Ambene injections - instructions, analogues, prices and reviews. Ambene - injections against severe pain and inflammation

21.10.2021

Latin name: Ambene
ATX code: M01BA01
Active substance: Dexamethosone
Manufacturer: Recordati Pharma, Germany
Pharmacy leave condition: On prescription
Price: from 4800 to 7000 rubles.

Compound

Such a tool as "Ambene" combines several active elements, in connection with this, its multidirectional action is ensured. The composition included the following substances:

Dexamethasone is a hormone. Glucocorticoid with a pronounced anti-inflammatory effect. The patient's body does not give side effects to this active substance
Lidocaine is an active anesthetic
Phenylbutazone - does not apply to hormonal drugs, it removes pain well, has an antipyretic effect. Capable of removing excess fluid from the human body
Salicylamide-o-acetate - a substance that accelerates the action of other elements
Cyanocobalamin - ensures the normal exchange of nucleic acids, as well as lipids. Allows you to control and stop the destruction of nerve tissue. This is true for severe diseases of the spine.

The absorption of the active components of "Ambene" occurs as quickly as possible, therefore, their influence begins instantly. They are excreted through the liver, as well as through the kidneys.

Sodium hydroxide is included as an auxiliary element.

Medicinal properties

"Ambene" is a combination drug, so the effect is provided by all its components. It gives analgesic, anti-inflammatory effect. Instantly removes even strong heat. Removes excess fluid.

Dexamethasone has a high anti-inflammatory index. At the same time, mineralocorticoid activity is completely absent. Phenylbutazone also effectively removes heat by removing excess fluid. Sodium salicylamide, provides the best solubility. And lidocaine makes injections painless.

All components complement and increase the influence of each other on the patient's body. The activity of the drug is quite long - 37 months.

Indications for use

Suitable for healing:

osteoarthritis
Ankylosing spondylitis
neuralgia
Neuritis
Radiculitis
rheumatoid arthritis
Degenerative diseases of the spine
Gout
Trauma

The average price is from 4800 to 7000 rubles.

Release forms

Ambene is sold as a solution for intramuscular injection. It is a set of solutions A and B:

Solution A is clear and may have a yellowish tinge. Ingredients: phenylbutazone, lidocaine, salicylamide, dexamethasone
Solution B is clear with a reddish tint. Ingredients: lidocaine, cyanocobalamin.

The drug is sold in double ampoules, consisting of A and B solutions, or in syringes, which are made of two chambers.

How to use

Doctors prescribe "Ambene" with daily injections, but no more than 3 injections within 7 days. When the treatment needs to be repeated, a break of about 2 weeks is observed.

The drug is administered intramuscularly, as deeply as possible. The patient should be in a horizontal position. The medicine is drawn into the syringe from 2 ampoules in the following order: A, B. If the injection is made from the original syringe, solution A is first injected, and then automatically solution B. The temperature of the injected should be close to the temperature of a person.

During pregnancy and lactation

“Abmena” is forbidden to be administered to expectant mothers during the period of bearing a child. If during the period of breastfeeding treatment with Ambene is required, then it is necessary to stop lactation.

Contraindications and precautions

There is an extensive list of provisions in which treatment with Ambene is contraindicated:

Gastritis and pancreatitis
Lymphadenitis (when BCG was introduced)
myasthenia gravis
Mycosis
Myopathy
Lactation
Myelosuppression
Pregnancy
Sjögren's syndrome
Diathesis hemorrhagic
8 weeks before scheduled vaccination and 14 days after
lupus erythematosus
Senile and childhood age
Operational intervention.

If the patient has previously shown an allergy in the form of urticaria, bronchospasm, rhinitis to taking any NSAIDs or acetylsalicylic acid, the drug is prohibited. "Ambene" is forbidden to use with high sensitivity to its components.

It is prescribed with caution to people with tuberculosis, mental illness, amoebiasis, epilepsy, bacterial infections, lung diseases, bronchial asthma, osteoporosis. For people of senile age, the medicine is prescribed to a minimum. Before use, it is important to make sure that the patient does not have a stomach ulcer.

Interaction with other drugs

If you use "Ambene" and other drugs with ethanol in the composition, then there is a risk of bleeding in the gastrointestinal tract
Simultaneous administration with insulin or hypoglycemic drugs leads to the development of hypohyperglycemia
Increases the toxic effects of methotrexate
If you use "Ambene" and heparin, dipyridamole, dose adjustment is required
"Ambene" increases the hypnotic effect of barbiturates
If cardiac glycosides are used, a slowdown in the digitalization of patients is likely to occur.
The action of "Ambene" can enhance anabolic steroids when taken at the same time
If liver enzyme inducers were taken before taking the drug, then the effect of the drug may be reduced.

Side effects

When receiving “Ambene”, there may be failures in such systems:

Hematopoietic system (thrombocytopenia, leukopenia, pancytopenia, aplastic anemia)
Digestive system (anorexia, gastralgia, vomiting)
CNS (dizziness, agitation, sleep disturbances, hearing and vision disorders)
Cardiovascular system (orthostatic collapse, hypertension)
Local reactions (sometimes the development of necrosis in the tissues near the injection, swelling)
Less often, side effects can manifest themselves in the form of a violation and functioning of the kidneys, the development of mycosis, and a decrease in immunity.

Overdose

In case of an overdose, the following consequences may occur:

Bleeding in the gastrointestinal tract
Vomiting and nausea
Fever and convulsions
Hyperventilation
Anuria
Edema of lungs and brain
High activity of transaminases
Agranulocytosis
Coma.

If necessary, ventilation of the lungs, other resuscitation, hemodialysis are carried out.

Terms and conditions of storage

Store in a place inaccessible to sunlight, at a temperature not exceeding 25 degrees Celsius. Shelf life - 3 years.

Analogues

Boehringer Ingelheim International, Germany
Price from 480 to 950 rubles.

Drug for intramuscular injection. Refers to non-steroidal anti-inflammatory drugs. It is used for spondylitis, arthritis, osteoarthritis.

pros

Can reduce body temperature, relieve pain and relieve inflammation at the same time
Has a prolonged action

Minuses

Movalis injections should not be given for a long period, as this can lead to the destruction of muscle fibers.

Merck KGaA, Germany
Price from 330 to 370 rubles.

A drug used to treat pain syndromes associated with diseases of the spine, neuralgia. It is administered intramuscularly. It can be used not only for treatment, but also for maintenance therapy in the recovery process.

pros

It is a unique combination of B vitamins, due to which the maximum therapeutic effect is achieved.
Available not only in the form of injections, but also in the form of tablets

Minuses

Often gives a side effect in the form of a rash on the skin.

AMBENE

Prices include shipping:

3 packs (1 ampoule each) - 124 €

1 pack (50 ampoules) - 177 € per pack

2 packs (50 ampoules) - 152 € per pack

Ambene tablets

Out of production

1 pack (50 tablets) - 95 €

2 packs - 68 € per pack

Ambene packs of 10 ampoules are discontinued

Tradename: Ambene® parenteral

Manufacturer: Recordati Pharma, Germany.

Dosage form of release: Solution for intramuscular injection in a 2 ml ampoule.
One package contains 1 ampoule and 50 ampoules.

Note! Merckle Recordati has now switched from the production of double ampoules and ready-made syringes with Ambene® Parenteral to a new form of release: 2-component formulation in one ampoule. The old form in the form of double ampoules or ready-made syringes no longer exists.

Active substance : Sodium phenylbutazone 400mg, lidocaine hydrochloride 1H2O 4mg.

When is this drug used?
Ambene has anti-inflammatory, analgesic, antipyretic and uricosuric effects to relieve acute conditions with radiculitis, osteochondrosis (including degenerative diseases of the spine), neuralgia, neuritis, gout, spondylitis (ankylosing), osteoarthritis, rheumatoid arthritis, articular syndrome, trauma.

The scheme of application of the drug and dosage:
Ambene is intended for intramuscular injection, its dosage is determined by the attending physician.

Traditional scheme: injected deep intragluteally, intramuscularly, slowly 1 injection every other day, but no more than three injections per week.

What are the contraindications?
Ambene parenteral cannot be used for:

acute gastritis;
peptic ulcer of the stomach and duodenum (including history);
diseases of the cardiovascular system (including acute myocardial infarction, chronic heart failure in the decompensation phase, myocardial diseases with impaired conduction, ventricular arrhythmias);
severe renal dysfunction;
severe liver dysfunction;
severe dysfunction of the thyroid gland;
viral infection (including herpes infection, chicken pox, parotitis; poliomyelitis, with the exception of the bulbar form of the disease);
systemic mycosis;
glaucoma;
myelosuppression;
severe myopathy, myasthenia gravis;
Sjögren's syndrome;
systemic lupus erythematosus;
hemorrhagic diathesis;
giant cell (temporal) arteritis, polymyalgia rheumatica;
pancreatitis;
stomatitis;
a period of 8 weeks before and 2 weeks after routine vaccination;
lymphadenitis after the introduction of the BCG vaccine;
surgical operations;
pregnancy;
lactation (breastfeeding);
children's age up to 14 years;
old age;
information in the history of the occurrence of urticaria, acute rhinitis, bronchospasm on the reception of acetylsalicylic acid or other NSAIDs;
hypersensitivity to the components of the drug, derivatives of pyrazolone, salicylate

Precautions for use and warnings

Care should be taken when prescribing the drug to patients with impaired renal function, patients with diabetes mellitus, tuberculosis, epilepsy, mental illness, bronchial asthma, hay fever, chronic nonspecific lung diseases, acute and chronic bacterial infections, amoebiasis, arterial hypertension or hypotension, thromboembolism with severe osteoporosis.

In the above cases, Ambene is used only with appropriate treatment of the underlying disease or syndrome. Due to the long half-life of phenylbutazone with prolonged use of high doses of Ambene, the possibility of cumulation of the drug should be considered; this applies especially to patients with impaired liver function.

Before starting a course of treatment, Ambene should conduct a thorough examination of the patient, in particular, in order to exclude peptic ulcer of the stomach and duodenum.

To reduce the risk of side effects, it is necessary to prescribe the lowest possible dose of the drug; this applies especially to debilitated and elderly patients.

To prevent irritation at the site of the intramuscular injection, which is possible with the introduction of highly concentrated solutions of the drug, it is necessary to inject deeply into different areas. Manipulation is carried out in absolutely sterile conditions. During the period of drug therapy, the food of patients should contain a sufficient amount of potassium, protein, vitamins and little fat, carbohydrates and salt.

In the event of fever, headache, changes in the skin and mucous membranes, with the development of leukopenia, agranulocytosis, when staining feces in a dark color, the drug is canceled.

Phenylbutazone affects the results of studies of thyroid function, therefore, appropriate analyzes should be carried out no earlier than 2 weeks after stopping treatment with Ambene.

Drugs containing cyanocobalamin may contribute to the distortion of clinical and laboratory parameters in patients with funicular myelosis and / or pernicious anemia.

Control of laboratory parameters

With long-term therapy, Ambene requires systematic monitoring of the picture of peripheral blood and the function of the kidneys and liver. In patients receiving diuretic drugs simultaneously with Ambene, regular monitoring of the level of potassium in the blood serum is necessary. In patients receiving anticoagulants at the same time as Ambene, it is necessary to systematically analyze the parameters of the blood coagulation system (prothrombin time).

Interaction with other drugs.
With the simultaneous use of Ambene and other anti-inflammatory drugs and drugs containing ethanol, the risk of bleeding from the gastrointestinal tract increases.

With the simultaneous use of Ambene with oral hypoglycemic agents (sulfonylurea derivatives) or insulin, hyper- or hypoglycemia is possible.

The simultaneous use of Ambene and indirect anticoagulants, heparin, dipyridamole or sulfinpyrazone may require dose adjustment due to the risk of bleeding.

With the simultaneous use of Ambene, an increase in plasma concentrations of sulfonamides and lithium preparations is possible.

With the simultaneous use of Ambene and methotrexate, an increase in the toxicity of the latter is possible.

With the simultaneous use of Ambene with phenytoin, symptoms of intoxication by the latter may develop.

With the simultaneous use of Ambene with barbiturates, their hypnotic effect may be increased.

With the simultaneous use of Ambene with cardiac glycosides, it is possible to slow down or accelerate the digitalization of patients.

With the simultaneous use of Ambene and antihypertensive drugs, the effect of the latter decreases.

With the simultaneous use of Ambene and diuretics, a decrease in diuresis and natriuresis, as well as the development of hypo- or hyperkalemia, is possible.

With the simultaneous use of Ambene and hormonal contraceptives, the effectiveness of the latter may decrease.

With the simultaneous use of Ambene with sulfinpyrazone or probenecid, their uricosuric effect may be reduced.

The use of drugs - inducers of microsomal liver enzymes (for example, barbiturates, promethazine, rifampicin, hydantoin) before the start of Ambene therapy reduces the effect of Ambene.

With the simultaneous use of anabolic steroids and methylphenidate enhance the effect of Ambene.

What side effects may occur phenomena?
From the digestive system: ulcerogenic effect, anorexia, gastralgia, nausea, vomiting, diarrhea; rarely - abnormal liver function; in some cases - bleeding and perforation of the gastrointestinal tract, hemorrhagic pancreatitis.

From the hematopoietic system: leukopenia, agranulocytosis, thrombocytopenia, pancytopenia, aplastic anemia.

Allergic reactions: exanthema, pruritus, fever; rarely - Stevens-Johnson syndrome, Lyell's syndrome, lupus-like syndrome, bronchospasm.

From the side of the central nervous system: dizziness, headache, sleep disturbances, agitation; rarely visual and hearing disorders, mental disorders.

From the side of the cardiovascular system: rarely - arterial hypotension, orthostatic collapse.

Local reactions: rarely - local pain in the injection area; in some cases - the development of abscesses and tissue necrosis.

Others: rarely - Itsenko-Cushing's syndrome, mycosis, impaired renal function, manifestation of an immunosuppressive effect (lowered resistance to infections, slower wound healing), lymphadenopathy, sialadenitis.

Overdose

Symptoms: Nausea, vomiting, abdominal pain, gastrointestinal bleeding, dizziness, headache, metabolic alkalosis or acidosis, hyperventilation, respiratory depression, fever, arterial hypotension, liver and kidney failure, bradycardia, cerebral and pulmonary edema, thrombocytopenia, aplastic anemia , increased activity of transaminases, heart failure, anuria, convulsions, coma.

Treatment: IVL and other resuscitation measures, according to indications - anticonvulsants (for example, intravenous administration of diazepam), hemodialysis.

Storage conditions:
The drug should be stored in a place protected from light at a temperature not exceeding 25°C.

Attention!
Before using the drug Ambene you should consult your doctor.
These instructions for use are given in free translation and are intended
for informational purposes only. For more information, please
refer to manufacturer's instructions.

average rating

Based on 0 reviews

Ambene is combination drug, which is used to treat diseases of the musculoskeletal system and pathologies of the peripheral nerves. The drug includes several active substances at the same time, due to which it acts quite effectively on the body and copes with diseases.

About the drug

Medication capable of exerting an analgesic effect, relieve inflammation and stop inflammatory processes, eliminates heat and temperature, and also enhances the excretion of uric acid.

Thanks to phenylbuzatone, which is present in the composition of the drug, all components dissolve better, and the drug begins to act quickly enough.

Manufacturer

The medicine is produced in Germany by the Merckle company.
Watch a video about the drug

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

Release form and composition

Dosage form of the drug Ambene solution. He, in turn, consists of two solutions A and B.

Solution A contains the following components: Dexamethasonum, Lidocaine hydrochloride, sodium salicylamide-o-acetate, Phenylbutazonum.

Excipients are: Nátrii hydroxídum, distilled water.

Active ingredients in solution B: Cyanocobalaminum, Lidocaine hydrochloride.

An additional component is distilled water.

The medication is available in two forms. Ambene in ampoules is double-shaped in packs of 3 or 10 pieces. In two-chamber syringes or Ambene injections with a kit that includes a disposable needle, a napkin and a patch, packs of 3 or 9 pieces.

Instructions for use and dosage

The medicine is used 1 piece per day, with or without intervals per day. In each situation individually. However, no more than 3 injections can be used per week. The duration of the course of treatment is the doctor. If repeated courses are required, then the next treatment should be started no less than a few weeks later.

Ambene is injected deep into the muscle, the rate of administration should be slow. The patient should lie horizontally during the procedure.

When making an injection from an ampoule, first of all, a solution is drawn into the syringe, labeled A, and then B.

Steps for making a solution in a syringe

Remove the rubber cap from the end of the syringe.
The needle from the kit is placed on the point, but the protective element is first removed. The piston is moved towards the top slowly until the first drop of the solution appears.
Then solution B will enter the connecting bridge in the front section of the syringe and mix with solution A
After mixing the solutions labeled A and B, the drug will begin to flow through the needle immediately into the body.

The temperature of the finished solution should be approximately the same as the body temperature of the patient to whom the injection is intended.

Indications for use

Medication widely used in medicine, or rather, it is used to treat the following diseases:

rheumatoid, gouty arthritis;
osteoarthritis;
arthrosis;
pathology of peripheral nerves (neuralgia, neuritis);
radiculitis;
degenerative diseases of the spine, incl. spinal hernia;
dysfunction of the brachial, lumbosacral plexus;
pain in the joints, incl. thigh muscles;
dorsalgia, etc.

Contraindications

Despite its therapeutic effect, the drug has many contraindications. The medicine should not be taken by people with:

pathologies of the cardiac system;
gastritis;
peptic ulcer of the stomach and duodenum;
disorders in the activity of the kidneys, liver, thyroid gland;
viral infections;
zaaminellosis;
glaucoma;
myelosuppression;
myopathy, myasthenia gravis;
dry Sjögren's syndrome;
hemorrhagic diathesis;
systemic lupus erythematosus;
temporal arteritis, polymyalgia rheumatica;
pancreatitis;
stomatitis.

In addition, the medicine is forbidden to take:

56 days before routine vaccination and 14 days after;
with lymphadenitis, which is caused by the introduction of the BCG vaccine;
during surgical interventions;
pregnant and lactating women;
children under the age of 14 and adults in old age;
if there is information in the anamnesis about the occurrence of urticaria, acute rhinitis, bronchospasm while taking acetylsalicylic acid or other NSAIDs;
special sensitivity to Ambene composition, as well as to pyrazolone derivatives and salicylates.

special instructions

The drug is contraindicated for administration in those patients who have pathologies in violation of the function and activity of the kidneys and liver.

Amben is used with caution in the treatment of patients with diabetes mellitus, tuberculosis, amebiasis, epilepsy, mental disorders, bronchial asthma, hay fever, chronic nonspecific lung pathologies, bacterial infections, arterial high or low blood pressure, thromboembolism, severe osteoporosis.

The dose of the drug should be reduced as much as possible to weakened and sick elderly people in order to to prevent adverse reactions.

During treatment, it is important to eat right. Food should be rich in potassium, protein, vitamins, and the intake of fats, carbohydrates and table salt should be reduced.

With the appearance of symptoms such as fever, headache, changes in the skin and mucous membranes, with the development of diseases such as leukopenia, agranulocytosis, when staining the stool in a dark color, the drug should be stopped.

If therapy is carried out for a long time, it is worth monitoring the state of peripheral blood, the work of the kidneys and liver. With parallel therapy with anticoagulants, it is important to control blood clotting.

If there is a need to investigate the function of the thyroid gland, the analysis should be performed no earlier than 14 days after stopping therapy with Ambene, since the phenylbutazone component may appear on the test results.

Taking the drug can also distort laboratory results in people with pernicious anemia and funicular myelosis.

In case of any changes in the state of health and existing diseases, it is worth consulting with a specialist.

Taking the drug by pregnant and lactating women

The drug can not be used by women during the period of bearing a child, as well as during lactation. If it is impossible to avoid taking the drug, then breastfeeding should be stopped.

Taking the drug by children and the elderly

The drug is not allowed to be taken by children under the age of 14, as well as by the elderly.

Side effects and overdose

Unwanted adverse reactions after taking the drug may occur throughout the body.

In the digestive system, the drug can cause anorexia, nausea, vomiting, diarrhea, perforation and bleeding of the gastrointestinal tract, an ulcerogenic effect, gastralgia can occur, liver activity can sometimes be disrupted, hemorrhagic pancreatitis.

The blood organs can react to the drug with agranulocytosis, thrombocytopenia, aplastic anemia, pancytopenia, leukopenia.

Allergic manifestations can occur in the form of itching, exanthema, fever on the skin, less often in the form of Stevens-Johnson syndrome, acute or toxic epidermal necrolysis, drug lupus, bronchospasm.

The nervous system can react with headaches, dizziness, excessive arousal, sleep disturbances, less often vision, hearing, and the psyche may be disturbed.

Cardiac system: low blood pressure,

From the side of the heart: sometimes arterial or orthostatic hypotension may occur.

Local reactions may occur at the injection site in the form of pain, accumulation of pus, death of part of the tissue (necrosis).

Other negative consequences can be expressed in hypercortisolism, mycosis, impaired renal function, reduced resistance to various infections and microbes, slow wound healing, lymphadenopathy, sialadenitis.

The chance of overdose is also high. It can be expressed in nausea, vomiting, pain in the gastrointestinal tract, its bleeding, dizziness, headaches, respiratory depression, an increase or decrease in the pH of the blood at the metabolic level, also in the form of hyperventilation, fever, low blood pressure, kidney failure, hepatic, cardiac, bradycardia, pulmonary edema, cerebral, thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, increased activity of transaminases, anuria, convulsions, coma.

Symptoms of an overdose are in many ways similar to the manifestation of side effects. If you have any of these symptoms, you should consult a doctor.

drug interaction

With simultaneous treatment with various medications, Ambene may react differently.

Name	Possible reaction
Anti-inflammatory medicines containing ethanol	Increases the possibility of bleeding from the gastrointestinal tract
Oral hypoglycemic (sugar-lowering) medicines (sulfonylurea derivatives) or insulin	Blood glucose may rise or blood sugar may drop below normal
Indirect anticoagulants, heparin, dipyridamole, sulfinpyrazone	In some cases, it will be necessary to adjust the dosage of the medication, as there is a possibility of bleeding
Methotrexate	May increase methotrexate toxicity
Phenytoin	Symptoms of phenytoin poisoning may occur
Barbiturates	May increase the hypnotic effect of barbiturates
cardiac glycosides	May slow down or speed up the digitalization of patients
Antihypertensive drugs	There is a possibility of reducing the therapeutic effect of antihypertensive drugs
Diuretics	May reduce diuresis and natriuresis, may develop a lack of potassium in the blood or an overabundance.
Hormonal contraceptives	The effectiveness of contraceptives will be reduced, which may lead to unwanted pregnancy
Sulfinpyrazone or probenecid	May decrease the uricosuric effect of sulfinpyrazone and probenecid
Anabolic steroids and methylphenidate	Enhance the healing effect of Ambene
Liver microsomal enzyme inducers, such as promethazine, rifampicin, hydantoin, barbiturate, if used prior to treatment with Ambene	Reduce the therapeutic effect of Ambene

Storage and dispensing from pharmacies

The shelf life of the drug is 36 months. It should be stored at a temperature not exceeding 25 0 C. It is released on prescription. Keep away from children.

Interaction with alcohol

During drug treatment consumption of alcoholic products is not recommended.

Analogues

The drug has a number of analogues in terms of therapeutic effect. There are no structural analogues with Ambene (according to the active ingredient). Therefore, really similar substitutes are difficult to find.

Combined drug Ambene, the action of which is due to the properties of the components that make up its composition. It has anti-inflammatory, analgesic and antipyretic effects, causes a uricosuric effect.

Pharmacological properties

Dexamethasone is a glucocorticoid that has a pronounced anti-inflammatory effect; the index of its relative anti-inflammatory activity is 30 with an almost complete absence of mineralocorticoid activity.

Phenylbutazone - NSAID, a pyrazolone derivative, has anti-inflammatory, analgesic and antipyretic effects, causes a uricosuric effect.

Sodium salicylamide-o-acetate, which is part of other ingredients, has an analgesic effect, and also contributes to better solubility of the drug.

Cyanocobalamin, which is involved in the synthesis of nucleic acids, activates lipid metabolism and, as a result, is important in cell regeneration and the formation of the myelin layer of nerve fibers, is part of the drug in a sufficiently high dose to enhance the analgesic effect.

Due to the presence of lidocaine hydrochloride, which is part of the other ingredients of the solution, injections of the drug are practically painless.

The active substances that make up Ambene potentiate each other's action, which allows you to reduce the dose of dexamethasone.

The activity of the drug is maintained for a long time (36 months) due to the separation of solutions A and B from each other.

Pharmacokinetics

Suction. After intramuscular administration, dexamethasone is rapidly absorbed into the systemic circulation.

Distribution. Phenylbutazone has a high degree of plasma protein binding.

Dexamethasone and phenylbutazone cross the placenta and are excreted in breast milk.

Metabolism. Due to the high binding of phenylbutazone to plasma proteins, its metabolism is slow, providing a long T1 / 2.

Indications for use

A drug Ambene is intended for the treatment of such diseases: arthritis (inflammation of the joint); neuralgia (spread of pain along the nerve); degenerative diseases (with a violation of the tissue structure) of the spine, accompanied by a pronounced pain syndrome (the injection form of the drug is used only during an exacerbation of the disease).

Mode of application

A drug Ambene appoint 1 injection per day daily or every other day. Make no more than 3 injections per week. If it is necessary to conduct repeated courses of treatment, the interval between them should be at least several weeks. Injections of the drug are made deep in / m, slowly; the patient should be in a horizontal position.

Rules for the preparation of an injection solution:

When using Ambene in the form of a set of 2 ampoules, first solution A is drawn into the syringe, then solution B.

When using the drug in the form of a finished syringe, the rubber cap is removed from the conical part of the syringe; the attached sterile needle, having removed the protective element, is installed on the cone; slowly move the piston rod with the plug forward until the first drop of solution appears. With the correct injection preparation technique, solution B enters the anterior chamber of the syringe through the connecting bridge and mixes with solution A. The drug is administered immediately after mixing the solutions. The temperature of the prepared solution should be close to the temperature of the patient's body.

Side effects

Side effects of the drug Ambene may be from the nervous system: dizziness, headache, convulsions, sleep disturbances, agitation, euphoria, psychosis. From the urinary system: anuria, impaired renal function. From the digestive system: nausea, vomiting, loss of appetite, abdominal pain, diarrhea, erosive and ulcerative lesions of the gastrointestinal tract, gastrointestinal bleeding, impaired liver function (rarely). On the part of the hematopoietic organs and the hemostasis system: leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia, pancytopenia. On the part of the respiratory system: hyperventilation of the lungs, depression of the respiratory center. From the CCC: bradycardia, lowering blood pressure, orthostatic collapse (rarely). From the senses: impaired vision and hearing. Laboratory indicators: metabolic alkalosis or acidosis, increased activity of "liver" transaminases. Allergic reactions: exanthema, pruritus, rarely - bronchospasm. Local reactions: pain at the injection site, abscess and tissue necrosis (rarely). Others: fever, swelling of the brain and / or lungs, coma, mycosis, immunosuppression (reduced resistance to infections, slowing wound healing). Treatment: IVL and other resuscitation measures; according to indications, antiepileptic drugs (in / in the introduction of diazepam), hemodialysis.

Contraindications

A drug Ambene contraindicated for use in diseases: hypersensitivity; acute gastritis; peptic ulcer of the stomach and duodenum (including in remission); acute myocardial infarction, CHF (II-III stage), myocardial diseases with impaired conduction, ventricular arrhythmias, liver and / or kidney failure, impaired thyroid function; viral infection (including herpes, chicken pox, parotitis, poliomyelitis, with the exception of the bulbar form of the disease); systemic mycosis; glaucoma, corneal injury; diseases of the blood and bone marrow (including leukopenia, thrombocytopenia, hemophilia), myelosuppression; myopathy, myasthenia; Sjögren's syndrome; hemorrhagic diathesis, porphyria; giant cell (temporal) arteritis, polymyalgia rheumatica; pancreatitis; stomatitis; lymphadenitis after BCG vaccination; surgical operations; deficiency of glucose-6-phosphate dehydrogenase; children's age (up to 14 years), old age. With caution. Diabetes mellitus, tuberculosis, amebiasis, epilepsy, mental illness, bronchial asthma, hay fever, COPD, bacterial infection, arterial hypertension, arterial hypotension, thromboembolism, osteoporosis.

Pregnancy

Ambene contraindicated for use in pregnancy.

If necessary, use Ambene during lactation, the issue of stopping breastfeeding should be resolved.

Interaction with other drugs

With the simultaneous use Ambene and other anti-inflammatory drugs and drugs containing ethyl alcohol, the risk of bleeding from the gastrointestinal tract increases.

When prescribing the drug with oral antidiabetic agents (sulfonylurea derivatives) or insulin, hyper- or hypoglycemia is possible.

Simultaneous use Ambene and anticoagulants of indirect action, heparin, dipyridamole or sulfinpyrazone may require dose adjustment of drugs depending on the indicators of prothrombin time.

Under influence Ambene there may be an increase in the level of plasma concentrations, sulfonamides and lithium preparations.

Application Ambene causes an increase in the toxicity of methotrexate.

With the simultaneous appointment of the drug with phenytoin, symptoms of intoxication with the latter may develop.

Under influence Amben The hypnotic effect of barbiturates may be enhanced.

The appointment of the drug together with cardiac glycosides can slow down or accelerate the digitalization of patients.

The simultaneous use of Ambene and antihypertensive drugs reduces the effect of the latter.

With the simultaneous administration of the drug and taking diuretics, it is possible to reduce diuresis and natriuresis, as well as the development of hypo- or hyperkalemia.

Under the influence of Ambene, the contraceptive effect of hormonal contraceptives may decrease.

Administration of the drug together with sulfinpyrazone or probenecid may reduce their uricosuric effect.

The use of drugs in the patient before the appointment of Ambene - inducers of microsomal liver enzymes (for example, barbiturates, promethazine, rifampicin, hydantoin) reduces the effect of the drug.

Anabolic steroids and methylphenidate enhance the effect of Ambene.

In the period before (8 weeks) and after (within 2 weeks) routine vaccination, the administration of the drug reduces or completely eliminates its effectiveness.

Overdose

Overdose symptoms Ambene: nausea, vomiting, abdominal pain, gastrointestinal bleeding, dizziness, headache, metabolic alkalosis or acidosis, hyperventilation, respiratory depression, fever, arterial hypotension, liver and kidney failure, bradycardia, cerebral and pulmonary edema, thrombocytopenia, leukopenia , agranulocytosis, aplastic anemia, elevated transaminases, cardiac decompensation, anuria, convulsions, coma.

Treatment: artificial ventilation of the lungs and other resuscitation measures; according to indications - anticonvulsants (for example, intravenous administration of diazepam), hemodialysis.

Release form

Set: solution A in ampoules and solution B in ampoules in a package of 3 or 10 pieces; solution for injection in a syringe with two separate chambers for solutions A and B in a package of 3 or 9 pieces.

Storage conditions

A drug Ambene should be stored in a place protected from light at a temperature not exceeding 25°C.

Terms of dispensing from pharmacies: the drug is dispensed by prescription.

Compound

Solution A for injection contains: dexamethasone - 0.0035 g, butadiene - 0.375 g, lidocaine hydrochloride - 0.004 g, sodium hydroxide - 0.04908 g, salicylamide sodium - 0.15 g, water for injection - 1.68 g. Solution B for injection contains: cyanocobalamin (vitamin B2) - 0.0025 g, lidocaine hydrochloride - 0.002 g, water for injection - 0.993 g.

Main settings

Name:	AMBENE
ATX code:	M09AX -

Pharmacological properties and forms of the drug "Ambene" allow not only to treat, but also to use it for prophylactic purposes - the indications for use are varied. In addition, the drug is perfectly combined with other anti-inflammatory drugs. However, without consulting a doctor, self-medication is unacceptable due to the high risk of undesirable consequences.

Description of the drug

The uniqueness of "Ambene Bio" lies in the careful selection of active ingredients. In close interaction, they have several therapeutic effects at once - from anti-inflammatory to regenerative and analgesic. Therefore, this drug is rightfully considered a first aid for acute pain in the joints.

The manufacturer created the drug in two ready-to-administer solutions - each in its own special packaging. Due to this, pharmacological properties increase significantly, and undesirable effects decrease, because the doses of the active substances included in the composition are minimal - they simply successfully complement each other after penetration into the human body.

Varieties:

injections "Ambene" - for intramuscular injections, on a medical tray 3 or 5 sets;
two-chamber syringes with an individual needle, as well as a napkin and adhesive plaster 3 or 9 pieces per pack.

There is also a form of tablets - biconvex, with a creamy tint and a rounded shape, packing in protective blisters of 10 pieces. Each pack contains 20 to 50 pieces.

The manufacturer tells in detail about the properties and rules for using the drug in the instructions, which must be attached to each package with the medication.

Indications for use "Ambene"

Most often, doctors who have studied the instructions for use recommend Ambene tablets and injections for the relief of articular syndrome. Main indications for use:

rheumatoid arthritis;
gouty form of osteoarthritis;
radiculitis and osteochondrosis of the spine;
spondylitis;
neuralgia and neuritis of various etiologies;
sports injuries of the joints and spine.

In some cases, doctors recommend "Ambene" in injections or tablets for other degenerative foci in the musculoskeletal system. The optimal doses, the frequency of administration (reception), as well as the duration of the treatment course are also determined by the doctor. Self-medication is absolutely unacceptable.

Less commonly, the drug is used for prophylactic purposes - to prevent the progression of articular disease. The specialist considers each of the indications taking into account the accompanying somatic disorders in the patient.

Pharmacological action of the drug

Since Ambene drugs are characterized by combination, pharmacodynamics must be considered taking into account all the components present in the composition. So, in solution A, non-steroidal anti-inflammatory activity is inherent in phenylbutazone, a derivative of pyrazolone. Thanks to him, the drug is able to provide analgesic, as well as antipyretic and uricosuric effects.

At the same time, against the background of sodium salicylamide-o-acetate entering the tissues, an analgesic effect will be observed - a decrease in the intensity of the pain syndrome. The same action is caused by the presence of lidocaine in the composition. Modern glucocorticosteroid dexamethasone has a powerful anti-inflammatory effect along with low mineralocorticoid activity.

Due to the component of solution B - cyanocobalamin - the drug has the following pharmacological properties:

the formation of nucleic acids is enhanced;
lipid metabolism is activated;
increased cartilage regeneration and the formation of a layer of myelin in the nerve fibers of the peripheral innervation.

Pharmacokinetics of the drug

After injection or oral administration into the patient's body, the components of "Ambene Bio" quickly enter the systemic channel and from there to the joint lesion. The components of the drug have a high activity of binding to plasma proteins, but are slowly metabolized. Therefore, the half-life is long - over 3-3.5 hours. With a decrease in the glomerular filtration rate in the kidneys, it is even greater.

Instructions for use "Ambene"

For the introduction of the medicinal substance "Ambene", you must first prepare a solution. The packaging must be unpacked, the ampoules must be warmed to a temperature of 35–36 degrees. Then, the contents from vials A and B are drawn into one syringe. After mixing the agent, the remaining air is squeezed out using the syringe plunger. A ready-made set of drugs 2 ml is carefully and slowly injected intramuscularly.

How to use the ready-to-use syringe:

remove the rubber cap;
install the needle directly on the syringe body;
remove the protective cover from the needle;
gently move the plunger of the syringe until the first drop of medicine appears at the tip of the needle;
solution B will mix with solution A through the built-in bridge inside the syringe chamber;
perform intramuscular injection manipulation.

The tablets are easy to swallow with a small amount of water. Multiplicity of reception 2-3 times a day for the first 2 days, then 1 piece 1-2 times a day, duration - no more than 15-20 days.

special instructions

To prevent the occurrence of side effects in debilitated patients, the drug is recommended to be administered in minimal doses.

Immediately before the start of therapy, a study should be carried out to determine the parameters of the general, as well as biochemical blood tests.

It is imperative to control the work of hepatocytes, as well as renal structures. The picture of laboratory results in patients with funicular myelosis, as well as pernicious anemia due to Ambene Bio, may be distorted.

Contraindications and side effects

Like most complex formulations, Ambene has a number of limitations. In the list of contraindications to the use of the drug, the manufacturer indicated:

exacerbation of peptic ulcer of the stomach or duodenum 12;
erosive gastritis;
acute stage of myocardial informant;
decompensated heart failure;
severe course of thyroid diseases;
ophthalmic injuries;
damage to the hematopoietic system and bone marrow;
myasthenia gravis or myopathy;
hemorrhagic variant of diathesis;
lymphadenitis and porphyria;
individual hyperreaction to the components of the drug.

A competent doctor will never prescribe a drug to pregnant and lactating women, since Ambene is characterized by severe teratogenic effects - significant damage will be caused to the child's health. It is also contraindicated for children under 12–14 years of age. In old age, the question of the admissibility of the use of the drug is decided on an individual basis. Simultaneous intake of "Ambene" and alcoholic beverages is unacceptable - this leads to severe toxic effects on the liver.

In addition, the risk of exacerbation of gastrointestinal diseases increases when interacting with other representatives of the NSAID subgroup. Hypoglycemia is possible when taken with antidiabetic agents. The toxicity of methotrexate, phenytoin, and sulfinpyrazone increases. Reduced benefit from barbiturates, antibiotics, liver enzymes.

An overdose of the drug will contribute to the development of side effects, such as:

convulsions;
cephalgia;
psychoses;
dizziness and sleep disturbances;
dyspepsia and vomiting;
deterioration of vision and hearing;
gastrointestinal bleeding.

From the local manifestations of the introduction of a medicinal substance, local pain in the injection area, redness of the tissues, and necrosis may appear.

The composition of "Ambene" and its useful properties

To obtain the maximum therapeutic effect, the drug components are placed in two containers. Solution A contains:

phenylbutazone;
lidocaine hydrochloride;
sodium salicylamide-o-acetate;
dexamethasone.

Of the auxiliary components are sodium hydroxide, as well as water for injection.

The composition of the drug B contains:

lidocaine hydrochloride;
cyanocobalamin.

As an auxiliary component - water for injection. In tablets, sodium phenylbutazone is predominantly presented.

As a complex remedy, the drug, even at the minimum dose in osteoarthritis, reduces pain. At the same time, the severity of the inflammatory process in the tissues quickly decreases - an attack of arthritis can be stopped in a short time. At the same time, the patient's temperature parameters are optimized, including in the area of the affected joint. Increased mobility and range of motion - with gonarthrosis, coxarthrosis, which is important for patients with severe degenerative foci. "Ambene Bio" also contributes to the correction of metabolic processes of lipids, as well as nucleic acids.

One of the secondary useful properties of the drug is the prevention of the transition of the disease of the joint into a chronic severe form, which does not allow you to perform work duties, forces you to use a cane and can lead to disability.

Where is the drug sold

Unfortunately, it is not possible to purchase "Ambene Bio" in a regular pharmacy chain. A remedy from Germany can be ordered at specialized pharmacies that work directly with the supplier. At the same time, the cost of the drug increases many times.

Of course, you can inexpensively order an injection solution or tablets on the official website of the supplier - it is easy to find on the Internet. It is enough to enter a query about the drug and how to purchase it in the search box. In the same place, on the official website, all information about the composition of the medicine, conditions of use is presented, certificates and reviews of patients are given.

Despite the fact that the price in this case is lower by 25-30%, there is no guarantee of the authenticity of the medication. Poor resellers often deceive online buyers. In cases of disagreement, it will be difficult to return the money and damaged health.

On average, with severe inflammation in the joints, the course of therapy will require from 10 to 20 injections. Therefore, "Ambene", according to the reviews of those who have already undergone such treatment, will cost 10-12 thousand rubles. In Moscow and St. Petersburg, prices are even higher, the same is true for remote regions of the country.

Shelf life and storage conditions of the medicine

In order for the combined remedy "Ambene Bio" to retain its full medicinal properties, it must be properly stored. The solution must be in the original packaging. It is better to place a cardboard pack in a cool place, for example, the bottom shelf on the refrigerator door.

Immediately before the intramuscular injection procedure, one ampoule or syringe must be warmed to human body temperature.

An open container with a medicine is not stored, since pathogens, when they enter the liquid, contribute to the destruction of the chemical bonds of the drug.

Doctors recommend avoiding getting the medication into the hands of children - severe consequences of drug poisoning are possible. Direct sunlight can penetrate the solution, so the packaging should not be exposed to the sun.

Shelf life of unopened packaging with Ambene Bio is 2.5–3 years. After the expiration of the officially specified date, which is stamped on the end of the cardboard pack, the drug is absolutely forbidden to enter the patient's body. Toxic processes will lead to a deterioration in the functioning of hepatocytes, as well as renal glomeruli.

Similar drugs

In terms of its pharmacological effects, Ambene Bio is similar to other representatives of the NSAID subgroup or chondroprotectors:

"Chondrolon";
"Rumalon";
"Xefocam" or "Movalis";
"Dexamethasone";
"Milgamma" or "Diprospan".

However, there is no complete coincidence of the composition and chemical compounds of the drug with analogues. This is its uniqueness for the treatment of osteoarthritis. In addition, each of them has its own indications for use, as well as contraindications, side effects and limitations. All such nuances can only be taken into account by a doctor. Self-medication increases the risk of complications and severe consequences.