Eufillin in ampoules instructions for intravenous use. Eufillin - indications for use

Instructions for use

Attention! The information is provided for informational purposes only. This instruction should not be used as a guide to self-medication. The need for prescription, methods and doses of the drug are determined exclusively by the attending physician.

general characteristics

international and chemical names: aminophylline (aminophylline), 3,7-dihydro-1,3-dimethyl-1H-purine-2,6-dione-1,2-ethanediamine;

basic physicochemical characteristics : transparent, colorless or slightly colored liquid;

compound: 1 ml of solution contains 0.0192 g theophylline, 0.0048 g ethylenediamine;

Excipients: water for injections.

Release form. Injection.

Pharmacotherapeutic group

Antiasthmatic drugs for systemic use. ATC code R03D A05.

Pharmacological properties

Pharmacodynamics. Eufillin relaxes the muscles of the bronchi, expands coronary (Coronary - surrounding organ in the form of a crown (crown), relating to the coronary arteries of the heart, for example, coronary circulation) vessels, dilates the vessels of the pulmonary circulation, reduces resistance blood vessels, lowers the pressure in the system pulmonary artery, increases renal blood flow, has diuretic effect, caused by a decrease in tubular reabsorption, increases the excretion of water, chloride ions, sodium, etc., inhibits aggregation (Aggregation(accession) - the process of combining elements into one system) platelets (Platelets- blood cells involved in the blood clotting process. With a decrease in their number - thrombocytopenia - there is a tendency to bleeding). Eufillin has a positive effect inotropic (Inotropic- changing force heart rate) effect against the background of relative tachycardia (Tachycardia- increase in heart rate to 100 or more beats per minute. Occurs with physical and nervous stress, diseases of the cardiovascular and nervous systems, diseases of the endocrine glands, etc.), increases electrical instability myocardium (Myocardium- muscle tissue of the heart, making up the bulk of its mass. Rhythmic coordinated contractions of the myocardium of the ventricles and atria are carried out by the conduction system of the heart). The cardiac stimulating effect of Eufillin is due to inhibition of phosphodiesterase activity and the accumulation of cAMP in the myocardium, which leads to increased glycogenolysis and stimulates metabolism (Metabolism- a set of chemical reactions that result in the synthesis or breakdown of substances and the release of energy. In the process of metabolism, the body perceives substances from the environment (mainly food), which, undergoing profound changes, turn into substances of the organism itself, the constituent components of the body). At the same time, Eufillin increases the myocardial oxygen demand. In addition, it blocks adenosine receptors (Receptor(Latin receptio - perception, English receptor): 1) specific sensitive formations in living organisms that perceive external and internal stimuli (extero- and interoreceptors, respectively) and transform the activity of the nervous system. Depending on the type of perceived irritation, there are mechanoreceptors, chemoreceptors, photoreceptors, electroreceptors, thermoreceptors\; 2) active groups of protein macromolecules with which mediators or hormones, as well as many drugs, specifically interact. A receptor is a conformationally mobile macromolecule or set of macromolecules, the binding of a ligand (agonist or antagonist) to which causes biological or pharmacological effects. A number of receptors exist in several subtypes. There are four main types of receptors: 1) membrane receptors associated with ion channels and consisting of several protein subunits that are located in the biological membranes of cells in a radial order, forming ion channels (for example, H-cholinergic receptors, GABA A receptors, glutamate receptors )\; 2) membrane receptors coupled to G-proteins, consisting of protein molecules that “stitch” biological membranes seven times\; the biological effect upon activation of these receptors develops with the participation of a system of secondary transmitters (Ca2+ ions, cAMP, inositol-1,4,5-triphosphate, diacylglycerol). Receptors of this type are available for a number of hormones and mediators (for example, M-cholinergic receptors, adrenergic receptors, etc.)\; 3) intracellular or nuclear receptors that regulate DNA transcription processes and, accordingly, protein synthesis by cells. They are cytosolic and nuclear proteins (for example, receptors for steroid and thyroid hormones)\; 4) membrane receptors that directly control the functions of the effector enzyme, associated with tyrosine kinase and regulating protein phosphorylation (for example, insulin receptors, a number of growth factors, etc.)), suppresses the effects of prostaglandins on smooth muscle, reduces the release histamine (Histamine- a derivative of the amino acid histidine. Contained in an inactive, bound form in various organs and tissues, it is released in significant quantities during allergic reactions, shock, and burns. Causes dilation of blood vessels, contraction of smooth muscles, increased secretion of hydrochloric acid in the stomach, etc.) and leukotrienes from mast cells. Intravenous administration of Eufillin relieves vasospasm, increases collateral circulation and oxygen saturation of the blood, reduces perifocal and general swelling (General swelling – swelling of tissues as a result of excessive accumulation of interstitial fluid, in most or all parts of the body) brain tissue, lowers cerebrospinal fluid and, accordingly, intracranial pressure.
Activates the respiratory center medulla oblongata, increases its sensitivity to carbon dioxide and improves alveolar ventilation, which ultimately leads to a decrease in the severity and frequency of apnea episodes.

Pharmacokinetics. In the blood with proteins (Squirrels- natural high-molecular organic compounds. Proteins play an extremely important role: they are the basis of the life process, participate in the construction of cells and tissues, are biocatalysts (enzymes), hormones, respiratory pigments (hemoglobins), protective substances (immunoglobulins), etc.) plasma (Plasma- the liquid part of the blood, which contains formed elements (erythrocytes, leukocytes, platelets). Changes in the composition of blood plasma are used to diagnose various diseases(rheumatism, diabetes etc.). Medicines are prepared from blood plasma) binds up to 60% (in healthy adults), in newborns - 36%, and in patients with liver cirrhosis - about 35%. The volume of distribution is in the range of 0.3 – 0.7 l/kg. In the liver, with the participation of cytochrome P 450, it is partially converted into caffeine. Half-life (Half-life(T1/2, synonymous with half-elimination period) - the period of time during which the concentration of drugs in the blood plasma decreases by 50% of baseline. Information about this pharmacokinetic indicator is necessary to prevent the creation of a toxic or, conversely, ineffective level (concentration) of the drug in the blood when determining the intervals between administrations) aminophylline depends on age, as well as on the presence concomitant diseases and in newborns and children up to 6 months – more than 24 hours; in children over 6 months – 3.7 hours; in adults without asthma – 8.7 hours; in adults with obstructive pulmonary diseases, pulmonary heart (Pulmonary heart– hypertrophy and/or dilatation of the right heart, resulting from pulmonary arterial hypertension caused by respiratory disease) and heart failure – exceeds 24 hours.
Excreted by the kidneys, incl. 10% in adults and 50% in children, unchanged.
The bronchodilating effect of aminophylline manifests itself when its concentration in the blood is 10-20 mcg/ml. Concentrations above 20 µg/ml are toxic (Toxic- poisonous, harmful to the body). The stimulating effect on the respiratory center is realized when the concentration of aminophylline in the blood is 5-10 mcg/ml.

Indications for use

Eufillin is used for bronchial asthma and bronchospasms of various origins (to relieve attacks), hypertension in the pulmonary circulation, for cardiac asthma (especially accompanied by bronchospasm and Cheyne-Stokes breathing), to improve renal blood flow, to relieve cerebral vascular crises of atherosclerotic origin and improve cerebral circulation, reducing intracranial pressure and edema (Edema– tissue swelling as a result of a pathological increase in the volume of interstitial fluid) brain in ischemic strokes (Stroke - acute disorder cerebral circulation (hemorrhage, etc.) with hypertension, atherosclerosis, etc. Manifested by headache, vomiting, disturbance of consciousness, paralysis, etc.), at chronic (Chronic- a long, continuous, protracted process, occurring either constantly or with periodic improvements in the condition) cerebrovascular insufficiency.

Directions for use and doses

Eufillin is prescribed intravenously for acute attacks bronchial asthma and strokes.
Intravenous aminophylline is administered in a slow stream over 4-6 minutes at a dose of 0.12 - 0.24 g (5-10 ml of a 2.4% solution, which is pre-diluted in 10-20 ml isotonic solution (Isotonic solution- approaching in composition and other indicators to blood serum, the so-called. saline. Used as blood substitutes) sodium chloride). If palpitations, dizziness, or nausea occur, the administration is slowed down or switched to drip administration of the drug. To do this, 10-20 ml of a 2.4% aminophylline solution (0.24-0.48 g) is diluted in 100-150 ml of isotonic sodium chloride solution and administered at a rate of 30-50 drops per minute. Children are administered intravenously in a single dose of 2-3 mg/kg (preferably by drip). Due to the occurrence side effects It is not recommended to administer aminophylline to children under 14 years of age this way.
For rectal administration in microenemas, 10-20 ml of a 2.4% solution is diluted in 20-25 ml of warm water.
The drug is administered into a vein under control blood pressure, heart rate, breathing rate and general well-being.
Higher doses of aminophylline for adults into a vein: single - 0.25 g, daily - 0.5 g. In extremely severe cases, especially in conditions resuscitation (Reanimation- complex therapeutic measures aimed at restoring fading or just extinguished vital important functions body), doses may be increased.
Higher doses for children intramuscularly and rectally – 7 mg/kg, daily – 15 mg/kg; intravenously single dose 3 mg/kg.
Due to the fact that Eufillin has a stimulating effect, it should not be used immediately before bedtime. When prescribing the drug at night, it is advisable to combine Eufillin with sleeping pills.

Side effect

With rapid injection into a vein - dizziness, headache, palpitations, sometimes accompanied by rhythm disturbances, nausea, vomiting, convulsions, a sharp decline blood pressure. When administered rectally, irritation of the rectal mucosa is possible. At hypersensitivity exfoliative effects are possible with ethylenediamine dermatitis (Dermatitis – inflammatory reaction resulting from direct exposure to external factors on the skin), fever.

Contraindications

Hypersensitivity (Hypersensitivity- increased response of the patient to the usual dose of the drug), acute cardiovascular failure, angina pectoris (Angina pectoris- a syndrome caused by myocardial ischemia and characterized by the episodic appearance of a feeling of discomfort or pressure in the precordial region, which in typical cases occurs during physical activity and disappears after its cessation or taking nitroglycerin under the tongue (angina pectoris)), paroxysmal tachycardia (Paroxysmal tachycardia- violation heart rate in the form of an attack of heartbeats with a contraction frequency of 140-220 beats/min)(especially intravenous administration), extrasystole (Extrasystole- heart rhythm disorder characterized by premature contraction the whole heart or its individual parts), severe hypotension, epilepsy, hepatic and/or renal failure, myocardial infarction (Myocardial infarction- ischemic necrosis of the myocardium, caused by a sharp decrease in the blood supply to one of its segments. The basis of MI is an acutely developed thrombus, the formation of which is associated with the rupture of an atherosclerotic plaque), pregnancy, lactation (Lactation- secretion of milk from the mammary gland), for intravenous administration – childhood up to 14 years old.

Overdose

Symptoms: anorexia, diarrhea (Diarrhea- frequent discharge of liquid feces, associated with accelerated passage of intestinal contents due to increased peristalsis, impaired absorption of water in the large intestine and the release of a significant amount of inflammatory secretion by the intestinal wall), nausea, vomiting, tachypnea, hyperemia (Hyperemia- plethora caused by increased blood flow to any organ or tissue area (arterial, active hyperemia) or obstructed outflow (venous, passive, congestive hyperemia). Accompanies any inflammation. Artificial hyperemia is caused by therapeutic purpose(compresses, heating pads, cups)) faces, tachycardia, ventricular arrhythmias (Arrhythmia- disturbance of normal heart rhythm. Arrhythmia manifests itself in an increase in heart rate (tachycardia) or slowdown (bradycardia), in the appearance of premature or additional contractions (extrasystole), in attacks of heartbeat (paroxysmal tachycardia), in complete irregularity of the intervals between individual heart contractions ( atrial fibrillation)) , insomnia, photophobia, generalized convulsions.

Treatment: withdrawal of the drug, stimulation of its elimination from the body (forced diuresis (Diuresis- the amount of urine excreted over a certain time. In humans, daily diuresis averages 1200-1600 ml), hemosorption (Hemosorption- this is the passage of blood in a special apparatus through an artificial filter consisting of synthetic materials (for example, activated carbon), which easily absorb and deposit “heavy” toxin molecules), plasma sorption, hemodialysis (Hemodialysis- a method of extrarenal blood purification for acute and chronic renal failure. During hemodialysis, toxic metabolic products are removed from the body, disturbances in water and electrolyte balance are normalized), peritoneal dialysis (Peritoneal dialysis- is based on the use of peritoneum - a thin and rich in blood vessels natural membrane that covers the intestines in abdominal cavity. The peritoneum acts as a dialyser. First, a special solution, dialysate, is injected into the abdominal cavity for several hours. The dialysate is administered through a thin tube - a catheter, which is installed in the lower part of the abdominal cavity. Inserting a catheter is a minor surgical procedure. Gradually, waste products of the body pass through the peritoneum from the blood into the dialysate. The dialysate (which now contains toxins) is then removed from the abdominal cavity and fresh dialysate is injected. When not in use, the catheter is closed and hidden under clothing. Patients typically use this dialysis method at home or at work. In the patient's home, the patient should be taken special place for dialysis. The patient should not miss dialysis exchanges. The most commonly used peritoneal dialysis techniques are: CAPD (continuous ambulatory peritoneal dialysis): dialysate exchanges are performed in the morning, then at lunch and in the afternoon. The last dialysate change is performed before bedtime. Each exchange procedure takes about 30 minutes. APD (automatic peritoneal dialysis): during the night, a special device - a cycler - repeatedly replaces the dialysate, filling and emptying the peritoneal cavity while the patient sleeps)) and the prescription of symptomatic drugs.

Features of application

During pregnancy and lactation, the use of the drug is possible only for health reasons.
Due to insufficient activity of biotransformation enzymatic systems of the liver (and the possibility cumulation (Cumulation- accumulation medicinal substance in the body, usually accompanied by an increase in effect and often leading to side or toxic effects)) in newborns and people over 55 years of age, aminophylline is prescribed with caution.
Intravenous administration to children under 14 years of age is contraindicated.

Interaction with other drugs

Pharmaceutically incompatible with acid solutions. Cannot be used with solution glucose (Glucose- grape sugar, a carbohydrate from the group of monosaccharides. One of the key metabolic products that provides living cells with energy), substances containing xanthine derivatives, indirect anticoagulants (Anticoagulants- drugs that reduce blood clotting), with other theophylline or purine derivatives.
Ephedrine and products containing it increase the risk of side effects. Propranolol weakens the effect on heart rate and bronchial tone.
Compatible with antispasmodics (Antispasmodics- medicinal substances that relieve spasms of smooth muscles internal organs etc. Used for bronchial asthma, renal colic and etc).
Pharmaceutically incompatible with calcium chloride, alkaloid salts, dibazole. Inactivates sodium benzylpenicillin. Eufillin potentiates the effect of diuretics by increasing glomerular filtration and a decrease in tubular reabsorption.

General Product Information

Conditions and shelf life. Store in a place protected from light and out of reach of children, at a temperature not exceeding +25 °C.
Shelf life - 3 years.

Vacation conditions. On prescription.

Package. Solution for injections (Injection- injection, subcutaneous, intramuscular, intravenous, etc. introduction into the tissues (vessels) of the body of small quantities of solutions (mainly medicines)) 2.4%, 5 ml in ampoules, No. 10.

Manufacturer.OOO " Pharmaceutical company"Health".

Location. 61013, Ukraine, Kharkov, st. Shevchenko, 22.

Website. www.zt.com.ua

This material is presented in free form on the basis of the official instructions for medical use of the drug.

Eufillin is a drug from pharmacological group adenosinergic drugs intended for systemic use. Available in the form of a solution for injection. Eufillin helps eliminate bronchial spasms and intensive care unit sputum. The therapeutic effect is achieved due to the ability of certain components of Euphyllin to act on the smooth bronchial muscles, providing a relaxing effect. In addition, it is capable of increasing contractile function heart muscle, normalize blood circulation processes in the myocardium. Eufillin is prescribed to patients with increased intracranial pressure, circulatory disorders in the brain, bronchial asthma and narrowing of the bronchial lumens.

1. Pharmacological action

Active substance Eufillina has a relaxing effect on the smooth muscles of the bronchi, actively relieving spasm and promoting sputum rejection. At the same time, the drug stimulates the respiratory center and improves gas exchange processes, which contributes to a more complete saturation of the body with oxygen. The contractility of the heart muscle also increases, which leads to improved functioning and improved blood supply not only to the myocardium, but also to all other organs. In addition, there is an expansion of the bile ducts, a slight diuretic effect and an increase in acidity gastric juice. Eufillin is completely absorbed. Maximum concentration of the active substance in the blood plasma is achieved 2 hours after oral administration. Euphyllin is neutralized with the formation of active breakdown products, which are subsequently excreted by the kidneys.

2. indications for use

• Sharp narrowing of the lumen of the bronchi of various origins;
• Relieving symptoms of sudden overfilling of cerebral vessels;
• Cerebrovascular disorders of various origins;
• Increased intracranial pressure;
• Renal blood flow disorders of various origins.

3. Method of application

Eufillin in tablet form: In this form, the drug is used in cases of mild and moderate severity. The dosage of Eufillin for pediatric patients is calculated as follows: 7-10 mg per kg of body weight. The resulting amount must be divided into 4 doses. The dosage of Eufillin for adult patients is 0.15 g of the drug twice or thrice a day. In all cases, Eufillin is taken after meals. The duration of treatment is up to several months. Eufillin in the form of injections: The drug is in the form intravenous infusions applies in cases acute manifestation symptoms of the disease. The dosage for adult patients is 5-10 ml of the drug, previously diluted in 10-20 ml of saline solution. The dosage for pediatric patients is calculated according to the following scheme: 3-2 mg of the drug per kg of body weight. Intravenous administration should occur quite slowly, at least 6 minutes. If side effects occur, the administration of Eufillin is either slowed down or stopped. In both cases, the patient continues to take the drug in the form of intravenous drips. The dosage for adult patients is 10-20 ml of the drug, previously diluted in 100-150 ml of physiological solution. Injection rate for this case- no more than 50 drops per minute. The drug in the form of intramuscular injections is used in cases where intravenous infusions are impossible. The dosage for adult patients in this case is 1 ml of solution. The use of Eufillin in the form of injections is carried out with a frequency of no more than 3 times a day and no more than 2 weeks. Eufillin in the form of microenemas: The dosage for adult patients is 10-20 ml of the drug at a time. The dosage for children is calculated individually, depending on the age of the patients. Higher doses of Eufillin for pediatric patients, regardless of the route of administration:

• The highest single dose is 7 mg of the drug per kg of body weight;
• Higher daily dose- 15 mg of the drug per kg of body.

Higher doses of Eufillin for adult patients, regardless of the route of administration:

• The highest single dose is 0.5 g of the drug;
• The highest daily dose is 1.5 g of the drug.

Higher doses of Eufillin for intravenous use:

• The highest single dose for pediatric patients is 3 mg of the drug per kg of body weight;
• The highest single dose for adult patients is 0.25 g of the drug;
• The highest daily dose for adult patients is 0.5 g of the drug.

Features of application: Patients suffering functional disorders liver and kidney patients should take the drug with caution and under the supervision of medical personnel.

4. Side effects

• When using Eufillin, different possible allergic reactions(skin rashes, fever, itching);
• Nervous system disorders (headaches, sleep disturbances, dizziness, disturbance of normal mental state, trembling of limbs);
• Violations digestive system(pain in the stomach, loss of appetite, stool disorders, nausea, vomiting, backflow of food from the stomach into the esophagus, exacerbation peptic ulcer stomach, exacerbation of peptic ulcer duodenum);
• Violations of cardio-vascular system(heart rhythm disturbances, pain in the heart area, palpitations, low blood pressure);
• From the use of Eufillin, disorders of the urinary system may occur (increase in the daily volume of urine output, the appearance of blood in the urine, the appearance of protein in the urine);
• Metabolic disorders (increased sweating, feeling hot, decreased blood glucose, redness of the face);
• Various breathing disorders.

5. Contraindications

• Gastric ulcer in the acute stage;
• Epileptic seizures;
• Hypersensitivity to the drug and its components;
• High blood pressure;
• Duodenal ulcer in the acute stage;
• Heart rhythm disturbances;
• Individual intolerance to Eufillin and its components;
• Cardiac circulatory failure;
• Hemorrhages of various locations;
• Patient age less than 3 years.

6. During pregnancy and lactation

Use Eufillin at all stages of pregnancy and lactation Not recommended. The use of Eufillin is permissible only in very rare cases when healing effect far exceeds the negative effect of the drug on the body of the mother and child, exclusively under the close supervision of the attending physician.

7. Interaction with other drugs

• Simultaneous use with other Xanthine derivatives is strictly contraindicated;
• Concomitant use with Allopurinol, Isoprenaline, Cimetidine, Lincomycin, Enoxacin, Fluoroquinolone, Propafenone, Methotrexate, Thiabendazole, Mexiletine, Ticlopyridine, macrolide antibiotics, Verapamil, Interferon-alpha and drugs containing ethanol, leads to an increase in the therapeutic effect of Eufillin, which requires a mandatory reduction in its dosage;
• Simultaneous use with diuretics and drugs that enhance the effect of adrenaline, an increase in the therapeutic effect of the latter is observed;
• Simultaneous use with drugs containing lithium ions and drugs that block adrenaline receptors leads to a decrease in the therapeutic effect of the latter;
• Simultaneous use with antidiarrheal drugs and drugs whose therapeutic effect is manifested in the ability to bind and remove various chemical compounds reduce the absorption of Euphyllin;
• Simultaneous use with Phenobarbital, Sulfinpyrazone, contraceptives in the form of tablets containing female sex hormones, Rifampicin, Phenytoin, Carbamazepine, Aminogrutetimide and Moracizine, leads to a decrease in the absorption of Eufillin, which requires increasing its dosage.

8. Overdose

• Digestive system disorders (nausea, vomiting, loss of appetite, bloody vomiting, bleeding of the digestive system);
• Nervous system disorders (sleep disorders, confusion, unexplained anxiety, increased sensitivity to light, tremors of limbs, convulsive syndrome, increased excitability);
• Metabolic disorders (necrotic phenomena in skeletal muscles, decreased potassium ion content, increased glucose content, oxygen starvation, shift in the acid-base balance of the blood to the left);
• Violations respiratory system(shortness of breath, rapid shallow breathing);
• Cardiovascular system disorders (heart rhythm disturbances, low blood pressure);
• Disorders of the urinary system (functional kidney failure).

If these conditions occur, use of the drug should be stopped immediately. To alleviate the condition of patients, gastric lavage is performed followed by use activated carbon in high dosages and diuretics. In addition, medication is used to eliminate the symptoms of overdose. Mechanical blood purification (dialysis) is ineffective.

9. Release form

Tablets, 150 mg - 10, 15, 20, 30, 40, 45, 50, 60, 75,100 or 125 pcs. Solution for injection, 24 mg/ml - 5 ml or 10 ml amp. 5 or 10 pcs; 240 mg/10 ml - amp. 5, 10, pcs; 120 mg/5 ml - amp. 5.10,pcs; 2.4% 240 mg/10 ml - amp. 5, 10 or 20 pcs; 240 mg/1 ml - amp. 10 pieces.

10. Storage conditions

Eufillin must be stored in a dry place without access to light. Recommended temperature regime- no more than 20 degrees. Shelf life - no more than 5 years.

11. Composition

1 tablet of Eufillin:

• aminophylline - 150 mg;
• Excipients: calcium stearate, potato starch.

1 ml solution:

• aminophylline - 24 mg;
• Excipients: water.

12. Conditions for dispensing from pharmacies

The drug is dispensed according to the prescription of the attending physician.

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* Instructions for medical use of the drug Eufillin are published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, YOU MUST CONSULT WITH A SPECIALIST

Instructions for medical use of the drug

Eufillin

Tradename

Eufillin

International nonproprietary name

Aminophylline

Dosage form

Solution for intravenous administration 24 mg/ml, 10 ml

Compound

1 ml of solution contains

active substance - aminophylline 24.0 mg

excipient- water for injections

Description

Clear, colorless or slightly colored liquid

Pharmacotherapeutic group

Drugs for the treatment of obstructive diseases respiratory tract. Other drugs for the treatment of obstructive airway diseases for systemic use.

Xanthines

Aminophylline

ATX code R03DA05

Pharmacological properties

Pharmacokinetics

Bioavailability - 90-100%. The time to reach the maximum concentration in the blood plasma with intravenous administration is 0.3 g - 15 min, the maximum concentration in the blood plasma is 7 mcg / ml. The volume of distribution is in the range of 0.3-0.7 l/kg (30-70% of “ideal” body weight), with an average of 0.45 l/kg. Communication with plasma proteins in adults - 60%, in newborns - 36%, in patients with liver cirrhosis - 36%. Penetrates breast milk(10% of the dose taken), through the placental barrier (the concentration in the fetal blood serum is slightly higher than in the maternal serum).

Aminophylline exhibits bronchodilating properties in concentrations of 10-20 mcg/ml. Concentrations above 20 mg/ml are toxic. The stimulating effect on the respiratory center is realized at a lower content of the drug in the blood - 5-10 mcg/ml. Metabolized at physiological pH values ​​with the release of free theophylline, which is further metabolized in the liver with the participation of several cytochrome P450 isoenzymes. As a result, 1,3-dimethyluric acid (45-55%) is formed, which has pharmacological activity, but is 1-5 times inferior to theophylline. Caffeine is an active metabolite and is formed in small quantities, with the exception of premature newborns and children under 6 months, in whom, due to the extremely long half-life of caffeine, its significant accumulation occurs in the body (up to 30% of that for aminophylline).

In children over 3 years of age and in adults, the phenomenon of caffeine accumulation is absent. Half-life in newborns and children up to 6 months. - more than 24 hours; in children over 6 months - 3.7 hours; in adults - 8.7 hours; for “smokers” (20-40 cigarettes per day) - 4-5 hours (after quitting smoking, pharmacokinetics normalize after 3-4 months); in adults with chronic obstructive pulmonary diseases, pulmonary heart disease and pulmonary-heart failure - over 24 hours. Excreted by the kidneys. In newborns, about 50% of theophylline is excreted unchanged in the urine versus 10% in adults, which is associated with insufficient activity of liver enzymes.

Pharmacodynamics

Bronchodilator, purine derivative; inhibits phosphodiesterase, increases the accumulation of cAMP in tissues, blocks adenosine (purine) receptors; reduces the flow of Ca2+ through the channels of cell membranes, reduces the contractile activity of smooth muscles.

Relaxes the bronchial muscles, increases mucociliary clearance, stimulates contraction of the diaphragm, improves the function of the respiratory and intercostal muscles, stimulates the respiratory center, increases its sensitivity to carbon dioxide and improves alveolar ventilation, which ultimately leads to a decrease in the severity and frequency of apnea episodes. By normalizing respiratory function, it helps saturate the blood with oxygen and reduce the concentration of carbon dioxide.

Strengthens ventilation of the lungs in conditions of hypokalemia.

It has a stimulating effect on the activity of the heart, increases the strength and frequency of heart contractions, increases coronary blood flow and myocardial oxygen demand. Reduces the tone of blood vessels (mainly those of the brain, skin and kidneys). It has a peripheral venodilating effect, reduces pulmonary vascular resistance, and lowers pressure in the pulmonary circulation. Increases renal blood flow and has a moderate diuretic effect.

Expands extrahepatic biliary tract.

Stabilizes mast cell membranes, inhibits the release of mediators of allergic reactions.

Inhibits platelet aggregation (suppresses platelet activating factor and PgE2 alpha), increases the resistance of red blood cells to deformation (improves the rheological properties of blood), reduces thrombus formation and normalizes microcirculation. It has a tocolytic effect, increases the acidity of gastric juice.

When used in large doses, it has an epileptogenic effect.

Indications for use

status asthmaticus (additional therapy)

ischemic cerebrovascular accident (as part of combination therapy)

left ventricular failure with bronchospasm and Cheyne-Stokes type breathing disorder

edematous syndrome of renal origin (as part of complex therapy)

Directions for use and doses

For adults:

5-10 ml of a 24 mg/ml solution (0.12-0.24 g), which is pre-diluted in 10-20 ml of isotonic sodium chloride solution, is administered intravenously slowly (over 4-6 minutes). If palpitations, dizziness, or nausea occur, the rate of administration is slowed down or switched to drip administration, for which 10-20 ml of a 24 mg/ml solution (0.24-0.48 g) is diluted in 100-150 ml of isotonic sodium chloride solution; administered at a rate of 30-50 drops per minute.

Eufillin is administered parenterally up to 3 times a day, for no more than 14 days.

Higher doses of aminophylline for adults: single - 0.25 g, daily - 0.5 g.

At emergency conditions adults are administered intravenously at a dose of 6 mg/kg, diluted in 10-20 ml of 0.9% NaCl solution, administered slowly over at least 5 minutes.

For status asthmaticus, intravenous drip administration is indicated - 720-750 mg.

For children:

The drug is contraindicated in children under 14 years of age due to side effects.

Higher doses for children from 14 to 18 years of age intravenously - single 3 mc/kg, daily - 0.25 to 0.5 g.

Side effects

- dizziness, headache, insomnia, agitation, anxiety, irritability, tremor, fever, flushing

Palpitations, tachycardia, arrhythmia, decreased blood pressure, up to collapse (with rapid intravenous administration), cardialgia, increased frequency of angina attacks

- gastralgia, diarrhea , nausea, vomiting, gastroesophageal reflux, heartburn, exacerbation of peptic ulcer, diarrhea, loss of appetite (with long-term use)

- skin rash, itching, increased sweating

Induration, hyperemia, pain (at the injection site)

- chest pain, tachypnea

Hypoglycemia

Increased diuresis, albuminuria, hematuria

The incidence of side effects decreases with decreasing dose of the drug.

Contraindications

Children under 14 years old

Hypersensitivity (including to other xanthine derivatives: caffeine, pentoxifylline, theobromine)

Epilepsy

Severe arterial hyper- or hypotension

Severe tachyarrhythmias

Hemorrhagic stroke

Retinal hemorrhage

Carefully: pregnancy, age over 55 years and uncontrolled hypothyroidism (possibility of cumulation), sepsis, prolonged hyperthermia, gastroesophageal reflux, peptic ulcer of the stomach and duodenum (history), adenoma prostate gland.

Drug interactions

Ephedrine, beta-agonists, caffeine and furosemide enhance the effect of the drug. In combination with phenobarbital, diphenin, rifampicin, isoniazid, carbamazepine or sulfinpyrazone, a decrease in the effectiveness of aminophylline is observed, which may require an increase in the doses of the drug. The clearance of the drug is reduced when prescribed in combination with macrolide antibiotics, lincomycin, allopurinol, cimetidine, isoprenaline, beta-blockers, which may require a dose reduction. Oral estrogen-containing contraceptives, antidiarrheal drugs, intestinal sorbents weaken, and H2-histamine blockers, slow calcium channel blockers, mexiletine enhance the effect (they are associated with the cytochrome P450 enzymatic system and slow down the metabolism of aminophylline). When used in combination with enoxacin and other fluoroquinolines, the dose of aminophylline is reduced. The drug suppresses therapeutic effects lithium carbonate and beta blockers. Prescription of beta-blockers - interferes with the bronchodilatory effect of aminophylline and can cause bronchospasm. Eufillin potentiates the effect of diuretics by increasing glomerular filtration and reducing tubular reabsorption. With caution, aminophylline is prescribed simultaneously with anticoagulants, other theophylline or purine derivatives. It is not recommended to use aminophylline with drugs that excite the central nervous system (increases neurotoxicity). The drug cannot be used with dextrose solutions and is not compatible with glucose, fructose and levulose solutions. The pH of the mixed solutions should be taken into account: pharmaceutically incompatible with acid solutions.

Increases the likelihood of developing side effects of glucocorticosteroids, mineralocorticosteroids (hypernatremia), general anesthesia (increases the risk of ventricular arrhythmias).

When used simultaneously with enoxacin, small doses of ethanol, disulfiram, fluoroquinolones, recombinant interferon alpha, methotrexate, mexiletine, propafenone, thiabendazole, ticlopidine, verapamil and with influenza vaccination, the intensity of action of aminophylline may increase, which may require a reduction in its dose.

special instructions

The drug is prescribed with caution, under constant medical supervision, to patients:

WITH pronounced violations liver and kidney functions (liver and/or renal failure)

Peptic ulcer of the stomach and duodenum (history), with bleeding from the gastrointestinal tract in a recent history

In case of severe coronary insufficiency (acute phase of myocardial infarction, angina pectoris)

For widespread vascular atherosclerosis

For hypertrophic obstructive cardiomyopathy

With frequent ventricular extrasystole

With increased convulsive readiness

With uncontrolled hypothyroidism (possibility of cumulation) or thyrotoxicosis

With prolonged hyperthermia

For gastroesophageal reflux

With prostate hypertrophy.

Pregnancy and lactation

The use of aminophylline during pregnancy can lead to the creation of potentially dangerous concentrations of theophylline and caffeine in the body of the fetus and newborn. Newborns whose mothers received aminophylline during pregnancy (especially the third trimester) require medical supervision to control possible symptoms intoxication with methylxanthines. Prescribing the drug during pregnancy requires a careful assessment of the benefits for treating the mother and the potential risk to the fetus, and is carried out only for extreme health conditions.

Breastfeeding should be discontinued while taking the drug.

Features of influence medicinal product on the ability to drive a vehicle or potentially dangerous machinery

Considering the possibility of development side effects drug, you should refrain from driving vehicles and potentially engaging in activities during treatment dangerous species activities that require increased concentration and speed of psychomotor reactions.

Overdose

Symptoms: anorexia, diarrhea, nausea, vomiting, epigastric pain, gastrointestinal bleeding, tachycardia, ventricular arrhythmia, tremor, generalized convulsions, hyperventilation, sharp decrease in blood pressure.

Treatment: withdrawal of the drug, stimulation of its removal from the body (forced diuresis, hemosorption, plasma sorption, hemodialysis, peritoneal dialysis) and the prescription of symptomatic drugs. Diazepam (by injection) is used to relieve seizures. Barbiturates should not be used. In case of severe intoxication (eufillin content more than 50 g/l), hemodialysis is recommended.

Eufillin for osteochondrosis is used as a vasodilator. The medicine reduces increased tone smooth muscles, and also promotes unhindered blood flow and improved microcirculation in cartilage tissues.

Composition, release form and purpose of the drug

The active ingredient of Euphyllin is aminophylline (0.025 g), the additional one is injection water (up to 0.001 l). The medicine is sold in several forms - tablets and injections.

Eufillin belongs to the pharmacotherapeutic group of bronchodilators; it is used to normalize peripheral and cerebral blood flow. The vasodilator drug Eufillin is prescribed for lung diseases (bronchitis, asthma, emphysema, etc.), cerebral blood flow disorders (to eliminate intracranial pressure), and heart failure. The action of the drug Eufillin helps to increase the strength and frequency of contractions of the heart muscles, stimulating the respiratory center.

The drug is available in the form of tablets and injections.

In the treatment of osteochondrosis, a dropper with aminophylline is prescribed for:

• Eliminate blood stagnation and improve its circulation in the affected area.
• Reducing muscle spasms.
• Normalization of the transmission of nerve impulses.

The effectiveness of the main active component is to dilate blood vessels, reduce vascular resistance and tone, which helps improve blood flow throughout the body, including in the cervical, lumbar, and thoracic regions, saturate it with oxygen and accelerate its delivery to tissues.

Mechanism of influence on the disease

Pain due to osteochondrosis can lead to reflex vascular spasm. Pathological bone growths can compress and irritate arterial, nervous, choroid plexuses, which leads to their narrowing and disruption of normal blood circulation in the tissues of the cervical, thoracic or lumbar region with osteochondrosis.

The drug Eufillin eliminates the problem of blood stagnation and improves its microcirculation.

The drug Eufillin has a relaxing effect on smooth vascular muscles in osteochondrosis, thereby eliminating the problem of blood stagnation and improving its microcirculation. Due to the increase in the lumen of blood vessels, the drug Eufillin also has an anticoagulant effect. In addition, improving local blood circulation helps reduce pain symptom, which is a constant companion of osteochondrosis.

Instructions for use

The use of the drug Eufillin for osteochondrosis as intravenous injections ensures rapid entry of active substances into the blood. At the beginning of treatment of osteochondrosis, a low concentration of a vasodilator drug is used. Eufillin is bred in saline solution and administered intravenously while monitoring the patient’s blood pressure and heart rate.

The dosage and duration of therapy for osteochondrosis with Eufillin should be prescribed by a doctor, taking into account age, indications, clinical symptoms and other factors. Self-medication is prohibited. 10–20 ml of the drug (2.4%) is diluted in 100–150 ml of sodium chloride solution and administered dropwise at a slow speed (30–50 drops/min.). For children, the dosage is smaller; it is prescribed individually according to age. Eufillin is almost completely absorbed by the body, the bioavailability of the drug is 90–100%. After a day, Eufillin is excreted from the body mainly through the liver.

The drug can be used in children only as prescribed by a doctor.

Electrophoresis procedures with Euphyllin have become quite popular. They promote rapid penetration of the drug through the skin into the body. Eufillin solution is applied to the electrode pads. Due to the action of alternating current, the power and strength of which fluctuate, a high concentration of the medicinal substance is created directly at the site of inflammation without saturating other environments of the body with Euphyllin. A course of electrophoresis procedures (at least 10), when carried out professionally, provides analgesic, anti-inflammatory, relaxing effects, and a restorative effect on trophic processes in the intervertebral cartilage.

Contraindications

Drop administration of Eufillin for the treatment of osteochondrosis of the cervical, lumbar and thoracic regions has the following contraindications:

1. Sharply decreased blood pressure.
2. Epilepsy.
3. Heart, coronary insufficiency.
4. Arrhythmia, angina pectoris.
5. Paroxysmal tachycardia.

Also among the contraindications: alcoholism, period of breastfeeding, allergy to the active ingredient, severe pathologies of the liver, kidneys, age under 3 years.

Elderly patients, as well as women carrying a child, should use Euphyllin with caution for the treatment of osteochondrosis.

The use of Eufillin for cervical, thoracic or lumbar osteochondrosis may be accompanied by headache, heartburn, dizziness, nausea, and fever. Very rarely, the drug Eufillin causes hypoglycemia, muscle weakness, and cramps. If you are hypersensitive to the active substance of Eufillin after intravenous administration, the following side effects may appear:

• A rush of blood to the facial area.

• Tachycardia, arrhythmia.
• Chest pain.

If such symptoms appear, the dropper with Eufillin is canceled.

If side effects occur, the drug must be discontinued immediately.

Cost and substitutes: which is better

The cost of Eufillin solution is quite low - it ranges from 30–70 rubles. There is only one drug on the pharmaceutical market with a similar active ingredient - Aminophylline-Eskom. There are also medications with similar therapeutic effect, but with other active substances: Diprophylline (solution), Teopek (tablets), etc. However, the cost of analogues is much higher than that of Eufillin.

Eufillin – effective drug to improve blood circulation. Due to its vasodilating properties, its use in osteochondrosis helps eliminate congestion, pain and muscle spasms.

INSTRUCTIONS for medical use of the drug

Registration number:

Tradename:

Eufillin

INN:

Aminophylline

Dosage form:

solution for intravenous administration

Compound:

1 ml contains:

Active substance:
aminophylline for injection (aminophylline) - 24.0 mg;

Excipient:
water for injection - up to 1 ml

Description:

clear, colorless or slightly colored liquid

Pharmacotherapeutic group:

bronchodilator

ATX code:

R03DA05

Pharmacological properties

Pharmacodynamics
The drug inhibits phosphodiesterase, increases the accumulation of cyclic adenosine monophosphate in tissues, blocks adenosine (purine) receptors, reduces the flow of calcium ions through cell membrane channels, and reduces the contractile activity of smooth muscles.

Relaxes the bronchial muscles, stimulates the respiratory center and improves alveolar ventilation, which ultimately leads to a reduction in the severity and frequency of apnea episodes.

It has a stimulating effect on the activity of the heart, increases the strength and frequency of heart contractions, increases coronary blood flow and myocardial oxygen demand. Reduces the tone of blood vessels (mainly those of the brain, skin and kidneys). It has a peripheral venodilating effect, reduces pulmonary vascular resistance, and lowers pressure in the pulmonary circulation. Increases renal blood flow, enhances the release of adrenaline by the adrenal glands. Has a moderate diuretic effect. Expands extrahepatic bile ducts. Inhibits platelet aggregation (suppresses platelet activating factor and prostaglandin E2 alpha), increases the resistance of red blood cells to deformation (improves the rheological properties of blood), reduces thrombus formation and normalizes microcirculation.

It has a tocolytic effect, increases the acidity of gastric juice. When used in large doses, it has an epileptogenic effect.

Pharmacokinetics
Bioavailability of the drug is 90-100%.

The maximum concentration (7 mcg/ml) with intravenous administration of 300 mg is achieved after 15 minutes.

The volume of distribution is in the range of 300-700 ml/kg (30-70% of “ideal” body weight), with an average of 450 ml/kg.

Communication with plasma proteins in adults - 60%, in newborns - 36%, in patients with liver cirrhosis - 36%. Penetrates into breast milk (10% of the dose taken), through the placental barrier (the concentration in the fetal blood serum is slightly higher than in the maternal blood serum).

Aminophylline exhibits bronchodilating properties in concentrations of 10-20 mcg/ml. Concentrations above 20 mg/ml are toxic. The stimulating effect on the respiratory center is realized at a lower content of the drug in the blood - 5-10 mcg/ml.

Metabolized at physiological pH values ​​with the release of free theophylline, which is further metabolized in the liver with the participation of several cytochrome P450 isoenzymes. As a result, 1,3-dimethyluric acid (45-55%) is formed, which has pharmacological activity, but is 1-5 times inferior to theophylline. Caffeine is an active metabolite and is formed in small quantities, with the exception of premature newborns and children under 6 months, in whom, due to the extremely long half-life of caffeine, its significant accumulation in the body occurs (up to 30% of that for aminophylline).

In children over 3 years of age and in adults, the phenomenon of caffeine accumulation is absent.

The half-life in newborns and children under 6 months is more than 24 hours; in children over 6 months - 3.7 hours; in adults - 8.7 hours; for smokers (20-40 cigarettes per day) - 4-5 hours (after quitting smoking, normalization of pharmacokinetics occurs for 3-4 months); in adults with chronic obstructive pulmonary disease (COPD), pulmonary heart failure - over 24 hours.

Excreted by the kidneys. In newborns, about 50% of theophylline is excreted unchanged in the urine versus 10% in adults, which is associated with insufficient activity of liver enzymes.

Indications for use:

Broncho-obstructive syndrome of any origin: bronchial asthma (drug of choice in patients with bronchial asthma of physical exertion and as an additional remedy for other forms), chronic obstructive pulmonary disease, emphysema, chronic obstructive bronchitis, hypertension in the “lesser” circulation, night apnea. Ischemic cerebrovascular accident (as part of combination therapy to reduce intracranial pressure).

Left ventricular heart failure (as part of complex therapy).

Contraindications

Hypersensitivity to the drug, as well as to xanthine derivatives: caffeine, pentoxifylline, theobromine. Severe arterial hypotension or hypertension, paroxysmal tachycardia, extrasystole, myocardial infarction with cardiac arrhythmias, epilepsy, increased convulsive readiness, hypertrophic obstructive cardiomyopathy, thyrotoxicosis, pulmonary edema, severe coronary insufficiency, hepatic and/or renal failure, hemorrhagic stroke, retinal hemorrhage eyes, recent history of bleeding.

Carefully

Sepsis, peptic ulcer of the stomach and duodenum (history), elderly age(over 55 years), uncontrolled hypothyroidism (possibility of cumulation), widespread vascular atherosclerosis, prostate hyperplasia, children under 14 years of age (due to possible side effects).

Pregnancy and lactation

If it is necessary to use the drug during pregnancy, the expected benefit for the mother should be compared with potential risk for the fetus.

If necessary, use the drug during the period breastfeeding breastfeeding should be stopped.

Directions for use and doses

Method of administration: intravenously.

Adults are administered slowly (over 4-6 minutes) 5-10 ml of the drug (0.12-0.24 g), which is pre-diluted in 10-20 ml of 0.9% sodium chloride solution.

If a feeling of palpitations, dizziness, or nausea occurs, the rate of administration is slowed down or switched to drip administration, for which 10-20 ml of the drug (0.24-0.48 g) is diluted in 100-150 ml of 0.9% sodium chloride solution; administered at a rate of 30-50 drops per minute.

Before parenteral administration, the solution must be warmed to body temperature. Aminophylline is administered parenterally up to 3 times a day, for no more than 14 days. Higher doses of aminophylline for adults when administered intravenously: single - 0.25 g, daily - 0.5 g.

If necessary, children are administered aminophylline intravenously by drip at a single dose of 2-3 mg/kg. Higher doses for children with intravenous administration: single - 3 mg/kg, daily - at the age of up to 3 months - 0.03-0.06 g, from 4 to 12 months - 0.06-0.09 g, from 2 to 3 years - 0.09-0.12 g, from 4 to 7 years - 0.12-0.24 g, from 8 to 18 years - 0.25-0.5 g.

Side effect

From the nervous system: dizziness, headache, insomnia, agitation, anxiety, irritability, tremor.

From the cardiovascular system: palpitations, tachycardia (including in the fetus when taken by a pregnant woman in the third trimester), arrhythmias, decreased blood pressure, cardialgia, increased frequency of angina attacks.

From the digestive system: gastralgia, nausea, vomiting, gastroesophageal reflux, heartburn, exacerbation of peptic ulcer, diarrhea, with long-term use - decreased appetite.

Allergic reactions: skin rash, skin itching, exfoliative dermatitis, fever.

Others: chest pain, tachypnea, feeling of "hot flashes" in the face, albuminuria, hematuria, hypoglycemia, increased diuresis, increased sweating.

Side effects decrease when the dose of the drug is reduced, when the method of administration is changed (from jet to drip).

Local reactions: compaction, hyperemia, pain at the injection site.

Overdose

Symptoms: loss of appetite, gastralgia, diarrhea, nausea, vomiting (including blood). gastrointestinal bleeding, tachypnea, facial skin flushing, tachycardia, ventricular arrhythmias, insomnia, motor agitation, anxiety, photophobia. tremor, convulsions. In case of severe poisoning, epileptoid convulsions may develop (especially in children without any warning signs), hypoxia, metabolic acidosis, hyperglycemia, hypokalemia, decreased blood pressure, skeletal muscle necrosis, confusion, renal failure with myoglobinuria.

Treatment: drug withdrawal, forced diuresis, hemosorption, plasma sorption, hemodialysis (low efficiency, peritoneal dialysis is ineffective), symptomatic therapy(including intravenous metoclopramide - for vomiting). If convulsions occur, maintain airway patency and administer oxygen therapy. To relieve seizures, administer diazepam 0.1-0.3 mg/kg intravenously (but not more than 10 mg).

Interaction with other drugs

Pharmaceutically incompatible with acid solutions.

Increases the likelihood of developing side effects of glucocorticosteroids, mineralocorticosteroids (hypernatremia), drugs for general anesthesia (increases the risk of ventricular arrhythmias), drugs that excite the central nervous system (increases neurotoxicity).

Antidiarrheal drugs and oral estrogen-containing contraceptives weaken the effect of aminophylline (they bind to the cytochrome P450 enzymatic system and change the metabolism of aminophylline).

Rifampicin, phenobarbital, phenytoin, isoniazid, carbamazepine and moracizine, being inducers of microsomal oxidation, increase the clearance of aminophylline, which may require an increase in its dose.

When used simultaneously with macrolide antibiotics, lincomycin, allopurinol, cimetidine, isoprenaline, small doses of ethanol, disulfiram, fluoroquinolones, recombinant interferon alpha, methotrexate, mexiletine, propafenone, thiabendazole, ticlopidine, verapamil and with influenza vaccination, the intensity of the action of aminophylline may increase, which may require a reduction in its dose.

Enhances the effect of beta-adrenergic stimulants and diuretics (including by increasing glomerular filtration), reduces the effectiveness of lithium preparations and beta-blockers.

Compatible with antispasmodics, do not use in combination with other xanthine derivatives.

Prescribe with caution simultaneously with anticoagulants.

special instructions

Use caution when consuming large amounts of caffeine-containing foods or drinks during treatment.

Before use, the drug solution must be warmed to body temperature.

Impact on the ability to drive vehicles, operate machinery and engage in other activities that require concentration and speed of psychomotor reactions.
During treatment with the drug, it is not recommended to drive vehicles, machinery, or engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Release form:

Solution for intravenous administration 24 mg/ml.
5 or 10 ml in neutral glass ampoules. 10 ampoules each along with instructions for use and an ampoule scarifier in a cardboard box.
5 ampoules per blister pack. 2 blister packs each, along with instructions for use and an ampoule scarifier in a cardboard pack.
When using ampoules with a notch, a point or a break ring, do not insert a scarifier.

Storage conditions:

In a place protected from light at a temperature of 2 to 25 ° C.
Keep out of the reach of children.

Best before date:

3 years.
Do not use after the expiration date stated on the package.

Vacation conditions

Prescription release.

Manufacturer's address/
Organization accepting complaints:

st. Bolshiye Kamenschiki, 9, Moscow, 115172

Place of production

JSC "Moskhimfarmpreparaty" named after. N.A. Semashko"
1. st. Sergius of Radonezh, 15-17, Moscow. 107120;
2. st. B. Kamenshchiki, 9, Moscow. 115172.