The preparation “Bral” defines the instructions for use as a non-narcotic analgesic and antispasmodic. This is a combined medication that includes pitophenone hydrochloride (myotropic antispasmodic), metamizole sodium (non-narcotic analgesic) and fenpiverinium bromide (m-anticholinergic blocker).
Pharmacotherapeutic group
Metamizole sodium acts as a derivative of pyrazolone, exhibits analgesic, insignificant anti-inflammatory, antipyretic activity. Pitophenone hydrochloride in relation to smooth muscles has a papaverine-like myotropic relaxing effect. Fenpiverinium bromide has pronounced anticholinergic properties, reduces temperature and pain, relieves smooth muscle spasms. The combined use of these three components leads to a mutual increase in their pharmacological effects on the body, an increase in antispasmodic and analgesic effects.
Indications for appointment
The medicine “Bral” shows the instructions for use in patients with mild pain caused by smooth muscle spasm of the urinary or biliary tract, along with the development of renal or hepatic colic, postcholecystectomy syndrome (a condition that occurs after removal of the gallbladder), intestinal or bladder cramps, algodismenorea, biliary dyskinesia (hyperkinetic type), chronic spastic colitis, inflammation of the pelvic organs. The drug is also used for short-term therapy of acute pathologies of the joints and peripheral nervous system (myalgia, sciatica, arthralgia, neuralgia). The medication “Bral” recommends the use of it as an auxiliary tool for eliminating pain after diagnostic tests and surgical intervention. The medicine, among other things, is prescribed for fever during inflammatory and colds.
Release form, packaging, composition
In most cases, the drug "took" in the form of tablets. They are packaged in blisters / strips of ten pieces and packed in cardboard boxes one, two, ten blisters / strips. The “Bral” tablets have the following composition: each unit contains such active ingredients as metamizole sodium, pitophenone hydrochloride, fenpiverinium bromide - in the amount of 500, 5 and 0.1 milligrams, respectively.
The medication “Bral” is also available in the form of an injection solution (for intravenous / intramuscular administration), which is a clear yellowish liquid. Five ampoules made of hydrolytic dark glass, each with five milliliters of solution, are placed in a tray (cell packaging made of polyvinyl chloride film), which, in turn, is packed in a cardboard box with instructions. One milliliter of the solution contains the active ingredients: metamizole sodium, pitophenone hydrochloride, fenpiverinium bromide - in the amount of 500, 2 and 0.02 milligrams, respectively. In addition to them, the composition includes minor components: hydrochloric acid, water for injection.
The drug took. Instructions for use (tablets, solution)
Tablets should be taken orally after meals, without chewing, with a small amount of water. Children from fifteen years of age and adults are shown to drink one or two tablets twice or thrice a day (no more than six tablets per day). Until the age of fifteen, it is allowed to use the drug only in the presence of acute indications and as directed by a doctor. For small patients aged six to eight years, the “Bral” pill (the instructions indicate this) should be given half a tablet twice or thrice a day, not longer than five days. Children nine to twelve years old are prescribed two to three times a day for three-fourths of a tablet, adolescents of thirteen to fifteen years old - one tablet.
In cases of severe colic, the medication "Took" the instructions for use indicate parenteral use. Children from fifteen years old and adults are intravenously slowly (one milliliter per minute) injected with 2 milliliters of medication at a time (dose per day should not exceed four milliliters); from twelve to fourteen years old - 0.8-1 ml; from eight to eleven - 0.5-0.6 ml; from five to seven - 0.3-0.4 ml; from three to four - 0.2-0.3 ml and from a year to two - 0.1-0.2 ml. Children under one year of age are contraindicated in intravenous administration; intramuscular injections in an amount of 0.1-0.2 ml at a time are permissible for them. Children from one to two years old are injected intramuscularly with 0.2-0.3 ml, from three to four - 0.3-0.4 ml, for children from five to seven years old - 0.4-0.5 ml, from eight to eleven - 0.6-0.7 ml, from twelve to fifteen - 0.8-1 ml. If necessary, the procedure is repeated after six to eight hours. In one syringe it is not allowed to mix the “Bral” solution with other medicines. Before the injection, you need to warm the syringe with the medicine in your hand.
Side effects
When taking the drug in therapeutic doses, its tolerance is good. However, angioedema, allergic reactions in the form of skin itching, rash, in rare cases, urticaria, anaphylactic shock may develop. Single patients noted a burning sensation in the epigastrium, headache, and dry mouth. Possible occurrence of tachycardia, dizziness, cyanosis, decreased blood pressure. Hematopoiesis, thrombocytopenia, leukopenia, agranulocytosis (manifested by unreasonable increase in temperature, difficulty swallowing, sore throat, stomatitis, in some cases - symptoms of proctitis or vaginitis) can occur if you take Bral tablets for a long time. The use of the drug in large doses threatens with impaired renal function: red staining of urine, anuria, oliguria, interstitial nephritis, proteinuria. With a tendency to bronchospasm, taking the medicine can provoke an attack. In extremely rare cases, with the use of the drug, Steven-Johnson syndromes (exudative malignant erythema) and Lyell (epidermal necrolysis) develop. Among other things, it is possible (very rarely) the appearance of such negative effects as paresis of accommodation, decreased sweating, difficulty urinating. With the intramuscular injection of the drug, infiltrates may form at the injection site.
Contraindications
“Bral” painkillers should not be given to children under five years of age; it is forbidden to administer the drug intravenously in infancy and with a body weight of less than five kilograms. The drug is contraindicated in the following conditions and pathologies:
- hypersensitivity to the components present, including pyrazolone derivatives;
- inhibition of bone marrow hematopoiesis;
- severe renal / liver failure;
- glucose-6-phosphate dehydrogenase deficiency;
- severe angina pectoris;
- tachyarrhythmias;
- angle-closure glaucoma;
- decompensated heart failure;
- intestinal obstruction;
- prostatic hyperplasia (in the presence of clinical manifestations);
- megacolon, collapse.
It is not recommended to use the medication "Took" during pregnancy (especially in the first trimester and in the last six weeks) and in the lactation period. With caution, you should use the medicine if you are prone to arterial hypotension, hypersensitivity to NSAIDs, bronchial asthma, acute rhinitis or urticaria caused by acetylsalicylic acid.
Overdose
It manifests itself as vomiting, drowsiness, epigastric pain, decreased blood pressure, confusion, convulsions (in rare cases), and impaired renal and hepatic function. Indicated gastric lavage, oral administration of activated carbon and other enterosorbents, symptomatic therapy.
How much did "take"?
On average, a package of the drug, including ten tablets, will cost you 34-44 rubles, twenty tablets - 50-82 rubles, one hundred tablets - 210-285 rubles. The price of the solution for injection (a package of five ampoules of five milliliters) varies from 62-78 rubles.
special instructions
Until the cause is clarified, a medication cannot be used to relieve acute abdominal pain. During treatment with the drug "Bral" it is forbidden to drink alcohol, you should refrain from doing work that requires a quick mental / physical reaction, driving. Usually, parenteral administration of a drug is prescribed only in emergency situations, when for one reason or another, oral administration is not possible, for example, if absorption from the gastrointestinal tract is impaired. When introducing a solution in a volume of two milliliters, special care is needed, since there is a risk of a decrease in blood pressure. With intravenous injection, it is necessary to control the frequency of respiration and heart rate. Long-term use of a medication in the form of tablets necessitates monitoring the condition of the liver, the picture of peripheral blood.
Drug interaction
The drug "took" enhances the effect of ethanol. Joint use with phenothiazine derivatives, especially chlorpromazine, can lead to severe hyperthermia. It is possible to increase m-anticholinergic activity while taking with butyrophenones, tricyclic antidepressants, quinidine, amantadine, H1-blockers. Allopurinol, oral contraceptives increase the toxicity of the drug. Tranquilizers increase the analgesic effect of metamizole sodium. It is impossible to use X-ray contrast agents, penicillins, colloidal blood substitutes along with the “Bral” medication. If you use the tablets "Bral" and cyclosporine, the concentration in the blood of the latter will be reduced.