Pharmacodynamics and pharmacokinetics
The medication has sympathomimetic , antipyretic , immunostimulating and analgesic effects. The features of its action depend on the properties of the components included in the composition.
The active components are excreted mainly in the urine. In addition, some ascorbic acid may be excreted in the bile. The half-life of phenylephrine is 2-3 hours, and that of paracetamol is 1-4 hours.
Composition per 5 g sachet:
Active ingredients: paracetamol 750 mg, phenylephrine hydrochloride 10 mg, ascorbic acid 60 mg; excipients: citric acid 600.0 mg, sodium saccharin 40.0 mg, sodium citrate 500.0 mg, lemon tetrarom 100% P05.51 50.0 mg, lemon flavor 52293/TP.05.51 83.33 mg, quinoline yellow 14031 (E104) 0.75 mg, sucrose 2904.42 mg.
Pharmacotherapeutic group: a remedy for eliminating the symptoms of acute respiratory infections and “colds” (analgesic non-narcotic drug + alpha-adrenergic agonist + vitamin).
ATX code: N02BE51.
Side effects
When used according to the instructions, the medicine is well tolerated without side effects. In rare cases, the following negative reactions have been observed:
- digestive system and liver: increased activity of liver enzymes , vomiting, nausea, diarrhea , anorexia , dry mouth;
- nervous system: headache , insomnia , irritability, tinnitus, dizziness , tremor ;
- allergies : skin itching , rash, angioedema , urticaria , Lyell's syndrome , anaphylactic shock ;
- CVS: cardiac arrhythmia, leukopenia , thrombocytopenia , agranulocytosis , arterial hypertension , neutropenia , anemia , pancytopenia ;
- urinary system: oliguria , nephrotoxic effect , renal colic ;
- other: hyperhidrosis blood glucose levels .
Indications for use
The drug will help get rid of the following symptoms:
- hyperthermia (increased temperature);
- nasal congestion and rhinitis;
- muscle pain and chills;
- discomfort in the throat and paranasal sinuses;
- headaches and lacrimation.
In other words, Coldrex relieves unpleasant symptoms in the following diseases:
- sinusitis;
- rhinitis;
- sore throat;
- tonsillitis;
- pharyngitis;
- cold.
Overdose
The dose of the drug indicated in the instructions cannot be exceeded. In case of overdose, you should definitely consult a doctor, even if there are no pronounced negative symptoms, as there is a possibility of serious liver damage, encephalopathy , coma and metabolic acidosis .
In case of an overdose, nausea, headache, loss of appetite , vomiting, pallor, and pain in the epigastric region . In addition, in severe cases, arterial hypertension and hepatotoxic effects of the drug are possible. Manifestations of toxic reactions due to an overdose of paracetamol usually appear within 12-48 hours. In this case, the use of Acetylcysteine and Methionine .
In case of overdose, gastric lavage and the use of enterosorbents . Treatment is symptomatic.
Reception scheme
Powders HotRem and MaxGrip
Pour the contents of 1 sachet into a glass of hot water (200 ml) and stir until completely dissolved. You can add cold water or sugar before use.
Dosage:
- for adults - 1 sachet 3-4 times a day with an interval of 4-6 hours, but no more than 4 sachets within 24 hours;
- for children over 12 years old - 1 sachet every 6 hours, but not more than 3 sachets within 24 hours.
Powder Junior HotDrink
Children from 6 to 12 years old are recommended to take 1 sachet every 4 hours, but no more than 4 sachets per day. Do not exceed the indicated dose.
The contents of the sachet are poured into a mug and 125 ml of hot water is poured in, then stirred until completely dissolved.
Coldrex tablets
The drug is taken regardless of meals, washed down with plenty of water.
Dosage:
- for children 6-12 years old – 1 tablet 3-4 times a day;
- for children over 12 years old – 2 tablets no more than 4 times a day;
- for adults – 2 tablets up to 5 times a day.
Despite the high concentration of active substances in the tablets, they can be used even by pregnant women, but only after consultation with a specialist.
Broncho syrup
For convenience, each package of the drug is equipped with a measuring cup with marks of 5 and 10 ml.
Dosage:
- adults and children over 12 years old - 200 mg (10 ml) per 1 dose;
- children aged 3 to 12 years - 100 mg (5 ml) per 1 dose.
In both cases, if necessary, a single dose can be taken again every 2-3 hours.
Syrup Knight
The drug is taken 1 time per day - at night just before bedtime.
Dosage:
- adults and children over 12 years old - 20 ml (4 spoons of 5 ml);
- children aged 6 to 12 years - 10 ml (2 spoons of 5 ml).
Regardless of the form of release, Coldrex should not be used for more than 5 days in a row. If symptoms persist, you should interrupt treatment and consult a doctor.
Interaction
When combined with barbiturates , Carbamazepine , Diphenin , Rifampicin , Zidovudine and other inducers of microsomal liver enzymes, taking the drug can cause a hepatotoxic effect .
Coldrex Hotrem should not be taken together with other products containing paracetamol . In addition, use with MAO inhibitors , tricyclic antidepressants and beta-blockers , as well as within 14 days after their discontinuation.
Which is better - Fervex, Theraflu or Coldrex?
The easiest way to compare drugs is to analyze their composition:
- Coldrex: lemon 500 mg paracetamol + 10 mg adrenergic agonist + 60 mg ascorbic acid. Adequate dosage for a person weighing from 50 to 80 kg.
- Fervex: 500 mg paracetamol, 200 mg ascorbic acid, 25 mg antiallergic agent (histamine receptor blocker).
- TheraFlu lemon: 325 mg of paracetamol (enough for a child of 20-40 kg, but not for an adult), 20 mg of ascorbic acid, 10 mg of adrenomimetic, 20 mg of histamine receptor blocker.
It turns out that Coldrex is best taken for nasal congestion (it will quickly relieve the symptom), Fervex - for bacterial infections, especially during exacerbation of chronic tonsillitis, because it contains an anti-allergy drug. While TheraFlu in a standard dosage will only help a child 6-12 years old.
Reviews
Those who leave reviews of Coldrex Hotrem powder report the following advantages of the drug:
- efficiency;
- fast action;
- pleasant taste;
- the presence of various flavoring additives (lemon, currant);
- convenient packaging;
- ease of use;
- possibility to buy individually;
- availability in pharmacies.
Among the disadvantages of the product, reviews indicate the presence of contraindications and side effects, as well as the high price.
Release forms
Coldrex is a whole group of drugs that is used to relieve symptoms of flu and colds. The medicine is available in three forms.
Pills
They contain the largest amount of active ingredients, which helps to quickly get rid of the symptoms of ARVI. Coldrex tablets are indicated for use in adults and children aged 6-7 years;
Powder
The medicine in powder form is quickly absorbed into the blood, due to which it begins to act within 15 minutes after use.
- Coldrex Max Flu is a medicine for adults, which contains a maximum dose of paracetamol;
- Coldrex Hotrem is a powder with flavorings that give the drink a taste of honey or lemon. It contains saccharin and sucrose, so it is not recommended for diabetics;
- Coldrex Junior - designed specifically for children. The suspension contains fewer active ingredients, which reduces the likelihood of side effects.
The powder is diluted with water and then taken orally. In addition to active substances, the drug contains flavorings that give the hot drink a pleasant lemon or honey-lemon flavor.
Syrup
The release form is represented by two types of the drug - Coldrex Broncho and Coldrex Knight. These are expectorants and antipyretics, which include guaifenesin and camphor. According to the instructions, the syrup can be given not only to adults, but also to children over 3 years old.
Coldrex Hotrem powder price, where to buy
The cost of the product in a cardboard pack for 5 sachets is about 160 rubles. And the price of Coldrex Hotrem powder in a package of 10 sachets is approximately 260 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
Pharmacy Dialogue
- Coldrex HotRem for colds and flu, lemon flavor, powder, 5 sachetsSmith Kline Beecham
RUB 192 order - Coldrex HotRem for colds and flu, lemon and honey flavor, powder, 5 sachetsSmith Kline Beecham
RUB 194 order
- Coldrex HotRem for colds and flu, lemon and honey flavor, powder, 10 sachetsSmith Kline Beecham
RUB 322 order
- Coldrex HotRem for colds and flu, lemon flavor, powder, 10 sachetsSmith Kline Beecham
RUB 322 order
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Pharmacy24
- Coldrex Hotrem No. 10 Lemon powder SmithKleinBeecham S.A., Spain
122 UAH order
Carefully:
If you have one of the following diseases/conditions/risk factors, be sure to consult your doctor before taking the drug:
- Benign hyperbilirubinemia.
- Mild to moderate liver and kidney dysfunction.
- Acute hepatitis.
- Alcoholic liver disease.
- Difficulty urinating.
- Pyloroduodenal obstruction.
- Stenosing ulcer of the stomach and/or duodenum.
- Bronchial asthma.
- Cardiovascular diseases, including high blood pressure, occlusive vascular disease (Raynaud's syndrome).
- Pheochromocytoma.
- The presence of severe infections, including sepsis, because taking the drug may increase the risk of metabolic acidosis.
- Patients with glutathione deficiency (in particular, extremely malnourished patients suffering from anorexia, chronic alcoholism or patients with a low body mass index).
- Concomitant use of antihypertensive drugs.
Contraindicated
Increased sensitivity to any components of the drug, severe cardiac-vascular insufficiency, severely impaired liver function and/or liver disease, congenital hyperbilirubinemia, deficiency of glucose-6-phosphate dehydrogenase, alcoholism , blood disease (including anemia, leukopenia), thrombosis, thrombophlebitis, hyperactivity, acute pancreatitis, hypertrophy of the anterior gland, cervical diabetes, epilepsy, hyperthyroidism, pheochromocytoma, closed cuta glaucoma, arterial hypertension, severe forms: atherosclerosis, ischemic heart disease; disturbed sleep.
Do not combine with monoamine oxidase inhibitors (MAOIs) or for two days after taking them, with tricyclic antidepressants, beta blockers or other antihypertensive drugs and sympathomimetics.
Side effects
On the side of the skin and under the skin:
vysypannya, sverbizh, kropivyanka, allergic dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
On the side of the immune system
: allergic reactions (including angioedema), anaphylactic shock, hypersensitivity reactions.
Mental disorders:
psychomotor restlessness and disorientation, restlessness, nervousness, fear, twitchiness, sleep disturbance, insomnia, confusion, depression, hallucinations.
On the side of the nervous system:
headache, confusion, paresthesia.
On the side of the hearing and vestibular apparatus:
woohoo noise.
From the side of the organs
: mydriasis, acute cutaneous glaucoma (more often in patients with glaucoma), impaired vision and accommodation.
On the side of the scolio-intestinal tract:
fatigue, vomiting, dry mouth, discomfort and pain in the abdomen, hypersalivation, decreased appetite, baking, diarrhea.
On the side of the hepatobiliary system:
impaired liver function, increased activity of liver enzymes, hepatonecrosis (dose-related effect), liver failure.
On the side of the blood and lymphatic systems:
anemia (including hemolytic), sulfhemoglobinemia and methemoglobinemia, thrombocytopenia, leukopenia, agranulocytosis, pancytopenia, sinus and bleeding.
On the side of the lower part of the thyroid system:
disruption of the secretions, blockage of the secretions (more importantly, in patients with hypertrophy of the anterior ovary), nitric colic, nephrotoxic effect.
On the side of the cardiovascular system:
arterial hypertension, tachycardia or reflex bradycardia, accelerated heart rate, shortness of breath, heart pain.
On the side of the respiratory system, the organs of the chest and the mediastinum
: bronchospasm in patients sensitive to aspirin and other non-steroidal anti-inflammatory drugs.
Inshi:
gallbladder weakness, fever, hypoglycemia, glucosuria, impaired zinc and copper metabolism.
Use during pregnancy and breastfeeding
Pregnancy The drug should not be used during pregnancy without first consulting a doctor! Animal and human studies have not shown any risk of using paracetamol during pregnancy or adverse effects on fetal development. There are no sufficient data on the effect of drugs containing phenylephrine on the course of pregnancy. The maximum daily dose of ascorbic acid during pregnancy is 2000 mg, which significantly exceeds the maximum daily dose of the drug, so taking the drug in pregnant women is presumably not associated with the risk of side effects from ascorbic acid.
Breastfeeding period The drug should not be used during breastfeeding without first consulting a doctor! Paracetamol penetrates the placental barrier and into breast milk. Studies conducted on humans have not shown any negative effects on the baby's body during breastfeeding. Phenylephrine may pass into breast milk. The maximum daily dose of ascorbic acid during breastfeeding is 2000 mg, which significantly exceeds the maximum daily dose of the drug, so taking the drug in women during breastfeeding is not associated with side effects from ascorbic acid.
special instructions
The patient should be informed that if symptoms of the disease persist after 5 days of using the drug, they should stop taking it and consult a doctor.
The drug should be taken only in recommended doses.
Coldrex® HotRem should be taken with caution simultaneously with metoclopramide, domperidone, cholestyramine and indirect anticoagulants (warfarin).
Patients taking Coldrex® HotRem should refrain from drinking alcohol. It is not recommended to prescribe the drug for chronic alcoholism.
Patients on a low-sodium diet should be aware that 1 sachet of Coldrex HotRem contains 0.12 g of sodium.
Impact on the ability to drive vehicles and operate machinery
Since the active components of the drug do not have a sedative effect, when taken in recommended doses, there are no restrictions on driving a car or operating machinery.
Features of good stagnation
Before taking the drug, it is necessary to consult a doctor.
Take paracetamol. There is no difference between one-hour treatment and other drugs for the symptomatic treatment of colds and flu, vasoconstrictor drugs for the treatment of rhinitis, and medications that replace paracetamol. Immediate use of other drugs that replace paracetamol can lead to overdose. Overdose of paracetamol can cause liver failure, which may lead to the need for a liver transplant or death. The risk of overdose is greater in patients with non-cirotic alcoholic liver diseases.
Episodes of hepatic dysfunction/failure have been reported in patients with decreased glutathione levels, such as in patients who are severely malnourished, anorexic, or have low Body mass index or suffer from chronic alcoholism, sepsis.
Before taking the drug, please consult with your doctor if you are taking warfarin; Raynaud's disease (which can be manifested by painful pain in the fingers, but not by cold or stress), hypertension, cardiovascular disease, impaired liver function, and low blood pressure.
The drug contains phenylephrine, which can cause angina attacks.
One sachet (1 dose) contains 2.9 g of sucrose. It is necessary to treat those suffering from blood diabetes.
Patients with such rare episodes of illness as fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency should not take this drug. This medicinal benefit should not be compromised in patients taking other sympathomimetics (such as anti-stimulants, appetite suppressants and amphetamine psychostimulants). Use caution in patients taking digoxin, cardiac glycosides or cardiac alkaloids (eg ergotamine, methysergide).
Patients should contact a doctor if symptoms persist for more than 5 days, worsen, or if symptoms are accompanied by high fever, sore throat, or persistent headache.
In patients with severe infections such as sepsis, which are accompanied by a decrease in glutathione levels, when taking paracetamol, there may be a risk of metabolic acidosis. Symptoms of metabolic acidosis include rapid, rapid or difficult breathing, boredom, vomiting, loss of appetite. It is important to consult a doctor once these symptoms appear.
