Reonalgon

Reonalgon is a medicine with antispasmodic and analgesic activity. It is included in the group of artificial anticholinergic substances that are combined with analgesics. In addition to analgesics, it contains the active component pitofenone.

The drug exhibits a pronounced analgesic, antispasmodic (similar in effect to papaverine) and anticholinergic (similar in its therapeutic activity to atropine) effect, and in addition, a weak anti-inflammatory effect. [ 1 ]

Indications Reonalgon

It is used to relieve mild to moderate pain that occurs in the case of spasms affecting the smooth muscles of internal organs:

• developing accompanied by pain and dysuric disorders of inflammation affecting the urethra, as well as colic in the kidney area;
• spasms affecting the gastrointestinal tract, dyskinesia of the biliary tract and colic in the liver area;
• dysmenorrhea of a spastic nature.

Release form

The therapeutic drug is released in the form of tablets - 10 pieces in a cell package; in a box - 1 or 2 packages.

Pharmacodynamics

Metamizole has an intense antipyretic and analgesic effect, which is combined with a weaker spasmolytic and anti-inflammatory effect. These properties develop with the inhibition of PG binding with internal algogens, an increase in the excitatory threshold in the thalamus, and also with the conduction of pain intero- and exteroceptive impulses to the CNS. In addition, the substance affects the activity of the hypothalamus and the formation of internal pyrogens.

Fenpiverinium exhibits moderate parasympathetic and ganglionic blocking activity, and in addition reduces the motility and tone of the smooth muscles of the gastrointestinal tract and urinary and bile ducts.

Pitofenone has a papaverine-like effect on extravascular and vascular smooth muscles, with a pronounced antispasmodic effect. [ 2 ]

Pharmacokinetics

Metamizole demonstrates complete resorption at a high rate. Half an hour after application, 5% of the serum Cmax values are determined inside the serum. Part of the substance is synthesized with intraplasmic protein.

Within the body it participates in intensive biotransformation processes; its main metabolic elements remain therapeutically active.

Excretion occurs in the form of metabolic elements with urine. Only 3% of excreted metamizole is unchanged.

The degree of biotransformation is also affected by the type of acetylation associated with genetic parameters. Some elements are excreted in mother's milk.

Dosing and administration

The tablets should be taken orally, after meals, with plain water. Standard daily dosages are 1-2 tablets (it is prohibited to take more than 2 tablets per day). The medication can be taken for a maximum of 3 days.

• Application for children

The drug is not used in persons under 15 years of age.

Use Reonalgon during pregnancy

Reonalgon should not be prescribed during breastfeeding or pregnancy.

Contraindications

Main contraindications:

• severe intolerance associated with metamizole, pyrazolone derivatives or other components of the drug;
• megacolon or obstruction in the gastrointestinal tract;
• atony affecting the urinary or gall bladder;
• severe liver/kidney dysfunction;
• changes in peripheral blood counts (leukopenia or agranulocytosis);
• pathologies associated with blood (anemia of any nature, as well as neutropenia of infectious or cytostatic nature);
• glaucoma;
• G6PD deficiency;
• hepatic porphyria;
• suspicion of the presence of a surgical disease in the active phase;
• tachyarrhythmia;
• BA;
• states similar to collapse;
• prostatic hypertrophy, which causes a tendency to delay urination.

Side effects Reonalgon

Side effects include:

• allergy symptoms: epidermal rash, Quincke's edema, anaphylaxis, urticaria, bronchial spasm, itching, SJS and TEN;
• lesions affecting the digestive system: constipation, xerostomia, as well as exacerbation of ulcers in the gastrointestinal tract or gastritis;
• problems with the functioning of the cardiovascular system: tachycardia, palpitations, decreased blood pressure and heart rhythm disorders;
• disorders of hematopoietic processes: thrombocyto-, granulocyto- or leukopenia, agranulocytosis or anemia;
• urinary dysfunction: anuria, oliguria or proteinuria, acute renal failure, red tint of urine, as well as tubulointerstitial nephritis;
• Others: hepatitis, dizziness, visual disturbances and hypohidrosis.

Overdose

Reonalgon poisoning is usually associated with the action of metamizole in combination with anticholinergic effects; symptoms include respiratory paralysis and renal/liver dysfunction. Patients usually experience a syndrome of allergic-toxic nature, gastrointestinal dysfunction, and signs of hematopoietic dysfunction; severe intoxication may cause symptoms of brain damage.

If a patient is suspected of having an overdose, the medication should be stopped immediately and measures should be taken to help quickly excrete it from the body (gastric lavage, induction of vomiting and potentiation of urination). The drug has no antidote, so symptomatic measures are used.

Interactions with other drugs

The administration of the drug simultaneously with other medications should be done with extreme caution, because it contains metamizole, which induces enzyme activity.

Metamizole increases intraplasmic values of chloroquine, and also weakens the effect and reduces the plasma level of coumarin anticoagulants with cyclosporine.

The drug increases the hematotoxic activity of myelotoxic substances and chloramphenicol.

Sedatives and neuroleptics with tranquilizers potentiate the analgesic effect of metamizole.

Tricyclics with tempidone, allopurinol and oral contraceptives have a destructive effect on the metabolic processes of metamizole and enhance its toxic properties.

Phenylbutazone with barbiturates and other substances that induce the action of intrahepatic microsomal enzymes can weaken the effectiveness of metamizole.

The introduction of Reonalgon in combination with NSAIDs and other analgesics increases the likelihood of toxic symptoms.

Metamizole reduces intraplasmic levels of cyclosporine A; concomitant use with it may be risky if the patient has had a tissue transplant.

Storage conditions

Reonalgon should be stored in a place out of reach of small children. The temperature level should not exceed 25°C.

Shelf life

Reonalgon can be used within a 24-month period from the date of manufacture of the pharmaceutical product.

Analogues

The analogs of the drug are Baralgetas, Spazgan, Realgin with Baralgin, Spazmalgon and Bral with Baralginus, and in addition to this Spazmogard, Renalgan with Bralangin and Spazmadol. The list also includes Maxigan, Cyclopar and Trinalgin.