Contraindications and adverse reactions
You should avoid taking the drug in the form of drops in the following cases:
- epilepsy;
- liver diseases;
- brain diseases;
- alcoholism;
- period of lactation and childbearing.
The drug in tablets is contraindicated in the following cases:
- allergy to fructose and galactose;
- sucrase and lactase deficiency.
Taking the drug in any form is contraindicated in the presence of increased susceptibility to the constituent components. Do not give to children under 2 years of age (tablets up to 6 years of age).
In rare cases, after taking the drug, undesirable reactions from the digestive system may occur - pain in the abdominal area, vomiting, nausea. Allergies may also manifest themselves in the form of redness, itching and rashes on the skin. It is extremely rare that an allergic reaction is accompanied by shortness of breath and swelling of the face.
To date, no cases of drug overdose have been recorded.
Is it possible to take Sinupret during pregnancy?
Pregnant women can take the drug only as prescribed by their attending physician. In the 1st trimester, the drug is strictly contraindicated. Preference should be given to the drug in tablet form, since the drops contain alcohol. If any adverse reactions occur, you should immediately stop taking the medicine and tell your doctor.
During breastfeeding, it is better to refrain from taking Sinupret, since there is no clinical data on the possibility of penetration of the active components into breast milk.
Sinupret in the complex therapy of acute post-viral rhinosinusitis
Sinupret, acting on many pathogenetic links of the inflammatory process in the nasal cavity and paranasal sinuses, helps reduce the time required to use basic therapy (p < 0.05). As a result, the cost of treatment and the risk of developing complications from the gastrointestinal tract are reduced due to long-term complex use of drugs. In addition, when using Sinupret, a faster regression of clinical manifestations is observed. There are no side effects. The drug is clinically effective in the complex treatment of acute post-viral rhinosinusitis.
Table. Dynamics of clinical manifestations of the disease in patients of different groups, %
Acute rhinosinusitis, one of the most common diseases, has a different etiological nature (viral, bacterial, fungal) and develops under the influence of allergens and adverse environmental factors.
According to available data, among those who sought help in outpatient medical institutions and were hospitalized in otorhinolaryngological departments, patients with diseases of the paranasal sinuses predominated - from 15 to 62% [1]. The above confirms the relevance of this problem and the importance of timely diagnosis and effective treatment of acute rhinosinusitis [2].
Typically, acute rhinosinusitis develops against the background of an acute respiratory viral infection. Secondary bacterial infection of the nasal cavity and paranasal sinuses after a viral infection develops in 0.5–2% of adults and 5% of children. In 2–10% of cases, acute rhinosinusitis is of bacterial etiology, in 90–98% – viral.
During the process of virus reproduction, a cytopathic effect occurs on the cells of the ciliated epithelium, which provokes its morphofunctional dysfunction and leads to a decrease in the activity of mucociliary transport, hyperproduction of goblet cell secretions and a decrease in specific and nonspecific resistance.
According to international and domestic recommendations, the drugs of choice for the treatment of acute rhinosinusitis are antibiotics [3–5] and immunocorrective drugs. It is also possible to use mucoactive agents. The search for new drugs continues. It is also necessary to create treatment regimens aimed at quickly relieving local and general signs of inflammation and increasing the activity of the immune system.
In this context, the herbal medicine Sinupret, which is successfully used for diseases of the nose and paranasal sinuses, deserves special attention [6–8]. Sinupret has not only secretolytic, but also anti-inflammatory, immunomodulatory, and antibacterial effects. The use of the drug accelerates mucociliary transport of the mucous membrane [6, 9–12]. The wide spectrum of action of Sinupret is due to the medicinal plant components included in its composition.
In vitro study results
demonstrated the inhibitory effect of herbal medicine in drops (extract from primrose and verbena flowers) against influenza A, parainfluenza type 1 and respiratory syncytial virus (RSV) viruses [6–8, 12].
The herbal medicine in drops in vitro
had an immunomodulatory effect: it stimulated the phagocytosis of granulocytes and blood monocytes, increased the concentration of interleukin 1-beta, inhibited cyclooxygenase, and reduced the formation of the inflammatory mediator prostaglandin E [13, 14].
in vitro studies
High antiviral activity of the drug Sinupret was revealed against both DNA and RNA viruses. In particular, the components of the drug Sinupret indirectly inhibit the replication of nucleic acids of a wide range of viruses: influenza A, influenza strain H1N1, influenza subgroup A/California/07/2009 (H1N1), parainfluenza group 3, rhinosyncytial virus, RSV strain Long, human rhinovirus type B subtype 14, Coxsackievirus subgroup A9 and adenovirus C subtype 5 [13, 14].
In an in vitro
compared the synthetic antiviral drugs amantadine and ribavirin [13, 14]. Verbena herb extracts (at a dilution of 1:50) inhibited the formation of viral colonies in cell culture with a dose-dependent effect: by 58% - parainfluenza virus type 1, by 62% - influenza/A/Chile 1/83 virus, by 80% - RSV.
The high pharmaceutical quality of Sinupret is due to the concept of phytoniring - an innovative approach to the production of herbal medicines (discovering the mechanisms of action of plants). The effectiveness and safety of the drug are ensured through high-quality primary material, control and compliance with the requirements for composition (accurate identification) and purity of components, a standardized production process using modern technology (a gentle process for obtaining the drug without temperature stress prevents unwanted changes in the active components) [14, 15 ].
The secretolytic properties of Sinupret are realized through two mechanisms - indirect secretolytic (due to the effects of saponins) and reflex expectorant action (activation of the nervus vagus
) [eleven]. Stimulation of secretory cells of the nasal mucosa and paranasal sinuses by saponins leads to a decrease in secretion viscosity [6, 11]. In addition, the herbal medicine increases the activity of the ciliated epithelium, thereby accelerating the evacuation of secretions from the upper respiratory tract and eliminating mucostasis [6–8, 11]. The plant extracts included in Sinupret are able to block the exudation phase and reduce the permeability of the vascular wall. As a result, swelling of the nasal mucosa is reduced, the evacuation of secretions from the paranasal sinuses is facilitated, drainage and ventilation of the paranasal sinuses are restored, nasal congestion is eliminated, and the protective function of the respiratory tract epithelium is normalized [6, 11].
The anti-inflammatory and decongestant effects of Sinupret are due to the action of saponins in sorrel and primrose extracts, which suppress the activity of cyclooxygenase and, therefore, inhibit the synthesis of the inflammatory mediator, prostaglandin E2 [15].
The anti-inflammatory and decongestant effects of the drug are comparable to those of the highly effective anti-inflammatory substance phenylbutazone [13, 15].
The herbal medicine normalizes mucociliary transport of mucous membranes – the main mechanism of their protection and self-cleaning [9]. Thanks to its complex effect on all parts of the pathogenesis of acute rhinosinusitis, the herbal medicine promotes effective sanitation of the paranasal sinuses [9, 10].
Material and methods
To assess the dynamics of the course of acute post-viral rhinosinusitis, we observed 210 patients who used the drug Sinupret simultaneously with basic therapy, in an outpatient setting and in the otorhinolaryngology department at the clinical base of the Department of Otorhinolaryngology of the Medical Institute of Peoples' Friendship University of Russia during 2021. The diagnosis of acute post-viral rhinosinusitis was made otorhinolaryngologists based on patient complaints, medical history, results of physical examination, rhinoscopic examination, and X-ray methods for examining the paranasal sinuses.
Patients of the first group (n = 110) were prescribed basic therapy: vasoconstrictor nasal drops for five to seven days, antiviral drugs due to severe manifestations of acute respiratory viral infection and antibacterial drugs to prevent bacterial complications for five to ten days, depending on the severity of the disease. Patients of the second group (n = 100), in addition to basic therapy, took Sinupret two tablets three times a day for ten days. Patients in both groups were comparable in severity of the disease.
The effectiveness of the prescribed treatment was assessed based on the dynamics of complaints and the presence of changes in the nasal mucosa. Patients were examined at the time of initial consultation, three days later, and on the fifth, seventh and tenth days after the initial consultation.
Results and discussion
No side effects were observed while taking Sinupret. A positive result was observed from the fifth day of treatment (table). Thus, free breathing was recorded in 33.6% of patients in the first group and 45% in the second. There was no purulent discharge in 34.6% of patients in the first group and 56% in the second. Relief of pain in the paranasal sinuses on the fifth day of treatment occurred in 72.7% of patients with basic therapy and 83% of patients taking Sinupret in addition to it.
By the seventh day of treatment in the first group, complaints of difficulty in nasal breathing remained in 38.2% of patients, the presence of nasal discharge – in 35.7%, and pain – in 9%. While taking the drug Sinupret, a week after the start of treatment, slight nasal congestion was recorded in 12.1% of patients, and discharge from the nasal cavity - in 8.9%. By the tenth day of observation, patients in the second group had no complaints regarding the ENT organs.
It should be noted that the improvement in general condition and relief of local manifestations of rhinosinusitis occurred differently in the groups. The duration of basic therapy in the groups was different, but no one used antibacterial drugs for less than five days. 13.6% of patients in the first group received basic drugs for five days, 9% for six days, 58.2% for seven days. In the Sinupret group, 83.4% of patients stopped taking basic medications due to regression of complaints and relief of the clinical picture of acute rhinosinusitis within five days.
conclusions
As the results of the study showed, the herbal drug Sinupret is well tolerated by patients, promotes rapid regression of clinical manifestations of acute post-viral rhinosinusitis, and is also effective in the complex therapy of acute post-viral rhinosinusitis.
Patients with acute rhinosinusitis who took Sinupret experienced faster recovery and return to work compared to those who received only basic therapy. Sinupret, acting on many pathogenetic components of inflammation in the nasal cavity and paranasal sinuses, helps to reduce the time required to use basic therapy. As a result, the risk of developing complications from the gastrointestinal tract is reduced due to long-term use of a combination of drug groups.
