Paracetamol and pregnancy

About the drug:

Zinepar is a combined drug used in inflammatory and inflammatory-dystrophic diseases of the musculoskeletal system.

The analgesic effect of diclofenac sodium is due to two mechanisms: peripheral (through suppression of prostaglandin synthesis) and central (due to inhibition of prostaglandin synthesis in the central and peripheral nervous system). It inhibits platelet aggregation.

Paracetamol has analgesic, antipyretic, and weak anti-inflammatory action.

Indications and dosage:

Pain syndrome of weak and moderate severity in diseases:

ENT organs (pharyngitis, tonsillitis, otitis media)

Biliary tract (biliary colic)

Urinary tract (renal colic)

Cerebral vessels (migraine)

Female genital organs (algodysmenorrhea, adnexitis)

Musculoskeletal system (rheumatoid arthritis, psoriatic, juvenile arthritis, ankylosing spondylitis, gouty arthritis, osteoarthritis, osteochondrosis)

Extraarticular tissues (tendovaginitis, bursitis)

Post-traumatic and postoperative pain

For adults and children over 18 dose: one tablet 2-3 times a day.

In order to quickly achieve the desired therapeutic effect, take 30 minutes before a meal. In other cases, take before, during or after a meal in unchecked form, drinking plenty of water. The average duration of treatment is 5-7 days.

Paracetamol and pregnancy


Symptoms: pale skin, anorexia, nausea, vomiting; hepatonecrosis (severity of necrosis is directly dependent on the degree of overdose). Toxic effect of the drug in adults is possible after taking more than 10-15 g of paracetamol: increased activity "hepatic" transaminases, an increase in prothrombin time (12-48 hours after administration); A detailed clinical picture of liver damage occurs after 1-6 days. Rarely, liver dysfunction develops with lightning speed and may be complicated by renal failure (tubular necrosis).

Treatment: the introduction of donators of SH-groups and precursors of the synthesis of glutathione – methionine after 8-9 hours after overdose and N-acetylcysteine ​​- after 12 hours. The need for additional therapeutic measures (further introduction of methionine, in / in the introduction of N-acetylcysteine) is determined in depending on the concentration of paracetamol in the blood, as well as the time elapsed after its administration.

Side effects:

Nausea, abdominal pain

Dizziness, visual disturbances

Paresthesia (with long-term use)

Asthenia, shortness of breath, sexual dysfunction

Thrombocytopenia, leukopenia, anemia, agranulocytosis

Skin rash, pruritus, urticaria, anaphylactic reactions, angioedema (in such cases, therapy is stopped immediately)

Vomiting, diarrhea, stomach bleeding

Peripheral edema, tachycardia, hyperemia of the skin

Hypotension, arrhythmias, shortness of breath (when used in high doses)


Hypersensitivity to diclofenac and paracetamol (nonsteroidal anti-inflammatory drugs)

Peptic ulcer of the stomach and duodenum, intestinal diseases in the acute phase

"Aspirin" asthma, "aspirin" triad (combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses, and intolerance to ASA and pyrazolone preparations)

Inhibition of bone marrow hematopoiesis

Pregnancy, lactation period

Children’s age up to 18 years

Acute hepatic porphyrias, severe liver dysfunction

Severe renal dysfunction

Interaction with other drugs and alcohol:

The drug increases the plasma concentration of digoxin and cyclosporine while taking. Against the background of potassium-sparing diuretics, the risk of hyperkalemia increases, against the background of anticoagulants – the risk of bleeding. Reduces the effects of diuretic, hypotensive and hypnotic drugs. Increases the likelihood of side effects of methotrexate and cyclosporine nephrotoxicity. Acetylsalicylic acid reduces the concentration of diclofenac in the blood. With simultaneous use with oral hypoglycemic drugs may develop as hypo-and hyperglycemia.

Stimulants of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which makes it possible for severe intoxications to develop even with a small overdose. Ethanol contributes to the development of acute pancreatitis. Inhibitors of microsomal oxidation (in

Composition and properties:

One tablet contains:

Active substances: Diclofenac sodium 50 mg,

paracetamol 500 mg,

Excipients: microcrystalline cellulose, maize starch, sodium methylhydroxybenzoate, sodium propylhydroxybenzoate, povidone K-30, magnesium stearate, purified talcum, sodium starch glycolate, sodium crosscarmellose, purified water, HPMC, silicon colloid silica,

The tablets are white, round, odorless, with a risk on one side.

After ingestion, diclofenac sodium is sucked out of the gastrointestinal tract (GIT). The maximum plasma concentration is reached after 1-2 h. Food intake slows the rate of exhaustion, the degree of absorption does not change. The drug is 99% bound to plasma proteins, penetrates well into tissues and synovial fluid, where its concentration can exceed that in blood plasma. The elimination half-life from blood plasma is 1-2 h, from synovial fluid -3-6 h. Approximately 60% of the dose is excreted as metabolites by the kidneys, less than 1% is excreted unchanged, the rest is excreted as metabolites with bile.

Paracetamol is characterized by rapid and complete absorption from the gastrointestinal tract, uniform distribution in tissues, a relatively short half-life. The action of the drug begins after 30 minutes. after oral administration. The maximum concentration in the blood occurs in 10-60 minutes. and it is about 6 µg / ml, then gradually decreases and after 6 h it is 11–12 µg / ml. Paracetamol is metabolized mainly in the liver by conjugation with glucuronide, conjugation with sulfate. The half-life is 1-3h. Excreted in the urine, mainly in the form of glucuronide and sulfate conjugates. Less than 5% paracetamol is excreted as unchanged paracetamol.

Store in a dry, dark place at a temperature not exceeding 25 ° C

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