Baralgin solution d/in. amp. 5ml No.5

Renal colic is not an independent disease - it is one of the symptoms of urolithiasis. This is an acute condition that is characterized by severe pain in the lumbar region. The cause of pain is excessive stretching of the renal pelvis, caused by pressure on it from the kidney, from which urine does not flow. An attack of renal colic provoked primarily by a violation of the patency of the ureter due to its blockage with a calculus. In addition, the sharp pain that accompanies this condition is familiar firsthand to many patients with diagnoses such as:

• prolapse of the kidney - may be accompanied by kinking of the ureter and impaired urine outflow;
• tumors of the kidneys and nearby organs;
• tuberculosis.

Also, the cause of the attack may be damage to the kidneys and internal organs located in close proximity to them due to injury.

Pharmacological properties

Pharmacodynamics.
the drug contains three active components. Thanks to the combination of antispasmodic (pitofenone hydrochloride and fenpiverinium bromide) and analgesic (metamizole sodium) components, the drug is used in cases where it is necessary to obtain a quick and long-term antispasmodic effect, namely: with renal colic, spasms of smooth muscles of the urinary tract, spasms of the stomach, intestines, biliary colic, spastic dysmenorrhea, migraine-like conditions and in other cases accompanied by spasm of smooth muscles and pain. the analgesic effect of metamizole sodium is associated with central and peripheral mechanisms. Metamizole sodium inhibits the cyclooxygenase pathway of arachidonic acid metabolism and also prevents the release of prostaglandins, which increase the body's sensitivity to painful stimuli. pitofenone, like papaverine, has a direct myotropic effect on smooth muscles and causes their relaxation. Fenpiverine, due to its anticholinergic effect, exhibits an additional relaxing effect on smooth muscles. Pharmacokinetics. Metamizole is metabolized in the liver and excreted from the body by the kidneys. T½ of its main metabolite is 1.8–4.6 hours. Metamizole passes through the placenta and enters breast milk.

When administered intramuscularly, it is quickly absorbed. Metamizole has a systemic bioavailability of about 85%. Metamizole binds to plasma proteins by 50–60%. The volume of distribution is about 0.7 l/kg. Metamizole undergoes intensive biotransformation in the liver, and its main metabolites are pharmacologically active. Cmax (for all metabolites) is established in approximately 30–90 minutes.

It is excreted by the kidneys in the form of metabolites, and only 3% of the excreted amount of metamizole is excreted unchanged. T½ - about 10 hours.

Indications

Pain syndrome due to spasms of smooth muscles of internal organs: renal colic, spasms of the bladder and urinary tract, hepatic colic, spasms of the stomach and intestines, spastic dysmenorrhea, biliary dyskinesia;

for short-term pain relief from arthralgia, neuralgia, sciatica;

as an adjunct to relieve pain after surgical interventions and diagnostic procedures;

for short-term symptomatic treatment of headache, migraine pain, myalgia;

pain relief from angina pectoris and myocardial infarction.

Symptoms of renal colic

In both women and men, this pathological condition is accompanied by similar symptoms. This is the sudden appearance of severe pain of a cramping nature. The pain is localized in the lumbar region and can radiate to the perineum and lower extremities. Frequent, painful urination is also common.

In many cases, renal colic is accompanied by increased gas formation, bloating, severe nausea and vomiting. This aggravates the patient’s already serious condition.

Application

Dosage for adults and children over 15 years of age: The recommended dose is 1-2 tablets 2-3 times a day (maximum daily dose - 6 tablets) for no more than 3 days.

Increasing the daily dose or increasing the duration of treatment is possible only under the supervision of a physician.

Baralgin should be used only as directed and under the supervision of a physician.

Children. Dosage for children depends on age: children aged 13 to 15 years - 1 tablet 2-3 times a day. The maximum daily dose is 3 tablets.

Baralgin, solution for injection, is used intravenously or intramuscularly. From 2 to 5 ml of injection solution is injected intramuscularly.

If necessary, the dose should be repeated after 6–8 hours.

The maximum daily dose should not exceed 10 ml of injection solution (equivalent to 5 g of metamizole sodium).

IV administration should be carried out slowly (1 ml over 1 minute) to the patient in a supine position under the control of blood pressure, heart rate and respiration. The injection solution must be at body temperature. The maximum daily dose is 2 ml.

Duration of treatment is 2–3 days.

After achieving a therapeutic effect, you can switch to treatment with oral analgesics and antispasmodics.

If there is no therapeutic effect, treatment should be discontinued.

Treatment of renal colic at UNION CLINIC

First aid for a patient with an attack of renal colic

involves an injection of painkiller. A patient's high temperature is an indication for immediate hospitalization.

In most cases, the attack ends after the stone that triggered it passes away along with the urine. If this does not happen - and also in cases where treatment of renal colic caused by other causes has not been carried out - this can lead to serious consequences. A common complication of colic is acute pyelonephritis, which can cause the death of the patient in a matter of days.

For a person who monitors his health, the risk of a sudden attack of colic is practically reduced to zero. Lead a healthy lifestyle, move more and get a medical examination at least once a year. Detection of urolithiasis and other pathologies in the early stages is necessary in order to take timely measures, avoiding chronic disease and the development of complications.

UNION CLINIC guarantees complete confidentiality of your request.

Contraindications

Hypersensitivity to metamizole, pyrazolone derivatives and/or any component of the drug. gastrointestinal obstruction and megacolon; atony of the gallbladder or bladder; severe renal and liver dysfunction; changes in the composition of peripheral blood (agranulocytosis, leukopenia), blood diseases (anemia of any etiology, cytostatic or infectious neutropenia), deficiency of glucose-6-phosphate dehydrogenase; liver porphyria; glaucoma; suspicion of acute surgical pathology; ba; collapsed states; tachyarrhythmia; prostatic hypertrophy with a tendency to urinary retention.

Diagnosis of renal colic in women and men

If symptoms of renal colic appear, you should immediately consult a doctor! Self-administration of painkillers and thermal procedures (bath, heating pad) can affect the diagnosis of acute surgical pathology (for example, acute appendicitis).

To make a diagnosis, ultrasound of the kidneys and intravenous urography are usually used. This is an x-ray with intravenous contrast agent. These instrumental studies are effective in detecting stones blocking the ureter, as well as its pathological changes. Prolapse of the kidneys, kinking of the ureter, pathological expansion of the renal pelvis and other less common causes that provoke an attack of renal colic - nothing will go unnoticed if diagnostic procedures are carried out by a qualified specialist! At our medical center in St. Petersburg, patients are treated by experienced urologists, nephrologists and doctors of other specializations.

Side effects

Allergic reactions: urticaria, skin rash, itching; rarely - bronchospasm, angioedema, anaphylactic shock and very rarely - toxic epidermal necrolysis and Stevens-Johnson syndrome.

From the digestive tract: discomfort, dry mouth, constipation, exacerbation of gastritis and gastric ulcer.

From the cardiovascular system: decreased blood pressure, tachycardia, heart rhythm disturbances.

From the hematopoietic organs: agranulocytosis, thrombocytopenia, leukopenia.

Anticholinergic effects: decreased sweating, accommodation paresis, tachycardia, difficulty urinating.

From the nervous system: dizziness, blurred vision.

From the urinary system: urinary retention, development of acute renal failure and interstitial nephritis.

Local reactions: infiltrates and other changes at the injection site.

special instructions

Use with caution:

with impaired renal and/or liver function;

for diseases of the stomach (achalasia, gastroesophageal reflux, pyloric stenosis of the stomach);

with prostatic hyperplasia;

with a tendency to arterial hypotension and orthostatic reactions;

in the presence of hyperthyroidism.

Patients with asthma, as well as those prone to chronic respiratory infections and other hypersensitivity reactions, as well as hypersensitive to other substances that are not drugs, are at risk in which a state of shock (intolerance) may occur when using any analgesic or anti-inflammatory drug analgesic). This tendency toward drug intolerance may also exist in patients who react by sneezing, watery eyes, or severe facial flushing to drinking small amounts of alcohol.

If you suspect the presence of agranulocytosis or thrombocytopenia, you should immediately stop using the drug. The risk of shock is significantly higher after parenteral administration than after oral administration. Before starting treatment with Baralgin, the patient should be asked about the history of hypersensitivity. Particular attention should be paid to the indications for the use of Baralgin, as well as a medical examination of patients with systolic blood pressure below 100 mm Hg. Art. and unstable angina, circulatory failure (as a result of myocardial infarction).

Metamizole sodium metabolites can change the color of urine to red, which is of no clinical significance.

Use during pregnancy and lactation. Baralgin should not be used during pregnancy.

If necessary, use during lactation should stop breastfeeding.

Children. The drug is not prescribed to children under 15 years of age (in solution form), and under 13 years of age (in tablet form).

The ability to influence reaction speed when driving vehicles or other mechanisms. During treatment with Baralgin, a decrease in mental and physical activity is possible in patients who drive vehicles, as well as in persons engaged in activities that require quick physical and mental reactions, so you should refrain from driving vehicles or working with other mechanisms that require quick reactions.

Baralgin® M

When treating patients receiving cytotoxic drugs, metamizole sodium should only be taken under medical supervision.

Anaphylactic/anaphylactoid reactions

When choosing a method of drug administration, it should be taken into account that parenteral use is associated with a higher risk of anaphylactic/anaphylactoid reactions.

The following conditions cause an increased risk of developing hypersensitivity reactions to metamizole sodium:

- bronchial asthma induced by taking analgesics;

- intolerance to analgesics such as urticaria or angioedema;

- complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including a history);

- chronic urticaria;

- alcohol intolerance (increased sensitivity to alcohol), against the background of which, even when taking a small amount of certain alcoholic beverages, patients experience sneezing, lacrimation and severe redness of the face. Alcohol intolerance may indicate a previously unidentified syndrome of bronchial asthma associated with analgesics (aspirin asthma);

- intolerance or hypersensitivity to dyes (for example, tartrazine) or preservatives (for example, benzoates);

- a history of anaphylactic or other immunological reactions to other pyrazolones, pyrazolidines and other non-narcotic analgesics (see section “Contraindications”).

Before using the drug Baralgin® M, it is necessary to conduct a thorough interview with the patient. If it is determined that the patient was at particular risk of developing azaphylactoid reactions, the drug should be prescribed only after carefully weighing the possible risks and expected benefits. If a decision is made to use the drug Baralgin® M in such patients, strict medical monitoring of their condition will be required, and it is necessary to have means to provide them with emergency care in the event of the development of anaphylactic/anaphylactoid reactions.

In predisposed patients, anaphylactic shock may occur, so patients with bronchial asthma or atopy should be prescribed metamizole sodium with caution.

Severe skin reactions

Life-threatening skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), have been described with the use of metamizole sodium. If symptoms of SJS or TEN (such as a progressive skin rash, often with blistering or mucosal lesions) occur, treatment with metamizole sodium should be discontinued immediately. It is prohibited to ever repeat treatment with the drug.

Patients should be informed about the subjective and objective symptoms of these diseases. They should be carefully monitored for skin reactions, especially during the first weeks of treatment.

Agranulocytosis

Agranulocytosis, which develops during treatment with metamizole, is of immunoallergic origin and lasts for at least one week. This reaction occurs very rarely and can be severe, life-threatening and even fatal. This reaction is not dose-related and may occur at any time during treatment.

All patients should be instructed to discontinue use of the drug and immediately consult their physician if the following subjective or objective symptoms possibly associated with neutropenia occur: fever, chills, sore throat, mouth ulcers. In case of development of neutropenia (number of neutrophils <1500 per mm3), it is necessary to immediately stop treatment, urgently perform a detailed general blood test and continue monitoring the blood composition until the number of formed elements returns to normal values.

Pancytopenia

If pancytopenia develops, treatment should be stopped immediately; complete blood count parameters should be monitored until they return to normal.

All patients should be instructed to immediately seek medical attention if subjective or objective symptoms suggestive of blood changes (eg, general malaise, infections, persistent fever, bruising, bleeding, pallor) occur during treatment with metamizole.

Isolated hypotensive reactions

Administration of metamizole sodium may cause isolated hypotensive reactions. These reactions may be dose dependent and occur more often after parenteral administration.

Acute abdominal pain

It is unacceptable to use the drug Baralgin® M to relieve acute abdominal pain (until the cause is determined).

Liver and kidney dysfunction

In patients with impaired liver or kidney function, Baralgin® M should be used only after consulting a doctor, since in these patients the rate of elimination of the drug is reduced.

Impact on laboratory results

In patients treated with metamizole, changes in the results of laboratory tests performed using the Trinder test and similar tests (for example, analysis of serum creatinine, triglycerides, HDL cholesterol and uric acid concentrations) were recorded.

Interactions

When taken simultaneously: h1-receptors, butyrophenone, phenothiazine, amantadine or quinine with baralgin, the anticholinergic effect of baralgin may be enhanced. when baralgin is administered simultaneously with cyclosporine, a decrease in cyclosporine levels is possible. During the treatment period, alcohol consumption is prohibited. It is possible that urine may turn red as a result of metabolic products being excreted from the body. the color of urine is restored after the end of treatment. baralgin may contribute to inaccurate determination of blood glucose levels (show too low a result) using the glucose oxidase method. barbiturates, phenylbutazone and other liver enzyme inducers weaken the effect of metamizole sodium. tricyclic antidepressants, oral contraceptives, and allopurinol disrupt the metabolism of metamizole sodium and increase its toxicity.

Note!

Description of the drug Baralgin solution d/in. amp. 5ml No. 5 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.