Relationship to plasma proteins is 14-21%, the total distribution. The time to maximum concentration of 0.5 hours. The average value of the maximum concentration of 23.2 ng / ml. The drug is metabolized by monoamine oxidase oxidation involving deca steroid to form metabolites, the main ones are indoleacetic analogue sumatriptan without having pharmacological activity towards serotonin receptors, and its glucuronide.
Relief of migraine attacks (especially accompanied by vomiting) with or without aura.
- hypersensitivity to any component of the drug;
- hemiplegic, basilar migraine and oftalmoplegicheskaya form;
- Coronary heart disease (including myocardial infarction, myocardial infarction, angina, Prinzmetal), as well as the presence of symptoms to suggest the presence of coronary artery disease;
- occlusive peripheral vascular disease;
- stroke or transient ischemic attack (including a history..);
- uncontrolled hypertension;
- receiving simultaneously with ergotamine or derivatives thereof (including methysergide);
- use in patients receiving monoamine oxidase inhibitors or earlier than 2 weeks after the cancellation of these drugs;
- severely impaired liver and / or kidney problems;
- age 18 years and older than 65 years (safety and efficacy has not been established);
- pregnancy and lactation.Carefully:
- controlled hypertension;
- diseases that may change the absorption, metabolism or excretion of the drug (eg, renal or hepatic function);
- epilepsy or any condition with a reduction in seizure threshold);
- in patients with hypersensitivity to sulfonamides (administration sumatriptan can cause allergic reactions, the severity of which varies from cutaneous manifestations of anaphylaxis. Data on the cross-sensitivity is limited, however, caution should be exercised in the appointment of sumatriptan in these patients).Dosing and Administration
Rectal, 1 suppository at a migraine attack occurs.
If migraine symptoms do not disappear or diminish after the first dose, then the cupping of the same attack again taking the drug should deca steroid not be. However, the drug can be used for relief of subsequentmigraine attacks.
If the patient has felt improvement after the first dose, and then resumed symptoms can take a second dose for the next 24 hours. The maximum dose of sumatriptan should not exceed 300 mg over a 24-hour period.Side effects Common Pain, sensation of heat or tingling, feeling of compression or gravity. These symptoms are usually transient, but can be intense and occur in any part of the body including the chest and throat. Hot flashes, dizziness, weakness, fatigue, drowsiness usually are mild or moderate and are transient in nature. On the part of the cardiovascular system arterial pressure, bradycardia, tachycardia, a transient increase in blood pressure (observed shortly after receiving sumatriptan). Rarely -Violation heart rate, transient ischemic deca steroid changes such as myocardial infarction, coronary artery spasm. Sometimes develops Raynaud’s phenomenon. On the part of the gastrointestinal tract Nausea, vomiting, ischemic colitis (but link these side effects with sumatriptan has not been established);dysphagia, abdominal discomfort. On the part of the central nervous system and sensory organs Dizziness, rarely seizures. Sometimes after taking sumatriptan noted diplopia, flashing before the eyes, nystagmus, scotoma, reduced visual acuity. Very rarely develops partial transient loss of vision. However, it should be borne in mind that visual impairment may be associated with himself a migraine attack.Hypersensitivity deca steroid reactions ranging from cutaneous manifestations (rash, urticaria, pruritus, erythema) to rare cases of anaphylaxis. From the laboratory parameters Minor changes in the activity of “liver” transaminases.
After oral administration trimetazidnn durabolin rapidly and almost completely absorbed in the gastrointestinal tract. Bioavailability – 90%. The time to reach maximum plasma concentration – 2 chasa (maximum concentration after a single dose of 20 mg of trimetazidine about 55 ng / ml). Easily penetrates the blood-tissue barriers. Poluvyvёdeniya period . Contact with blood plasma proteins – 16%. Report from the body by the kidneys (60% unchanged).
Indications for use
Ischemic heart disease: prevention of angina attacks durabolin (in the complex therapy).
Kohleovestibulyarny violations ischemic nature, such as dizziness, tinnitus, hearing loss. Chorioretinal vascular disorders.
- Hypersensitivity to any component of the drug;
- Renal impairment durabolin;
- Severe hepatic dysfunction;
- Age 18 years (effectiveness and safety have been established);
- Rare hereditary disease: lactose intolerance, lactase deficiency, glucose-galactose malabsorption.
Pregnancy and lactation
The drug is contraindicated in pregnancy because durabolin of the lack of clinical data on the safety of its use. If necessary, the appointment during lactation should stop breastfeeding. It is not known whether trimetazidine is excreted in breast milk. In experimental studies found no teratogenic effects of trimetazidine.
Dosing and Administration
Inside, during a meal.
The recommended dosing regimen – 2-3 capsules (40-60 mg) per day, 2-3 hours. The course of treatment – on doctor’s advice.
Allergic reactions (itchy skin), seldom durabolin – dyspeptic symptoms (nausea, vomiting, gastralgia). Rarely – headache, a feeling of palpitations.
Currently, the cases of overdose have been reported.
Interaction with other medicinal products
are not described.
Do not use for the relief of angina attacks. Do not indicated for the initial course of therapy of unstable angina or myocardial infarction.
In the case of angina attack should review and adapt the treatment.
Effect on management of vehicles and mechanisms
Trimetazidine does not affect the ability to drive and transport works and require high speed of psychomotor reactions.
Following oral administration trimebutine is rapidly absorbed from the gastrointestinal tract, maximum plasma concentration decanoate is achieved in 1-2 hours. The bioavailability is 4-6%. The volume of distribution (Vd) – 88 l. The degree of binding to plasma proteins is low – about 5%. Trimebutin slightly crosses the placental barrier.
Metabolism and excretion of
trimebutine biotransformed in the liver and excreted in the urine primarily as metabolites (approximately 70% during the first 24 hours).
- Motor disorders in functional gastrointestinal disease, gastroesophageal reflux disease, dyspepsia with gastroduodenal disorders (abdominal pain, dyspepsia, nausea, vomiting), irritable bowel syndrome (functional disorder of the gastrointestinal tract, manifested, in particular, pain and abdominal cramps, spasms of the intestine, flatulence, diarrhea and / or constipation).
- Post-operative paralytic ileus, preparation for radiological and endoscopic examination of the gastrointestinal tract.
Use in children: diarrheal disorders associated with impaired gastrointestinal motility fact.
: Hypersensitivity to the decanoate components included in the composition of the drug. Children under 3 years – for this dosage form.
Application of pregnancy and lactation
is not recommended to use the drug in the I trimester of pregnancy. Do not appoint Trimedat lactation, due to the lack of reliable clinical data supporting the safety of the drug during this period.
In experimental studies revealed no data on the teratogenicity and embryotoxicity drug.
Dosing and Administration
Adults and children from 12 years.: 100-200 mg 3 times a day
Children 3-5 years: 25 mg 3 times daily.
Children 5-12 years: 50 mg 3 times a day .
Rare: skin reactions
So far, cases of drug overdose Trimedat were reported.
Interaction with other drugs
drug interactions Trimedat preparation is not described.
tablets of 100 mg, 200 mg. 10 tablets decanoate in blisters of polyvinyl chloride film and aluminum foil printed patent. At 1, 2 or 3 blisters with instruction on use are placed in a pile of cardboard boxed.
The temperature is not above 25 ° C. Keep out of the reach of children.
Sodium concentration is normalized with the cancellation (dose reduction) deca durabolin cycleor conservative treatment (restriction of fluid intake). Patients with impaired renal function, and low concentration of sodium in the blood serum, or in patients receiving concomitant treatment with drugs that promote sodium excretion from the body (diuretics, drugs affecting the secretion of antidiuretic hormone) before therapy should determine the concentration of sodium in the serum. Further should be controlled in the serum sodium concentration of 2 weeks after initiation of therapy and then monthly for 3 months or as needed. With special attention to these risk factors should be treated in older patients. The appointment of diuretics and other drugs that reduce the concentration of sodium in the blood serum of patients treated should follow the same recommendations. When the appearance of clinical symptoms of hyponatremia, measure the sodium concentration in the blood serum. For the remaining patients, the measurement of the concentration of sodium in the blood serum can be carried out during routine blood tests.
In the treatment of patients in very rare cases, it noted the development of agranulocytosis, aplastic anemia and pancytopenia. Considering the small frequency of occurrence of agranulocytosis, aplastic anemia and pancytopenia, the presence of confounding factors (eg, concomitant use of other drugs, comorbidities), a causal relationship between the development of adverse events data and the use of the drug can not be established. With the development of symptom suppression of bone marrow hematopoiesis is necessary to consider the abolition of the drug.
Patients treated with anticonvulsants, rarely observed episodes of suicidal behavior and thinking. The results of meta-randomized placebo-controlled studies have shown a small increased risk of suicidal behavior in patients treated with anticonvulsants. The mechanism of increase suicide risk in these patients is not established. Stages of treatment requires careful monitoring of patients receiving drug treatment.
It is necessary to carry out the control of body weight in all patients with heart failure to timely identification of fluid retention. When liquid or delay in the progression of heart failure symptoms sodium concentration should be determined in the blood serum. In case of hyponatremia should limit the amount of fluid consumed. Since the use of oxcarbazepine in very rare cases may impair cardiac conduction, the need for careful monitoring of patients with prior conduction disturbances , receiving deca durabolin cycle. When using rarely reported on the development of severe dermatological reactions, such syndrome, toxic epidermal necrolysis (Lyell’s syndrome), exudative erythema multiforme. Patients with the above dermatological reactions may require hospitalization in connection with the development of life-threatening conditions; very rarely can be fatal. When applying dermatological reactions were observed in both children and adults, and developed an average of 19 days after the start of dosing. There are some reports of recurrence of skin reactions at the resumption of receiving . With the development of skin reactions during treatment should consider the abolition of the drug and the appointment of other antiepileptic drugs.
There have been reports of rare cases of hepatitis, which in most cases were resolved successfully. At suspicion on a hepatitis need to consider the abolition of the drug.
Women of childbearing age taking oral contraceptives at the same time should be warned about the possible decrease in the effectiveness of hormonal contraceptives. This category of patients receiving is recommended additional use non-hormonal methods of contraception.
Women of childbearing age recommended, if possible, as monotherapy.
As with any antiepileptic drugs, deca durabolin cycle should be withdrawn gradually because of the risk of increased frequency of seizures.
Trileptal in form for oral suspension contains ethanol in an amount of less than 100 mg per dose. The slurry also contains the parabens, which can cause allergic reactions (possibly delayed).
The structure of the suspension for oral administration include sorbitol, therefore Trileptal in the form of suspensions should not be administered to patients with the inherited disorder of tolerance to fructose.
The effect on the ability to drive vehicles and use machines Patients who during treatment with deca durabolin cyclearises dizziness, drowsiness or other disorders of the central nervous system, do not drive vehicles or operate machinery during treatment.
There are few reports of overdose. The maximum dose described in the reports was approximately g. After the symptomatic treatment of all cases achieved recovery. Symptoms: drowsiness, dizziness, nausea, vomiting, hyperkinesia, hyponatraemia, ataxia, nystagmus.
Treatment. There is no specific antidote. Symptomatic and supportive treatment. It should be borne in mind that in order to reduce absorption of oxcarbazepine may be conducted gastric lavage and an appointment activated carbon.
Interaction with other medicinal products and other forms of interaction . The inhibition of enzymes oxcarbazepine and its pharmacologically active metabolite are inhibitors of cytochrome . Thus, the simultaneous use Trileptal in high doses and drugs are metabolized with nandrolone (eg, phenobarbital, phenytoin), can lead to their interaction. Some patients may require a dose reduction substrates. It has been demonstrated that oxcarbazepine s weak or does not interact with the following microsomal enzymes. The induction of enzymes As inducers of cytochrome , oxcarbazepine reduce plasma concentrations of drugs metabolized by these enzymes: digidropiridinovgh calcium antagonists, oral contraceptives, and antiepileptic drugs (eg, carbamazepine). In an application with Trileptalom also may reduce plasma concentrations of other drugs that are substrates for enzymes , (eg, drugs of immunosuppressants – cyclosporine). Since in vitro is a weak inducer transferase, it is unlikely that in vivo it is able to affect the metabolism of drugs that are excreted as conjugates with glyukurokovoy acid (eg, valproic acid and lamotrigine). However, even taking into account the weak inducing ability of oxcarbazepine , may require increased doses of both of the drugs that are metabolized transferase. In case of cancellation may require dose reduction of these drugs. With In vitro, studies have confirmed the ability of inducing a weak oxcarbazepine and nandrolone with regard to isozymes of subsystems nzymes. Inducing influence of oxcarbazepine to other enzymes known.
- The concentration of phenytoin in blood plasma increases to 40% while applying Trileptal a dose of 1200 mg daily or higher. Therefore, when using Trileptal in the above doses may need to reduce the dose of phenytoin.
Increasing the concentration of phenobarbital in serum while the use slightly (15%) With the simultaneous use of strong inducers (ie carbamazepine, phenytoin and phenobarbital) decreases the concentration.
have Trileptal showed no auto-induction phenomena. Hormonal contraceptives proved interaction with the components of oral contraceptives: ethinyl estradiol and levonorgestrel. Mean values for them is reduced by 48-52% and 32-52%, respectively. Interaction studies with other oral or implanted contraceptives have been conducted. Thus, the simultaneous use nandrolone and hormonal contraceptives can lead to reduced efficiency of the latter. Calcium channel blockers simultaneous use and felodipine may reduce the value of felodipine at 28%, although the plasma concentration remains within the therapeutic range. On the other hand, while the use of verapamil may decrease in serum concentration of 20%. This reduction in the concentration in the serum has clinical importance. Interaction with other drugs cimetidine, erythromycin, dextropropoxyphene not affect the pharmacokinetic parameters ; viloksazin little effect on the plasma concentration . There was no any interaction with warfarin as coadministration with single and repeated.
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