Universal reference book for medicines
Name of the drug: NEUROMIDIN ® (NEUROMIDIN)

Active substance: ipidacrine

Type: Cholinesterase inhibitor

Manufacturer: OLAINFARM (Latvia)
Composition, form of production and packaging

Solution for w / m and s / to the introduction in the form of a transparent, colorless liquid.

1 ml

ipidakrine hydrochloride (in the form of monohydrate) 5 mg

Excipients: hydrochloric acid concentrated - to pH 3.0, water d / u - up to 1 ml.

1 ml - ampoules glass (5) - packings cellular planimetric (2) - packs cardboard.

1 ml - ampoules glass (10) - packings cellular planimetric (1) - packs cardboard.

Solution for w / m and s / to the introduction in the form of a transparent, colorless liquid.

1 ml

ipidakrine hydrochloride (in the form of monohydrate) 15 mg

Excipients: hydrochloric acid concentrated - to pH 3.0, water d / u - up to 1 ml.

1 ml - ampoules glass (5) - packings cellular planimetric (2) - packs cardboard.

1 ml - ampoules glass (10) - packings cellular planimetric (1) - packs cardboard.

INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2017.

PHARMACHOLOGIC EFFECT

Cholinesterase inhibitor.
It has a direct stimulating effect on impulse conduction on nerve fibers, interneuronal and neuromuscular synapses of the peripheral and central nervous system. The pharmacological action of the drug Neuromidine ® is based on a combination of two mechanisms of action: blockade of the potassium channels of the membrane of neurons and muscle cells; reversible inhibition of cholinesterase in synapses.
Neuromidine ® enhances the effect on the smooth muscles of not only acetylcholine, but also adrenaline, serotonin, histamine and oxytocin.

Neuromidine ® has the following pharmacological effects: improves and stimulates impulse in the nervous system and neuromuscular transmission;
strengthens the contractility of smooth muscle organs under the influence of agonists acetylcholine, adrenaline, serotonin, histamine and oxytocin receptors, with the exception of potassium chloride; improves memory, inhibits the progressive development of dementia.
PHARMACOKINETICS

Suction

With n / to or in / m introduction, the drug is rapidly absorbed.
C max in blood plasma is reached after 25-30 minutes after administration.
Distribution

Binding to plasma proteins is 40-50% .
Ipidacrin quickly enters the tissues, the half-distribution period is 40 minutes.
Metabolism

Ipidacrine is metabolized in the liver.

Excretion

It is excreted by the kidneys, and also extrarenally (through the digestive tract).
T 1/2 of the drug for parenteral administration is 2-3 hours. Excretion by the kidney occurs mainly through tubular secretion and only 1/3 of the dose is released by glomerular filtration.
For parenteral administration, 34.8% of the drug dose is excreted unchanged in the urine.

INDICATIONS

- diseases of the peripheral nervous system: mono- and polyneuropathy, polyradiculopathy, myasthenia gravis, myasthenic syndrome of various etiologies;

- diseases of the central nervous system: bulbar paralysis and paresis;
the recovery period of organic CNS lesions, accompanied by motor and / or cognitive impairment.
DOSING MODE

Enter sc or to / m.
Doses and duration of treatment Neuromidin is determined individually, depending on the severity of the disease.
Diseases of the peripheral nervous system:

With mono- and polyneuropathy, polyradiculopathy of various etiologies - IM or SC 5-15 mg 1-2 times / day, treatment course - 10-15 days (in severe cases, up to 30 days);
further treatment continues with the tablet form of the drug.
With myasthenia gravis and myasthenic syndrome of various etiologies - in / m or s / c 15-30 mg 1-3 times / day, with further transition to the tablet form.
The general course of treatment is 1-2 months. If necessary, the course of treatment can be repeated several times with a break between courses in 1-2 months.
CNS diseases:

In case of bulbar paralysis and paresis, 5-15 mg 1-2 times / day is prescribed for 10-15 days;
if possible, switch to a tablet form.
For rehabilitation with organic lesions of the central nervous system in / m 10-15 mg 1-2 times / day, the course - up to 15 days;
then, if possible, switch to a tablet form.
SIDE EFFECT

Reactions caused by stimulation of m-cholinergic receptors: <10% - salivation, increased sweating, palpitation, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, convulsions.
Salivation and bradycardia can be reduced by m-holinoblokatorami (atropine and others).
When using the drug in high doses: <10% - dizziness, headache, chest pain, vomiting, general weakness, drowsiness, skin allergic reactions (itching, rash).
In these cases, reduce the dose or briefly (for 1-2 days) interrupt the reception of the drug.
Other: <10% - increase in the tone of the uterus, skin manifestations of allergic reactions.

CONTRAINDICATIONS

- epilepsy;

- Vestibular disorders;

- extrapyramidal diseases with hyperkinesis;

- angina pectoris;

- pronounced bradycardia;

- bronchial asthma;

- mechanical obstruction of the intestine or urinary tract;

- Stomach ulcer or duodenal ulcer in the phase of exacerbation;

- Pregnancy (the drug raises the tone of the uterus);

- the period of lactation (breastfeeding);

- children and adolescents under 18 years of age (no systematic data on the application);

- Hypersensitivity to the components of the drug.

With caution should prescribe the drug for peptic ulcer of the stomach and duodenum, thyrotoxicosis, diseases of the cardiovascular system, as well as in patients with obstructive diseases of the respiratory system in the history or in acute respiratory diseases.

PREGNANCY AND LACTATION

Contraindicated use of the drug during pregnancy and lactation (breastfeeding).

The drug does not have teratogenic, embryotoxic effects.

APPLICATION FOR CHILDREN

Contraindicated in children and adolescents under 18 years.

SPECIAL INSTRUCTIONS

Use in Pediatrics

There are no systematic data on the use of the parenteral form of ipidacrin in children.

Impact on the ability to drive vehicles and manage mechanisms

During treatment, the patient should refrain from driving the car, as well as practicing potentially dangerous activities that require increased concentration and speed of psychomotor reactions.

OVERDOSE

Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, narrowing of the pupils, nystagmus, increased peristalsis of the digestive tract, spontaneous defecation and urination, vomiting, jaundice, bradycardia, intracardiac conduction disturbance, arrhythmias, lowering blood pressure, anxiety, anxiety, agitation, ataxia, convulsions, coma, speech disorders, drowsiness, general weakness.

Treatment: use of m-holinoblokatorov (atropine, cyclodol, metacin and others), symptomatic therapy.

DRUG INTERACTION

Neuromidine ® enhances sedation in combination with CNS depressants.

The effect of the drug and side effects are enhanced when combined with other cholinesterase inhibitors and m-cholinomimetic agents.

In patients with myasthenia gravis, the risk of developing a cholinergic crisis increases with the simultaneous use of Neuromidine with other cholinergic agents.

The risk of developing a bradycardia increases if beta-blockers were used before the start of treatment with Neuromidine.

The drug can be used in
combination with nootropic drugs.
Alcohol increases the side effects of the drug.

TERMS OF RELEASE FROM PHARMACY

The drug is released by prescription.

TERMS AND CONDITIONS OF STORAGE

The drug should be stored out of reach of children, protected from light at a temperature of no higher than 25 ° C.
Shelf life - 3 years.
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