QUPEN PLUS

INSTRUCTIONS FOR USE

KUPIN PLUS

QUPEN PLUS

Trade name of the drug:  Kupen Plus

Active ingredient (INN): paracetamol, caffeine

Dosage form: tablets

Compound:

Each tablet contains:

Paracetamol BF 500 mg

Caffeine BF 65 mg

Description: round, biconvex tablets.

Pharmaceutical form:  Uncoated tablets

ATX code : N02BE71

Pharmacology

Kupin Plus is a combination drug containing paracetamol and caffeine. The drug has an analgesic and antipyretic effect. Paracetamol is a drug from the group of non-steroidal anti-inflammatory drugs that helps reduce the level of prostaglandins in the central nervous system by inhibiting the enzyme cyclooxygenase. Caffeine enhances the pharmacological effects of paracetamol. Paracetamol after oral administration is well absorbed from the digestive tract, peak plasma concentration is observed 0.5-2 hours after administration. Metabolized in the liver. The half-life ranges from 1 to 4 hours and is excreted primarily in the urine in the form of metabolites.

Indications

For the temporary relief of mild to moderate pain associated with migraines, headaches, back pain, period pain, toothache, rheumatic and muscle pain, pain without serious symptoms of arthritis, colds and flu, sore throat and fever.

Directions for use and doses

Inside. For oral administration and short term use only.

The lowest effective dose should be used for the shortest time necessary to relieve symptoms. The patient should consult a physician if symptoms persist or worsen, or if the product needs to be used for more than 3 days.

Adults:  take 1 tablet no more than three times a day with water. Maintain at least a six-hour interval between repeated doses.

If 1 tablet does not have a therapeutic effect, you can take a maximum of 2 tablets no more than three times a day. Maintain at least a six-hour interval between repeated doses.

Do not take more than 8 tablets (4000 mg paracetamol) per day.

Elderly patients:  No special dosage modification is required.

Elderly patients have an increased risk of serious adverse reactions. If NSAID use is necessary, the lowest effective dose should be used for the shortest possible duration. The patient should be regularly monitored to prevent gastrointestinal bleeding during NSAID therapy.

Side effects

The drug is usually well tolerated by patients; in some cases, the development of these side effects is noted:

From the digestive tract: nausea, vomiting, pain in the epigastric region. In addition, changes in liver enzymes and hepatotoxicity.

From the hematopoietic system: thrombocytopenia, pancytopenia, anemia, including hemolytic, sulfate hemoglobinemia and methemoglobinemia.

Central nervous system: disturbance of sleep and wakefulness, irritability and dizziness.

From the cardiovascular system: hypertension, tachyarrhythmias.

Allergic reactions: skin rash, itching, urticaria, exudative erythema multiforme, Quincke’s edema, Lyell’s syndrome, anaphylactic shock.

Other: bronchospasm, hypoglycemia, hypoglycemic coma.

Contraindications :

This product is contraindicated:

• In patients with known hypersensitivity to NSAIDs, caffeine, paracetamol or any other components of the drug.
• In case of severe renal and/or liver failure, congenital hyperbilirubinemia, glucose-6-phosphate dehydrogenase deficiency.
• The drug is not prescribed to patients suffering from alcoholism, diseases of the hematopoietic system (severe anemia, leukopenia), thrombophlebitis, thrombosis, atherosclerosis and hypertension.
• The drug is not used to treat patients suffering from insomnia, glaucoma, including angle-closure glaucoma, epilepsy, hyperthyroidism, cardiac conduction disorders, decompensated heart failure, coronary heart disease, prostatic hypertrophy, diabetes mellitus and acute pancreatitis.
• The drug should not be prescribed to elderly patients and patients prone to vasospasm.
• The drug is contraindicated during pregnancy and lactation, as well as in children under 12 years of age.
• The drug should be used with caution in patients with liver and/or kidney disease.

Drug interactions

Concomitant use of the drug with monoamine oxidase inhibitors, tricyclic antidepressants and beta-adrenergic blockers is contraindicated. The break in treatment between taking monoamine oxidase inhibitor drugs and Panadol Extra should be at least 14 days. The rate of absorption of paracetamol increases when used simultaneously with metoclopramide and domperidone, and decreases when used simultaneously with cholestyramine. When combined with warfarin and other coumarin anticoagulants, the risk of bleeding increases. Barbiturates weaken the antipyretic effect of paracetamol when used in combination. Inducers of microsomal enzymes, hepatotoxic drugs and isoniazid increase the toxic effect of paracetamol on the liver. When used in combination, the drug reduces the effectiveness of diuretics. The simultaneous use of the drug with medications containing ethyl alcohol, as well as alcoholic beverages, is contraindicated. Caffeine, when used in combination, increases the effectiveness of alpha and beta adrenergic agonists, xanthine and drugs that stimulate the central nervous system. With the simultaneous use of cimetidine, oral contraceptives and isoniazid, an increase in the effectiveness of caffeine is observed. Caffeine, when used in combination, reduces the effectiveness of drugs that depress the central nervous system. Caffeine increases the lithium content in the blood, enhances the therapeutic effect of thyroid-stimulating drugs and improves the absorption of ergotamine in the gastrointestinal tract.

special instructions

In case of long-term use of high doses, monitoring of the blood picture is necessary.

While taking the drug, excessive consumption of tea and coffee is not recommended, as this can lead to agitation, insomnia, tachycardia, and cardiac arrhythmia.

To avoid liver toxicity, paracetamol should not be combined with alcoholic beverages, and it is not recommended for people prone to chronic alcohol consumption.

Patients suffering from atopic asthma and hay fever have an increased risk of developing allergic reactions.

May alter athlete doping test results.

Pregnancy and lactation

The use of the drug during pregnancy is possible only for health reasons. If it is necessary to use the drug during lactation, the issue of temporarily interrupting breastfeeding should be resolved.

Impact on the ability to drive and operate machinery

Side effects such as dizziness, drowsiness, fatigue and blurred vision are possible after taking NSAIDs. Therefore, patients treated with this drug should not drive or operate machinery.

Overdose

In case of an overdose of the drug, the development of nephrotoxic and hepatotoxic effects of the drug is possible, as well as the development of disorders of the hematopoietic system (anemia, thrombocytopenia, pancytopenia, leukopenia, neutropenia, agranulocytosis) and the central nervous system (increased excitability, dizziness, disturbance of sleep and wakefulness, tremor) . In addition, the development of tachyarrhythmia, convulsions, pallor of the skin, vomiting, hepatonecrosis, impaired glucose metabolism and metabolic acidosis is possible. In case of overdose, gastric lavage, intake of enterosorbents and symptomatic therapy are indicated. In case of severe overdose, intravenous administration of N-acetylcysteine ​​and oral administration of methionine are indicated (if the patient is not vomiting). In case of seizures, diazepam is used.