Aleval – drug with antidepressive action.
Aleval release in the form of tablets, film coated, round, biconvex, blue color, on one party of risk; on a break – white color a kernel (on 14 pieces in strips, 1 or 2 strips in a cardboard pack).
Structure of 1 tablet:
Relative (Aleval it is necessary to appoint with care in the presence of the following diseases / states):
Women of reproductive age during Aleval's use need to use effective methods of contraception.
Pill Aleval is taken inside, in morning or evening, irrespective of meal. Frequency rate of reception – once a day.
Initial adult dose at treatment of a depression and ROC – 50 mg. With an interval not more often than once a week, the dose can be increased gradually to maximum – 200 mg.
The initial effect can be expected within 7 days, full – in 2-4 weeks from the moment of the beginning of therapy (at ROC action can develop later). The maintenance dose at a long course has to be the smallest effective. It is adjusted depending on therapeutic effect.
The recommended dosing mode at treatment of ROC at children:
Initial adult dose at treatment of panic frustration and PTSR – 25 mg. It is possible its gradual (not more often than once a week) increase by 25 mg to maximum – 200 mg (taking into account portability and therapeutic effect).
The initial effect can be expected within 7 days, full – in 2-4 weeks from the moment of the beginning of therapy. The maintenance dose at a long course has to be the smallest effective.
At functional disturbances of kidneys, and also correction of the mode of dosing is not required to patients of advanced age.
Patients with heavy abnormal liver functions need to lower Aleval's dose or to increase breaks between receptions.
Owing to the termination of reception of Aleval the withdrawal which signs are hypesthesias, paresthesias, psychomotor excitement, depression symptoms, aggressive reactions, hallucinations, concern or symptoms of psychosis in rare instances develops (it is impossible to distinguish from symptoms of the main disease).
The combined use of Aleval with monoamine oxidase inhibitors is not recommended (it is necessary to observe a break not less than 14 days).
It is necessary to be careful at the combined use with other drugs which strengthen serotonergic neurotransmission (for example, with tryptophane, fenfluraminy or agonists of serotoninovy 5-NT-retseptorov). Whenever possible, such combination is recommended to be avoided as in this case the risk of development of a serotoninovy syndrome and malignant antipsychotic syndrome increases. Can be symptoms of a serotoninovy syndrome autonomous instability (fluctuations of arterial pressure, tachycardia, a hyperthermia), changes of the mental status (hallucinations, agitation, a coma), neuromuscular transmission changes (a lack of coordination of movements, a hyperreflexia) and/or disturbances from digestive tract (diarrhea, vomiting, nausea). Some symptoms (muscle tension, a hyperthermia, changes of the mental status, autonomous instability with a possibility of bystry fluctuations of parameters of the vital functions) can remind the symptomatology arising owing to a malignant antipsychotic syndrome.
Upon transition from other antidepressants and drugs used for therapy of obsessivno-compulsive frustration (in particular with it is long the operating drugs, for example, from fluoxetine), to sertraline it is necessary to be careful that is connected with limited clinical experience. The necessary interval for implementation of such transition is not established.
At the patients who are exposed to electroconvulsive therapy sufficient experience of use of Aleval is absent. The possible risk or success of such combination therapy is not studied. Also there is no experience of use of drug at a convulsive syndrome in this connection it is recommended to avoid purpose of therapy at patients with unstable epilepsy, and in case of controlled epilepsy it is necessary to exercise careful control of a state. Emergence of spasms demands treatment cancellation.
At some patients treatment by Aleval provoked development of maniacal frustration. Cases of activation of maniacal frustration at maniac-depressive psychosis owing to receiving other antidepressants or means applied to therapy of obsessivno-compulsive frustration are also described.
At liver diseases Aleval it is necessary to apply with care, decrease in a single dose or increase in time between administration of drug can be required. It is also necessary to be careful appointing therapy by the patient with hemorrhagic diseases in the anamnesis and in combination with the medicines having the established ability to change of functions of thrombocytes.
During therapy by Aleval the tranzitorny hyponatremia, most often in case of the combined use with diuretics or some other drugs, and also at elderly patients can develop. Emergence of a symptomatic hyponatremia demands drug withdrawal and purpose of adequate therapy which is directed to correction of concentration of sodium in blood. The headache, disturbances of concentration of attention and memory, instability and weakness belongs to symptoms of a hyponatremia that can lead to falling. In heavier current development of hallucinations, a faint, spasms, a coma, apnoea and a lethal outcome can be observed.
Risk group concerning suicide attempts are patients with a depression. This danger remains before remission development in this connection, from the moment of the beginning of therapy and before achievement of optimum clinical effect, behind a condition of patients it is necessary to establish constant medical control.
At children up to 24 years at a depression and other mental disturbances antidepressants increase probability of development of suicide behavior and suicide thoughts. Before Aleval's appointment this age group of patients needs to correlate advantage to possible risk. It is also necessary to consider that any depressive frustration in itself increases risk of a suicide. Therefore during therapy it is necessary to establish by antidepressants for early identification of changes or behavior disorders, and also suicide bents for all patients observation.
To manage vehicles, the special equipment, and also to perform the works connected with the increased risk during therapy it is not recommended.
In "the washing period" when replacing one inhibitor of neyronalny serotonin reuptake by another there is no need, however change of course of therapy demands care.
At the combined use of Aleval with some medicinal means / substances the following effects can be observed:
To store in protected from light, the place, dry, unavailable to children, at a temperature up to 25 °C.
Period of validity – 3 years.
If your liver ceased to work, death would come within a day.
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