Composition, form of production and packaging
Tablets of white color, round, flat-cylindrical, with a bevel.
ipidakrine hydrochloride (in the form of monohydrate) 20 mg
Excipients: lactose monohydrate - 65 mg, potato starch - 14 mg, calcium stearate - 1 mg.
10 pieces. - packings cellular planimetric (5) - packs cardboard.
INSTRUCTION FOR THE SPECIALIST.
Description of the drug approved by the manufacturer for the printed edition of 2017.
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 В® 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 В® enhances the effect on the smooth muscles of not only acetylcholine, but also adrenaline, serotonin, histamine and oxytocin.
Neuromidine В® 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.
After ingestion, the drug is rapidly absorbed from the digestive tract. C max in blood plasma is achieved after 1 hour.
Binding to plasma proteins is 40-50% . Ipidacrin quickly enters the tissues, the half-distribution period is 40 minutes.
Ipidacrine is metabolized in the liver.
It is excreted by the kidneys, and also extrarenally (through the digestive tract). Excretion by the kidney occurs mainly through tubular secretion and only 1/3 of the dose is excreted by glomerular filtration.
- 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 lesions of the CNS, accompanied by motor and / or cognitive impairment;
- treatment and prevention of intestinal atony.
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 different etiology - 10-20 mg (0.5-1 tab.) 1-3 times / day. The course of treatment is from 1 to 2 months. If necessary, the course of treatment can be repeated several times with a break between courses in 1-2 months.
To prevent myasthenic crises , for severe disorders of neuromuscular conduction, 1-2 ml (15-30 mg) of 1.5% solution of Neuromidine for injections are injected for a short time, then the treatment is continued, appointing Neuromidine В® in the form of tablets - the dose can be increased to 20- 40 mg (1-2 tablets) 5 times / day.
Diseases of the central nervous system:
When bulbar paralysis and paresis, during the recovery period of organic lesions of the central nervous system (traumatic, vascular and other genesis), accompanied by motor and / or cognitive impairment - 10-20 mg (0.5-1 tab.) 2-3 times / day. The course of treatment is from 2 to 6 months. If necessary, repeat the treatment.
For the treatment and prevention of atony of the intestine - according to 20 mg (1 tab.) 2-3 times / day for 1-2 weeks.
If the next dose has not been taken on time, in addition it should not be taken.
The maximum daily dose is 200 mg.
Reactions caused by stimulation of m-cholinergic receptors: <10% - salivation, increased sweating, palpitation, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, bronchospasm, 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.
- 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 apply the drug for peptic ulcer of stomach and duodenum, thyrotoxicosis, diseases of the cardiovascular system, in patients with obstructive diseases of the respiratory system in the history or in acute respiratory diseases, as well as with lactase deficiency, lactose intolerance, lactose / isomaltose malabsorption syndrome , t. the composition of the drug includes lactose.
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.
During the period of treatment, the patient should exclude the use of alcohol. Alcohol increases the side effects of the drug.
Impact on the ability to drive vehicles and manage mechanisms
During treatment, the patient should refrain from driving motor vehicles, as well as practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.
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.
Neuromidine В® 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.
Neuromidine В® weakens the inhibitory effect on neuromuscular transmission and conduction of excitation along the peripheral nerves of local anesthetics, aminoglycosides, potassium chloride.
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, dry, protected from light at a temperature of no higher than 25 В° C. Shelf life - 5 years.