Юмекс

Юмекс – drug from group of protivoparkinsonichesky means, inhibitors of a monoaminooxidase of type B. Active ingredient – селегилин. Participates in metabolism of a dopamine, other catecholamines. Drug carries out inhibition of the return serotonin reuptake in dopamine presynaptic receptors, increasing its concentration in kernels of both extrapyramidal system, and other departments of a brain.

Юмекс it is capable to potentiate, prolong effect of a levodopa in case of treatment of parkinsonism.

Юмекс it is not used for treatment of patients with the extrapyramidal symptomatology which is not followed by deficit of a dopamine (a chorea of Gentington, an essential tremor).

At oral administration of Yumeks it is quite intensively and quickly soaked up. The maximum concentration is reached 0,5-2 hours later. Contacts plasma proteins in number of 94%. Юмекс it is quickly metabolized in an organism. The main metabolites – L-amphetamine, L-methamphetamine, N-dizmetilselegilin. Both active agent, and metabolites are capable to get through a blood-brain barrier. Metabolites are removed with urine (about 73%) and through intestines (about 15%).

Indications to Yumeks's use

According to the instruction to Yumeks, drug is shown at treatment of a disease of Parkinson, symptomatic parkinsonism.

As monotherapy of Yumeks it can be used at the initial stages of a disease of Parkinson for a delay of use of a levodopa (with purpose of peripheral inhibitor of a decarboxylase or without it), it can also be applied together with a levodopa (with PID or without).

Contraindications to Yumeks's use

In the instruction to Yumeks the following contraindications are specified:

• Hypersensitivity to a selegilin;
• The extrapyramidal pathology which is not connected with deficit of a dopamine (a chorea of Gentington, an essential tremor);
• Pregnancy, lactation.

With extra care it is necessary to appoint Yumeks at such pathology:

• Peptic ulcer of a stomach, DPK;
• Lability of arterial pressure;
• Tachycardia;
• Heavy stenocardia;
• Psychosis;
• Dementia;
• Late dyskinesia;
• Krupnorazmashisty tremor;
• Thyrotoxicosis;
• Pheochromocytoma;
• Prostate hyperplasia;
• Closed-angle glaucoma.

In combination with a levodopa of Yumeks it is impossible to appoint at:

• To open angle glaucoma;
• Renal, liver failure;
• To melanoma;
• Oppression of TsNS;
• Convulsive attacks;
• HZL;
• To bronchial asthma;
• Myocardial infarction.

Route of administration, dosage

According to the instruction, Yumeks is applied orally in a daily dosage of 5-10 mg (at monotherapy and together with a levodopa). It is possible to accept Yumeks in the morning once. At a daily dosage of 10 mg it is possible to divide a dose into two receptions. At co-administration of Yumeks with a levodopa, the dosage of a levodopa can be lowered approximately by 30%.

Side effect

Drug of Yumeks at monotherapy is rather well transferred.

In the instruction to Yumeks the following side effects are described:

• Allergic reactions: short wind, rash, photosensitization, bronchospasm;
• from a GIT: dryness in a mouth, nausea, locks, diarrhea, a loss of appetite, a dysphagy;
• From CCC: orthostatic hypotension, is more rare – increase in the ABP, arrhythmia;
• From TsNS: change of mood, sleeplessness, dizziness, psychoses, dyskinesia;
• Others: increase in level of hepatic transaminases, an ischuria, a nocturia, a headache, a diplopia, visual acuity disturbance, the increased perspiration, a hair loss, a hypoglycemia.

As Yumeks is capable to exponentiate clinical effects of a levodopa, side effects of a levodopa (a hyperkinesia, excitement, the abnormal movements, confusion of consciousness, postural hypotension, arrhythmias, hallucinations) at a combination therapy also amplify.

Yumeks's interaction with other drugs

Yumeks's combinations with the following drugs are contraindicated:

• Sympathomimetics: danger of increase in arterial pressure;
• Pethidine: the MAO non-selective inhibitors and pethidine are incompatible. The mechanism of this interaction is unknown, however Yumeks's use, pethidine or other opioid analgetic absolutely contraindicated;
• Inhibitors of the return serotonin reuptake: drug of Yumeks cannot be accepted with fluoxetine in connection with risk of development of hypertensia, excitement, convulsions, an ataxy, hallucinations, maniacal psychosis. It is impossible to accept fluoxetine two weeks after Yumeks's cancellation. Due to the long elimination half-life of fluoxetine after its cancellation and before Yumeks's use there have to pass more than 5 weeks;
• Tricyclic antidepressants: the phenomena of crushing toxic defeat of TsNS (a tremor, dizziness, attacks) which is followed by hypotension, hypertensia, profuse sweating at patients who accepted this combination are described;

It is not recommended to combine Yumeks with MAO inhibitors (risk of severe hypotension).

Юмекс strengthens clinical effects of a levodopa, means, the oppressing TsNS, ethanol, increases the frequency of side effects of an amantadin.

Interaction with food

At monotherapy by Yumeks (unlike treatment by the MAO traditional inhibitors) it is not necessary to adhere to a special diet. However at a combination therapy with MAO or MAO inhibitors of A type it is necessary to avoid the food containing a large amount of tyramine: barmy products, aged cheese.

Special instructions

In connection with property of this drug to exponentiate action of a levodopa and to strengthen its side effects, constant control behind a condition of the patient is necessary. The involuntary movements, excitement arising at reception of this combination of drugs take place at reduction of a dosage of a levodopa. It is impossible to exceed the maximum daily dosage of Yumeks (10 mg) as at the same time drug loses selectivity that increases probability of development of hypertensia.

The researches revealing Yumeks's influence on ability to manage motor transport were not conducted. However it is necessary to refrain that potentially dangerous types of activity which require special attention, speed of motor, mental reactions.

Yumeks's use at pregnancy

Drug of Yumeks is contraindicated at pregnancy, a lactation.

Responses

Thanks to high clinical performance of Yumeks reviews of this drug positive. Юмекс well proved in treatment of a disease of Parkinson, and also symptomatic parkinsonism.

Yumeks's analogs

The following analogs of Yumeks are registered: Когнитив, Segan, Niar, Selegilin, Eldepril, Stillin.