AnviMax®

Pharmacotherapeutic group
ARI and "cold" symptoms remedy.
ATX Code: R05X The combined drug has anti-viral, interferonogenic, antipyretic, analgesic, antihistamine-angioprotective action. Paracetamol has analgesic and antipyretic effects.
Ascorbic acid is involved in the regulation of redox processes, contributes to the normal capillary permeability, blood clotting, tissue regeneration, plays a positive role in the development of immune reactions of the body, compensates for vitamin C deficiency.
Calcium gluconate, as a source of calcium ions, prevents the development of increased permeability and fragility of blood vessels, causing hemorrhagic processes during influenza and acute respiratory viral infection (ARVI), has antiallergic effect (mechanism is unclear).
Rimantadynobladaet antiviral activity against influenza A. Blocking the M2 channels of influenza A virus, violates its ability to penetrate into the cells and release ribonucleoprotein, thereby inhibiting the most important stage of viral replication. Induces the production of interferon alpha and gamma. With influenza B virus, rimantadine has an anti-toxic effect.
Rutozid is an angioprotector. Reduces capillary permeability, swelling and inflammation, strengthens the vascular wall. It inhibits aggregation and increases the degree of red blood cell deformation.
Loratadine, a blocker of H1-histamine receptors, prevents the development of tissue edema associated with the release of histamine.
Pharmacokinetics
Paracetamol. Absorption is high. Communication with plasma proteins - 15%. It penetrates the blood-brain barrier. Metabolized in the liver in three main ways: conjugation with glucuronides, conjugation with sulfates, oxidation by microsomal liver enzymes. In the latter case, toxic intermediate metabolites are formed, which are subsequently conjugated with glutathione, and then with cysteine ​​and mercapturic acid. The main isoenzymes of cytochrome P450 for this pathway are the isoenzyme CYP2E1 (predominantly), CYP1A2, and CYP3A4 (secondary role). When glutathione is deficient, these metabolites can cause damage and necrosis of hepatocytes. Additional metabolic pathways are hydroxylation of up to 3-hydroxy paracetamol and methoxylation to 3-methoxy-paracetamol, which are subsequently conjugated with glucuronides or sulfates. In adults, glucuronidation predominates. Conjugated paracetamol metabolites (glucuronides, sulfates and conjugates with glutathione) have low pharmacological (including toxic) activity. Excreted by the kidneys as metabolites, mainly conjugates, only 3% unchanged. Elderly patients decrease the clearance of the drug and increase the half-life.
Ascorbic acid is absorbed in the gastrointestinal tract (mainly in the intestine). Communication with plasma proteins - 25%. Diseases of the gastrointestinal tract (peptic ulcer and 12 duodenal ulcers, constipation or diarrhea, worm infestation, giardiasis), the use of fresh fruit and vegetable juices, alkaline drinking reduces the absorption of ascorbic acid in the intestine. The plasma ascorbic acid concentration is normally around 10-20 μg / ml. The time of maximum concentration in the blood plasma after oral administration is 4 hours. It penetrates easily into leukocytes, platelets, and then into all tissues; the greatest concentration is reached in the glandular organs, leukocytes, liver and lens of the eye; penetrates through the placenta. The concentration of ascorbic acid in leukocytes and platelets is higher than in erythrocytes and in plasma. In deficient conditions, the concentration in leukocytes decreases later and more slowly and is considered as a better criterion for assessing the deficit than in plasma.Metabolized predominantly in the liver to deoxyascorbic and further to maximal acetic acid and ascorbate 2-sulfate. Excreted by the kidneys, through the intestines, spot unchanged and in the form of metabolites. Smoking and ethanol use accelerate the destruction of ascorbic acid (turning into inactive metabolites), reducing the reserves in the body. Displayed during hemodialysis.
Calcium gluconate. Approximately 1 / 5-1 / 3 of orally administered calcium gluconate is absorbed in the small intestine; This process depends on the presence of ergocalciferol, the pH, diet patterns and the presence of factors capable of binding calcium ions. Absorption of calcium ions increases with its deficiency and the use of a diet with a reduced content of calcium ions. About 20% is excreted by the kidneys, the rest (80%) - by the intestines.
Rimantadine. After ingestion is almost completely absorbed in the intestine. Absorption is slow. Communication with plasma proteins is about 40%. The volume of distribution is 17-25 l / kg. Concentration in nasal secretion is 50% higher than plasma. Metabolized in the liver. More than 90% is excreted by the kidneys within 72 hours, mainly in the form of metabolites, 15% - unchanged. In chronic renal failure, the half-life increases by 2 times. In individuals with renal insufficiency and in elderly people, it can accumulate in toxic concentrations if the dose is not adjusted in proportion to the decrease in creatinine clearance. Hemodialysis has a minor effect on clearance of rimantadine.
Rutoside. The time of maximum concentration in the blood plasma after oral administration is 1–9 hours. It is mainly excreted in the bile and to a lesser extent by the kidneys. The half-life is 10-25 hours.
Loratadine. Quickly and completely absorbed in the gastrointestinal tract. The maximum concentration in the elderly increases by 50%. Communication with plasma proteins - 97%. Metabolized in the liver to form the active metabolite of descarboethoxyloratadine with the participation of cytochrome CYP3A4 isoenzymes and to a lesser extent CYP2D6. Does not penetrate the blood-brain barrier. Excreted by the kidneys and with bile. In patients with chronic renal failure and during hemodialysis, the pharmacokinetics are virtually unchanged.