Pain is considered one of the most unpleasant phenomena in human life. Most of the existing drugs can relieve weak or moderate intensity pain. Opioid analgesics, which include Zaldiar, described in this article, help get rid of even severe pain caused by serious illnesses.
Despite the fact that the drug is not narcotic, its dispensing in pharmacies is carried out only by prescription (form 148). This is due to the fact that certain components that make up its composition are referred to by specialists as potent substances. The prices for medicines of this group cannot be called affordable for a wide range of consumers, which is also a certain obstacle to the wide distribution of the drug. But we’ll talk about this a little later, but first we’ll look at the composition of the tablets, the basic properties of its active substances and much more.
The composition of the tablets "Zaldiar"
What is the peculiarity of Zaldiar? Composition - this is what plays a dominant role in the effectiveness of any drug. In addition to the well-known and widely used paracetamol, which is present in tablets in an amount of 325 mg, Zaldiar contains a substance known as tramadol hydrochloride (37.5 mg). If consumers have been familiar with paracetamol almost since childhood, then tramadol is less well known in wide circles. In addition, he is sometimes considered a drug, although in fact he is not. Like all opioid analgesics of a synthetic origin, tramadol has the ability to act in two directions, which allows it to be used to eliminate pains of high and medium intensity. This will be discussed in more detail in the section on pharmacological properties.
In addition to the active substances, the Zaldiar preparation contains a set of auxiliary components: cellulose, starches, magnesium stearate, dyes and much more.
Description of the drug, release form
The drug is available in the form of tablets, coated with a enteric film membrane. The shape of the tablets is oblong, round, biconvex, on the one side the inscription "t5" is applied, and on the other - the logo of the manufacturer "GrĂĽnental". Sheath color is light yellow. At the fracture of the tablet, two layers are clearly visible: the outer yellow and the inner - white or almost white.
Zaldiar tablets are packaged in blisters of 10 pieces, which are placed in cardboard boxes of 1, 2, 3 or 5 pieces together with instructions for use.
Pharmacokinetics and pharmacodynamics of the drug "Zaldiar"
The composition of the drug immediately includes two active active substances with an anesthetic effect. That is why the tablets "Zaldiar" application instruction relates to combination drugs. The effect of eliminating pain in this case spreads in several directions at once. That allows you to eliminate even severe pain.
The pharmacodynamics of paracetamol is the deactivation of cyclooxygenase in the pain and temperature centers of the brain. However, this substance does not affect peripheral tissues, namely their prostaglandinsynthetic functions. In addition, paracetamol does not affect the water-electrolyte balance of the body.
Tramadol acts on pain centers in a slightly different way: the substance and its metabolites have the ability to activate the so-called m-opiate receptors. It also activates non-opioid receptors through membrane hyperpolarization at the synapses of the spinal cord and spinal neurons. Despite the similarity of the action of tramadol with narcotic substances, its effect is 6,000 times weaker, for example, morphine.
The absorption of paracetamol and tramadol in the digestive tract occurs quite quickly. In this case, the complete absorption of paracetamol is much faster than tramadol. The splitting of these active substances occurs mainly in the liver. They are excreted mainly through the urinary system (30% unchanged, at least 60% as metabolites).
Indications for use
The drug “Zaldiar” recommends taking it in case of occurrence of severe and moderate in intensity pain of various origins (vascular diseases, injuries, inflammations, etc.). In addition, it is advisable to use this drug before medical procedures (diagnostic and therapeutic) that can cause pain. It is not possible to buy the drug Zaldiar without a doctor’s prescription, as mentioned above. That is why its use is available only in those cases when it is really necessary.
Contraindications
Regarding the use of Zaldiar tablets, the instructions for use mention contraindications, which imply the impossibility of taking this medicine, as well as its analogues in active substances. The first and most important contraindication is the individual intolerance of its constituent components, including auxiliary substances. The second contraindication is the patient's age up to 14 years. In addition, there is a fairly extensive list of diseases and conditions in which the drug is not possible due to the risk of various complications.
So, we will consider in which cases Zaldiar tablets are contraindicated (analogues of active substances should also not be used in the cases listed below):
- epileptic seizures not controlled by the use of special drugs;
- severe kidney and liver diseases, in particular hepatic and renal failure;
- condition after drug withdrawal, or the so-called withdrawal syndrome;
- alcohol or drug intoxication (including drugs that depress the central nervous system, sleeping pills, analgesics and other medicines).
The above conditions are binding. Next, we list the situations in which the use of the Zaldiar preparation requires caution and constant monitoring of the patient's condition:
- shock condition resulting from injury or in other cases;
- traumatic brain injuries of varying severity;
- increased intracranial pressure (hypertension);
- medication-controlled epilepsy;
- impaired respiratory function;
- confusion or confusion of consciousness of various origins;
- viral liver diseases (hepatitis);
- diseases of the biliary tract;
- alcoholism with or without liver damage;
- addiction to drugs;
- hyperbilirubinemia (benign);
- pain in the epigastric region of unknown origin.
In addition, the drug “Zaldiar” recommends that the instructions for use be taken with caution to persons whose age exceeds 75 years, as well as to those who, in addition to this medicine, are prescribed psychotropic and other painkillers with the so-called central effect (including local anesthesia )
In order to avoid an unjustified risk to the patient’s health, the doctor must conduct all necessary studies before prescribing the drug, with which you can identify the above diseases.
How to take the drug "Zaldiar": instructions
The drug "Zaldiar" is taken exclusively under the supervision of a doctor. The dosage and regimen are determined by a specialist, based on the patient’s condition, the severity of pain. According to the recommendations of doctors, it is necessary to take pills whole, without crushing and without chewing. The amount of water with which the medicine is washed down should be sufficient so that it freely enters the stomach.
The initial dose for adult patients (over 14 years old) is 1-2 tablets, depending on the recommendations of a specialist. It is not recommended to consume more than 8 Zaldiar tablets per day. Between receptions it is necessary to observe a time interval of 6 hours. If the next dose was missed for any reason, there is no need to use the present and previous doses of the drug.
For elderly patients (over 75 years old), you can use the usual doses of the drug, but it is worth considering the fact that the excretion of the drug components and metabolites in such people is slower than in other age groups. In this regard, it is recommended to increase the interval between doses of tablets to 10-12 hours.
Renal and hepatic insufficiency also requires adjusting the regimen of taking and dosing the drug "Zaldiar". It should be noted that during hemodialysis, the active substance of the tramadol tablets is practically not removed from the body. Based on this, patients with impaired renal function should not take a repeated dose of the drug after this procedure, as this can lead to an overdose. The same recommendations can be addressed to patients with severe impaired liver function. The risk of complications does not come from tramadol, but from paracetamol. The risk of complications is significantly increased in individuals whose liver has undergone changes due to exposure to alcohol.
Drug interaction with other drugs
The drug "Zaldiar", reviews of which will be described below, is able to interact with many drugs. Not always this combination has a positive effect on the patient's body. That is why experts recommend that people who take these pills report on taking the drug when prescribing other drugs to them.
It is important to remember that co-administration of the Zaldiar medicine, the price of which will be announced later, with other opioid drugs entails the risk of withdrawal syndrome due to competition of active substances with respect to pain receptors. If you need to take this drug, other drugs with similar properties should be canceled.
Medications that depress the activity of the central nervous system, which include tranquilizers and sleeping pills , enhance the side effects characteristic of Zaldiar tablets. The same applies to alcohol-containing products.
A number of drugs, the main property of which is the induction of microsomal oxidation, as well as tricyclic antidepressants, barbiturates and ethanol, reduce the effect of the active components of Zaldiar tablets on pain centers, as a result of which their analgesic effect is reduced. The duration of the drug is also reduced.
The combined use of barbiturates with the drug reduces the effectiveness of paracetamol, and alcohol together with it can cause the development of acute pancreatitis. Non-steroidal anti-inflammatory drugs are also not recommended to be taken in conjunction with Zaldiar tablets due to their specific interaction with paracetamol. The fact is that this significantly increases the risk of developing renal failure and necrosis of the papillary structures of the kidneys. In especially severe cases, the patient may develop kidney or bladder cancer.
With prolonged use of the drug "Zaldiar" the effect on the body of even small dosages of anticoagulants increases, resulting in an increased risk of bleeding.
Adverse reactions
Zaldiar tablets have many side effects that affect almost all organs and systems. Often, patients from the first day of taking the drug begin to worry about dizziness, partial memory loss, convulsions or tremors. Also among the undesirable reactions of the body to taking the drug are mentioned phenomena such as drowsiness or insomnia, nausea, increased gas formation, digestive disorders and heart rhythm. In addition to the above, patients may experience menstrual irregularities, delayed or absent urination, dyspnea, aplastic anemia.
With prolonged treatment with Zaldiar, drug dependence or withdrawal symptoms may develop after a sharp refusal to take the pills. To avoid this, you should not take this medicine for longer than recommended by the instructions for use, and the drug should be discontinued by a gradual reduction in dose.
special instructions
Prolonged uncontrolled administration of drugs containing tramadol can lead to drug dependence, expressed in nervousness, psychomotor activity and phobias. In this regard, during the period of treatment with Zaldiar, the price of which is quite high, it is necessary to strictly observe the recommended duration of its administration. Patients who previously had this dependence should take the medication under the supervision of a doctor.
Driving vehicles and managing complex mechanisms during the treatment with the drug is better to stop.
Analogs of the drug "Zaldiar": prices and reviews
So, based on the foregoing, we can conclude that the main thing that should be guided when taking the drug "Zaldiar" is the instruction. The price of tablets in comparison with other potent drugs does not seem very high and amounts to about 800 rubles per package. The drug has few analogues: according to the content of two active components, only Forsodol tablets can be distinguished, the cost of which is much higher. Undoubtedly, the prices of medicines from the group of opioid analgesics cannot be low, and Zaldiar is the most affordable among these drugs.
According to experts, this medication helps to cope with pain even in very difficult cases. At the same time, they indicate that prolonged or uncontrolled drug treatment can lead to unexpected and extremely negative results. Patients who used this medicine were also satisfied with its effectiveness. But at the same time they noted that its abolition should take place gradually. Since in more than 70% of cases they had symptoms of the so-called withdrawal syndrome.