Andipal pills, 20pcs

Composition

Per tablet: Active ingredients: metamizole sodium (analgin) – 250 mg, phenobarbital-20 mg, bendazole (dibazole) – 20 mg, papaverine hydrochloride-20 mg. Auxiliary substances: potato starch-46 mg, talc-7 mg, stearic acid-3 mg, calcium stearate-4 mg

Pharmacological action

Pharmacotherapeutic group: analgesic combined agent (analgesic non-narcotic agent+antispasmodic agent+barbiturate).

ATX Code: N02BB72

Pharmacological properties

Pharmacodynamics

A combined drug that has vasodilating, analgesic, antispasmodic and sedative effects.

Andipal, as an antispasmodic agent, is used for spasms of peripheral vessels and brain vessels.

Reducing the total peripheral resistance, acting on arterioles, the drug reduces blood pressure, improves collateral blood circulation.

The combination of myotropic antispasmodics (bendazole and papaverine) with metamizole sodium enhances the analgesic effect of the latter in headache and migraine. The presence of phenobarbital in the preparation contributes to the manifestation of a sedative effect and increases the effect of other components.

Pharmacokinetics

Metamizole sodium: it is well and quickly absorbed into the gastrointestinal tract. It is hydrolyzed in the intestinal wall to form an active metabolite, unchanged metamizole sodium is absent in the blood (only after intravenous use, its insignificant concentration is detected in plasma). The association of the active metabolite with plasma proteins is 50-60%. It is metabolized in the liver and excreted by the kidneys. In therapeutic doses, it penetrates into breast milk.

Papaverine: absorption depends on the dosage form. The average bioavailability is 54%. Plasma protein binding is 90%. It is well distributed and penetrates through histohematic barriers. It is metabolized in the liver. The half-life (T_1/2) is 0.5-2 hours (can be extended up to 24 hours). It is excreted by the kidneys in the form of metabolites. Completely removed from the blood during hemodialysis.

Phenobarbital: when taken orally, phenobarbital is completely absorbed, but relatively slowly. The maximum concentration in the blood is observed 1-2 hours after use. About 50% binds to plasma proteins. The drug is evenly distributed in different organs and tissues; lower concentrations are found in brain tissues. The elimination half-life in adults is 2-4 days. It is released from the body slowly, which creates the prerequisites for accumulation. It is metabolized by microsomal liver enzymes. Excreted by the kidneys in the form of inactive metabolites 25-50% – unchanged.

Indications

Pain syndrome (mild or moderate) with spasms of smooth muscles of internal organs:  

• renal colic, biliary colic, intestinal colic;
• biliary dyskinesia, postcholecystectomy syndrome;
• spasm of the ureters and bladder;
• algodismenorrhea.

Spasm of the brain vessels, migraine. As an auxiliary drug: pain syndrome after surgical intervention and diagnostic procedures.

Contraindications

• Hypersensitivity (including to the pyrazolone derivative);
• the oppression of bone marrow hematopoiesis;
• severe hepatic and/or renal failure,
• deficiency of glucose-6-phosphate dehydrogenase;
• children under 8 years, pregnancy, lactation, tachyarrhythmias, severe angina, collapse, decompensated chronic heart failure;
• angle-closure glaucoma;
• prostatic hyperplasia;
• intestinal obstruction, megacolon.

Side effects

Allergic reactions. From the central nervous system: drowsiness, decreased speed of psychomotor reactions. From the gastrointestinal tract: nausea, constipation. From the cardiovascular system: arterial hypotension. With prolonged use: leukopenia, agranulocytosis, impaired liver and kidney function.

Interaction

Combination with nitrates (nitroglycerin, nitrosorbide, sustak, etc. ), calcium channel blockers (nifedipine, corinfar, etc. ), beta-blockers (anaprilin, metoprolol, talinolol, etc. ), ganglioblockers (pentamine, etc. ), diuretics (furosemide, hypothiazid, etc. ), myotropic antispasmodics (dipyridamole, Euphylline, etc. ) increases the effectiveness of anti-inflammatory drugs. antihypertensive effect of these drugs. Concomitant use with other non-narcotic analgesics can lead to a mutual increase in toxic effects. Combined use with adsorbents, astringents and enveloping agents reduces the absorption of the drug in the gastrointestinal tract.

How to take, course of use and dosage

Inside, adults and children over 8 years of age: 1 tablet 2-3 times a day. The duration of use without consulting a doctor should not exceed 3 days.

Special instructions

With prolonged (more than 7 days) use, it is necessary to monitor the picture of peripheral blood and the functional state of the liver. If there is no effect within 3 days, you should stop taking the drug and consult a doctor. During treatment, you should avoid engaging in potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions. Children and adolescents under 18 years of age should use the drug only as prescribed by a doctor.

Storage conditions

Store in a dry place, protected from light and out of reach of children.

Shelf

life is 2 years and 6 months. The drug should not be used after the expiration date.

Active ingredient

Bendazole, Metamizole sodium, Papaverine, Phenobarbital

Dosage form

Tablets