2 ampoules of 1% solution) intravenously or intramuscularly. If necessary, injections can be performed multiple times at intervals of at least 4 hours. Against the background of acute fibrinolysis, it is additionally recommended to administer fibrinogen in an average dose of 2–4 thousand mg, but not more than 8 thousand mg, under the control of fibrinolytic activity and the level of fibrinogen concentration in the blood.

The maximum single dose of Ambien should not exceed 100 mg (2 ampoules). The daily dose and duration of therapy are determined depending on the course of the disease.

Reviews about the medicine

Reviews for the drug are very mixed. Those who managed to get the product in Russia or Ukraine note that Ambene is really good at relieving inflammation and restoring joint mobility.

But since all people are different and the clinical picture is different for everyone, the effectiveness of the medicine is not confirmed.

, a large number of contraindications and side effects of the drug are also negative . Many are also frightened by the rather “killer” composition of the medication; patients do not dare to undergo a course of treatment due to fear of hormones.

Those who finally decided to undergo treatment with Ambene claim that it was this medicine that saved them from endless problems with the spine and helped them forget about pain.

Patients are advised to consult with a doctor and undergo tests before using this medicine, since ampoules are expensive, it is difficult to get them from us, and it will be very disappointing if you are intolerant to one or more components of the composition.

Important! If you have experience using Ambene injections, we ask you to share it in the comments, as this will greatly help site visitors decide or not decide on treatment with this drug.

Side effects

• cardiovascular system: increase/decrease in blood pressure, tachycardia;
• digestive system: diarrhea, vomiting;
• local reactions: thrombophlebitis at the injection site;
• others: allergic reactions, catarrhal phenomena of the upper respiratory tract, renal colic.

In some cases, during treatment with the drug, orthostatic hypotension, dizziness, and convulsions may occur. If these disorders occur, it is necessary to reduce the dose or stop administering Ambien.

Reception

Only a doctor prescribes injections. After examining the patient, he will select the frequency of taking Ambene and the dosage. The type of disease, the severity of the condition, the severity of symptoms and the individual characteristics of the patient are taken into account. To cause the desired therapeutic effect, when taking it, it is important to follow the instructions and strictly follow the established rules. It is better if the injections are given by a highly qualified medical professional. If this is not possible, and you have to give injections yourself, at home, then the instructions will help. The admission rules and algorithm of actions are as follows:

• Check the tightness of the packaging and the expiration date of the medicine; store it in the refrigerator before use.
• It is important that the temperature of the injected liquid corresponds to body temperature - immediately before the injection, the medicine can be heated or the ampoules can be rubbed in the palms of your hands.
• Remove the protective cap, insert a sterile needle and prepare the solution correctly - draw it into the syringe first from the ampoule marked A, then B, or mix the contents of the two chambers by moving the piston in the direction of the needle.
• Place the syringe in a sterile tray and treat the injection area with an antiseptic.
• Provide the patient with a horizontal position during the procedure, without sudden movements.
• Inject intramuscularly, preferably into the buttock, very slowly and deeply (always in different places) to avoid thickening of the skin and the formation of edema.

Because The medication contains potent substances - Ambien injections are prescribed to relieve exacerbation: inflammation, fever, acute pain syndrome in various neurological diseases, joint diseases, injuries, degenerative-dystrophic changes. To avoid negative reactions and overdose, long-term therapy should be carried out under constant medical supervision, monitoring peripheral blood parameters, kidney and liver tests. Scheme of medication use:

• the full course is limited to 3 injections per week - sequentially (daily without a break) or every other day;
• exceeding the indicated dosage of Ambene is unacceptable; if there is no therapeutic effect, it is recommended to change the drug;
• repeated treatment course in agreement with the attending physician, with an interval of at least 2-3 weeks;
• for elderly, senile patients or those with weakened immune systems, only the minimum dosage is permissible;
• When treating, especially osteochondrosis, it is important to follow a special diet - avoid fatty, salty, carbohydrate-rich foods. Give preference to protein, potassium-containing foods, vegetables and fruits.

Since 2010, the German pharmaceutical company Merckle Recordati has been producing Ambene tablets in 20 and 50 pcs. in a cardboard box. Tablets contain the active substance – sodium phenylbutazone, 200 mg. They are an easy-to-use alternative to technically complex and often painful intramuscular injections. Tablets are prescribed in the same cases as injections, but many doctors consider Ambene in tablet form to be an ineffective form of therapy. They are taken orally with plenty of water, following the following regimen:

• 1 day – 2-3 doses of 1 tablet;
• 2-4 days – 1-2 times/day, 1 tablet;
• 5-7 days – 1 tab. every 12 hours;
• further as prescribed by the doctor – 1 tablet/day.

Indications for use

Ambene is prescribed for short-term treatment - rapid relief of pain, joint syndrome, relief of inflammation, and fever. These symptoms are common to many diseases. The medication does not treat the disease itself; its action is aimed at relieving symptoms during an exacerbation. As indicated in the instructions for Ambien, the drug is effective for the following pathologies:

• diseases of the joints and spine accompanied by inflammation - osteoarthritis, spondylitis, ankylosing spondylitis, arthritis;
• degenerative-dystrophic changes - arthrosis, osteochondrosis, lumbago, intervertebral hernia;
• systemic vasculitis, inflammation of connective tissue - rheumatism, tendonitis, chondritis;
• acute attacks of gout, dorsalgia;
• diseases of the peripheral nervous system - radiculitis, neuritis, nerve inflammation, brachial, lumbosacral plexitis;
• acute injuries of the back, neck, shoulders, limbs, incl. sports;
• rehabilitation period after surgery on the joints or spinal column.

Contraindications, side effects

Before prescribing injections, a comprehensive examination of the patient must be carried out, laboratory data must be collected and interpreted, because Ambene is based on a complex chemical formula and there are many conditions for which this medicine is prohibited from being used. The instructions provide a list of contraindications for use, these are:

• disorders of the digestive processes - peptic ulcers, gastritis, duodenitis, pancreatitis;
• diseases of the visual organs - glaucoma, damage to the cornea;
• kidney, liver failure, thyroid problems;
• severe forms of diseases of the heart, blood vessels, blood system;
• acute infections;
• mental disorders;
• endocrine disorders;
• autoimmune diseases - senile arteritis, lupus erythematosus, aphthous stomatitis, Sjogren's syndrome;
• allergic reaction to any component of the drug;
• age – less than 14 or more than 65 years;
• period of surgery, vaccination, pregnancy, lactation.

If you strictly follow the instructions and prescriptions of the doctor - rules of administration, dosage, duration of course treatment, serious side effects do not occur often. In some cases, the body will respond to the administration of Ambene:

• problems with the gastrointestinal tract - discomfort in the abdomen, stomach, vomiting, loose stools, loss of appetite;
• violation of blood composition and circulation, as a result of deterioration in health - weakness, drowsiness, migraine, noise in the head, anemia;
• allergic manifestations, eczema, local skin reaction - pain at the injection site, inflammation, accumulation of pus, abscess, tissue necrosis;
• a sharp decrease in blood pressure, slowing heart rate;
• problems with the nervous system - insomnia, euphoria, irritability, dizziness.

Failure to follow the specialist’s recommendations may result in more serious consequences:

• fever, suffocation, bluish skin, loss of consciousness, convulsions;
• deep mental disorder, problems with hearing and vision;
• gastrointestinal bleeding;
• anuria, impaired salivation, Cushing's syndrome, enlarged lymph nodes;
• impaired renal function, heart function, immunosuppression.

special instructions

Before prescribing a hemostatic agent, it is necessary to check the fibrinolytic activity of the blood and fibrinogen content. When administering the solution intravenously, monitoring of coagulogram parameters is necessary, especially in cases of liver disease, coronary artery disease, or after myocardial infarction.

Impact on the ability to drive vehicles and complex mechanisms

There is no information about the adverse effect of a hemostatic agent on the ability to drive vehicles and operate complex and potentially dangerous mechanisms.