Neuromidin tablets 20mg, No. 50

• 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 central nervous system, accompanied by motor and / or cognitive impairments;

• treatment and prevention of intestinal atony.

Doses and duration of treatment with Neuromidin are determined individually, depending on the severity of the disease.

Diseases of the peripheral nervous system:

With mono- and polyneuropathy, polyradiculopathy of various etiologies, myasthenia gravis and myasthenic syndrome - 10-20 mg (0.5-1 tab.) 1-3 times / day. The course of treatment is 1 to 2 months. If necessary, the course of treatment can be repeated several times with a break between courses of 1-2 months.

To prevent myasthenic crises, in severe disorders of neuromuscular conduction, 1-2 ml (15-30 mg) of a 1.5% solution of Neuromidin for injection is briefly parenterally injected, then the treatment is continued, prescribing NeuromidinЃ orally 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:

With 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 impairments - 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 course of treatment.

For the treatment and prevention of intestinal atony - 20 mg (1 tab.) 2-3 times / day for 1-2 weeks.

If the next dose was not taken on time, it should not be taken additionally.

The maximum daily dose is 200 mg.

Tablets are white, round, flat-cylindrical, with a bevel.

1 tab.

ipidacrine hydrochloride (in the form of monohydrate) 20 mg

Excipients: lactose monohydrate - 65 mg, potato starch - 14 mg, calcium stearate - 1 mg.

• epilepsy;

• vestibular disorders;

• extrapyramidal diseases with hyperkinesis;

• angina pectoris;

• severe bradycardia;

• bronchial asthma;

• mechanical obstruction of the intestine or urinary tract;

• peptic ulcer of the stomach or duodenum in the acute phase;

• pregnancy (the drug increases the tone of the uterus);

• lactation period (breastfeeding);

• children and adolescents up to 18 years of age (there are no systematized data on the use);

• hypersensitivity to the components of the drug.

Use the drug with caution in case of gastric ulcer and duodenal ulcer, thyrotoxicosis, diseases of the cardiovascular system, in patients with a history of obstructive respiratory diseases or acute respiratory diseases, as well as with lactase deficiency, lactose intolerance, lactose malabsorption syndrome / since the preparation contains lactose.

pharmachologic effect

Cholinesterase inhibitor. It has a direct stimulating effect on the conduction of impulses along nerve fibers, interneuronal and neuromuscular synapses of the peripheral and central nervous systems. The pharmacological action of the drug NeuromidinЃ is based on a combination of two mechanisms of action: blockade of potassium channels in the membrane of neurons and muscle cells; reversible inhibition of cholinesterase at synapses.

NeuromidinЃ enhances the effect on smooth muscles not only of acetylcholine, but also of adrenaline, serotonin, histamine and oxytocin.

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

Pharmacokinetics

Suction

After oral administration, the drug is rapidly absorbed from the gastrointestinal tract. Cmax in blood plasma is reached after 1 hour.

Distribution

Plasma protein binding is 40-50%. Ipidacrine quickly enters the tissues, the half-distribution is 40 minutes.

Metabolism

Ipidacrine is metabolized in the liver.

Withdrawal

It is excreted by the kidneys, as well as extrarenally (through the gastrointestinal tract). Excretion by the kidneys occurs mainly by tubular secretion and only 1/3 of the dose is excreted by glomerular filtration.

Side effect

Reactions caused by stimulation of m-cholinergic receptors: <10% - salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, bronchospasm, convulsions. Drooling and bradycardia can be reduced with m-anticholinergics (atropine and others).

When using the drug in high doses: <10% - dizziness, headache, chest pain, vomiting, general weakness, drowsiness, allergic skin reactions (itching, rash). In these cases, reduce the dose or interrupt the drug intake for a short time (by 1-2 days).

Others: <10% - increased uterine tone, skin manifestations of allergic reactions.

Application during pregnancy and lactation

The use of the drug during pregnancy and lactation (breastfeeding) is contraindicated.

The drug has no teratogenic, embryotoxic effect.

Application in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

During the period of treatment, the patient should exclude alcohol consumption. Alcohol increases the side effects of the drug.

Influence on the ability to drive vehicles and mechanisms

During treatment, the patient should refrain from driving vehicles, as well as engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

Overdose

Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, pupillary constriction, nystagmus, increased gastrointestinal motility, spontaneous defecation and urination, vomiting, jaundice, bradycardia, impaired intracardiac conduction, arrhythmias, decreased blood pressure, agitation, anxiety, anxiety ataxia, convulsions, coma, speech disorders, drowsiness, general weakness.

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

Drug interactions

NeuromidinЃ enhances sedation in combination with drugs that depress the central nervous system.

The effect of the drug and side effects are enhanced when used together 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 Neuromidin with other cholinergic drugs.

The risk of developing bradycardia increases if beta-blockers were used before starting treatment with Neuromidin.

The drug can be used in combination with nootropic drugs.

NeuromidinЃ weakens the inhibitory effect on neuromuscular transmission and conduction of excitation along peripheral nerves of local anesthetics, aminoglycosides, potassium chloride.