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Drug of Kofeks includes such operating components as chlorpheniramine and Codeini phosphas.
Additional substances: sucrose, glucose solution, propilparagidroksibenzoat sodium, monohydrate of citric acid, crimson fragrance, sorbite solution, methylparahydroxysodium benzoate, sodium benzoate, E 110 dye, clear water.
Medicine is issued in the form of orange syrup with a pleasant smell and taste.
The combined cough remedy at cold.
Pharmacodynamics and pharmacokinetics
Syrup for cough of Kofeks includes chlorpheniramine which possesses antiallergic action and anticholinergic activity. It is H1 receptors inhibitor which liquidates effects it is endogenous the released histamine, the vascular reactions, hypostasis of fabrics and symptoms connected with allergic rhinitis. At reception it causes the expressed sedative action.
Chlorpheniramine semi-removal time – 12-15 hours. About 34% of a dosage are removed with urine within 2 days. Less than 1% of this active agent are allocated with a stake.
Codeine – an antibechic of the central action. It is an agonist of opioid receptors. On features of action it is close to morphine, but the anesthetizing action is slightly weaker and the center of breath is oppressed less. Codeine activates opioid receptors of neurons of a brain and reduces excitement of the tussive center. At long use can provoke locks.
Codeine is quickly soaked up from a gastrointestinal tract. Antibechic action when using drug according to the instruction becomes noticeable about 2 hours later and 4-6 more hours proceed. Codeine is quickly distributed in fabrics, mainly, in a liver, kidneys and a spleen.
At codeine biotransformation in a liver are formed morphine and norkodein. This active agent is almost completely removed by kidneys within a day.
Indications to use
Drug is used in the following cases:
- allergic cough;
- the dry and irritating cough because of infectious diseases.
It is impossible to apply syrup at negative reactions of an organism to its components. Besides, it is contraindicated at:
- obstructive respiratory diseases;
- acute respiratory depression;
- the increased intracranial pressure;
- paralytic impassability of intestines;
- dekompensirovanny heart failure;
- the expressed arterial hypertension;
- prostatauxes with the complicated urination;
- heavy dysfunction of a liver and kidneys;
- to glaucoma;
- to emphysema;
- obstructions of a neck of a bladder;
- to bronchial asthma;
Medicine is also not applied after operations on the bilious ways and at alcoholic intoxication.
At negative reaction of an organism to drug components the following side effects, as a rule, appear: difficulty of breath, delay of a cordial rhythm, vomiting, lock, problems with an urination, nausea. Besides, the listed negative effects are possible below:
- allergy: rash, Quincke's edema, itch, bronchospasm, small tortoiseshell, anaphylactic reactions;
- system of blood: thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia;
- Gastrointestinal tract: diarrhea, abdominal pains, lack of appetite, a spasm of zhelchevyvodyashchy ways, dryness in a mouth;
- urinogenital system: bladder sphincter spasm, decrease in a libido, impotence, disturbance of a menstrual cycle;
- CCC: feeling of a cardiopalmus;
- TsNS: sedation, incoordination, headache; the increased uneasiness, fatigue, excitement and irritability; nervousness, euphoria, vertigo, neuritis, dizziness, confusion of consciousness, a tremor, sleeplessness, paresthesias, a ring in ears, neurosis, spasms, a lethargy, disturbance of intellectual and physical activity, timidity, a dysphoria, sudden changes of mood, a loss of consciousness, a depression;
- others: dryness mucous, photophobia, rushes of blood, muscle tension, withdrawal, hyperhidrosis, miosis, vision disorders.
At prolonged use of codeine accustoming development is possible.
Application instruction (Way and dosage)
By means of a measured cap it is easy to dose Kofeks, the application instruction recommends to accept 4 measured caps a day to patients of 12 flyings. The dose in two is shown to children from 6 to 12 years less. And it is enough to children from 2 to 6 years to give only 1 measured cap (5 ml) a day. The maximum duration of treatment – 10 days.
In case of overdose by this medicine the following reactions are possible: a xeroderma and mucous, strengthening of side effects, increase of intraocular pressure, dizziness, an ischuria, disturbances from a gastrointestinal tract, a headache, excitement of TsNS.
Besides, the following symptoms of overdose are known:
- sedation, sleeplessness, tremor, apnoea, hallucinations, spasms;
- cardiovascular insufficiency, pressure decrease;
- ring in ears;
- sight misting;
- expansion of pupils;
- dryness in a mouth;
- rushes of blood;
- disorders of work of system of digestion.
As treatment the gastric lavage and reception of laxatives is shown. For the rest therapy symptomatic. However it is not necessary to apply analeptical means.
Overdose symptoms codeine:
- respiratory depression;
- the increased drowsiness;
- slackness of skeletal muscles;
- narrowing of pupils;
- cold and sticky skin.
Besides, bradycardia and arterial hypotension are in certain cases possible.
Therapy is symptomatic. It is necessary to pay special attention to recovery of the correct respiratory function. A specific antidote – a hydrochloride of Naloxonum which is entered intravenously. If necessary this means is entered repeatedly with an interval 2-3 minutes. The hemodialysis or a peritoneal dialysis are inefficient.
In combination with codeine it is necessary to take with caution:
- anticholinergic and anti-diarrheal drugs – the probability of an acute lock which can lead to torsion of guts increases;
- the anesthetizing and antipsychotic HP – strengthening of sedative and hypotensive action;
- tricyclic antidepressants – strengthening of sedation;
- Metoclopramidum and Domperidon – decrease in action is possible;
- anti-hypertensive medicines — potentiation of hypotensive action;
- Quinidine – decrease in analgesic effect.
Interaction with opioid antagonists leads to a withdrawal.
It is desirable to avoid a combination to Ciprofloxacin. It can lead to reduction of concentration of drug in a blood plasma. Cimetidinum blocks biotransformation of opioid analgetics that causes decrease in level of codeine in plasma. Interaction with Ritonavir can lead to a converse effect. The concomitant use with Meksiletin slows down his absorption.
If to apply chlorphenaminum together with alcohol or alcohol-containing drugs, it can cause symptoms of overdose and strengthen the oppressing action on TsNS.
It is not desirable to accept Kofeks together with MAO inhibitors as it can strengthen anticholinergic effect and the oppressing action on a nervous system.
Anticholinergic drugs in combination with chlorphenaminum strengthen action of each other. At emergence of undesirable effects from a gastrointestinal tract it is desirable to address the specialist immediately.
Ototoksichesky means can reduce such collateral means as a ring in ears, faints and dizziness.
Action of the photosensitizing drugs in combination with Kofeks can amplify.
Terms of sale
It is possible to buy syrup of Kofeks only according to the recipe.
It is necessary to hold drug in dry, unavailable to small children and the dark place at a temperature up to 25 °C.
Period of validity
Coincidence on the ATH code of the 4th level:
- To Terafl Bro
- Doctor MOM
- Tonzilgon of N
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- img class="drug-slider-img" src="//medicalmed.us/img/Antigrippin-anvi-110x80.jpg" tppabs="medicalmed.us/wp-content/uploads/2015/01/antigrippin-anvi-110x80.jpg">Antigrippin-ANVI
- Rinikold Bronkho
The known following analogs of Kofeks which have other structure, but indications match:
- pastils Isla-mint;
- drops Papalor;
- drops Rezistol;
- syrup Malipin;
- tablets Antitussin;
- Bronkhipret's tablets;
- Bronchial balm of Bells;
- balm Bronkhomed;
- Aspirin Complex;
- balm Bronkho Balm;
- tablets Ekstraterm;
- Doctor MOM;
- Flyukold Plus;
- tablets to Sinupret Forta;
- syrup Ekhinasal;
- syrup Kofol;
- syrup Linkas;
- collecting Pulmoran;
Today About Kofeks generally are divided into two groups. To the first reasonings of addicts on how to accept this means for achievement of the necessary effect, and concern to the second – appeals of the indignant people that similar drugs need to be prohibited.
Nevertheless, Kofeks can quite be accepted on doctor's orders. The main thing, strictly to follow the instruction on drug to avoid dependence on this means, and also not to provoke emergence of undesirable side effects. Besides, many specialists advise to refrain from purpose of this means to children. They recommend to do it only in extreme cases when it is necessary to get rid of painful fits of coughing. And it is desirable to give drug only in the conditions of a hospital.
Section: For cough
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