Neyromidin

General characteristics. Structure:

Active agent: an ipidakrina a hydrochloride (in the form of monohydrate) 5 mg

Excipients: Acidum hydrochloricum concentrated - to рН 3.0, water for and - to 1 ml.

Pharmacological properties:

Cholinesterase inhibitor. Exerts the direct stimulating impact on carrying out an impulse on nerve fibrils, mezhneyronalny and neuromuscular synapses peripheral and the central nervous system. Pharmacological effect of the drug Neyromidin® is based on a combination of two mechanisms of action: blockade of potassium channels of a membrane of neurons and muscle cells; reversible inhibition of cholinesterase in synapses.

Нейромидин® strengthens action on unstriated muscles not only of acetylcholine, but also adrenaline, serotonin, a histamine and oxytocin.

Нейромидин® has the following pharmacological effects: improves and stimulates carrying out an impulse in a nervous system and neuromuscular transmission; increases contractility of smooth muscle bodies under the influence of agonists of atsetilkholinovy, adrenalinic, serotoninovy, histamine and oksitotsinovy receptors, except for chloride potassium; improves memory, slows down progreduated development of dementia.

Pharmacokinetics. Absorption
After intake drug is quickly soaked up from a GIT. Cmax in a blood plasma is reached in 1 h.
After parenteral administration drug is quickly soaked up. Cmax in a blood plasma is reached in 25-30 min. after introduction.

Distribution.
Linkng with proteins of a blood plasma makes 40-50%. Ipidakrin quickly comes to fabrics, the period of semi-distribution makes 40 min.

Metabolism
Ipidakrin is metabolized in a liver.

Removal
It is removed by kidneys, and also ekstrarenalno (through a GIT). Excretion kidneys occurs, mainly, by canalicular secretion and only 1/3 doses are allocated by glomerular filtering.

At parenteral administration of 34.8% of a dose of drug it is removed with urine in not changed look.

Indications to use:

— diseases of a peripheral nervous system: mono - and a polyneuropathy, a polyradiculopathy, a myasthenia, a myasthenic syndrome of various etiology;
— TsNS diseases: bulbar paralyzes and paresis; the recovery period of organic lesions of TsNS which are followed by motive and/or cognitive disturbances;
— treatment and prevention of an atony of intestines (the tableted form).

Route of administration and doses:

Doses and duration of treatment by Neyromidin define individually depending on severity of a disease.

Diseases of a peripheral nervous system:

Parenterally drug is used in oil or п / to. At mono - and polyneuropathies of various genesis appoint 5-15 mg 1-2, a course of treatment - 10-15 days (in hard cases up to 30 days); further treatment is continued by the tableted drug form. At a myasthenia and a myasthenic syndrome - on 15-30 mg 1-3, with further transition to the tableted form. The general course of treatment makes 1-2 months. If necessary the course of treatment can be repeated several times with a break between courses in 1-2 months.

TsNS diseases:

Parenterally at bulbar paralyzes and paresis appoint п / to or 1-2 10-15 days, in oil on 5-15 mg; at an opportunity pass to the tableted form. For rehabilitation at organic lesions of TsNS in oil on 10-15 mg 1-2, a course - up to 15 days; further at an opportunity pass to the tableted form.

Features of use:

During treatment the patient has to exclude alcohol intake. Alcohol strengthens side effects of drug.

Influence on ability to driving of motor transport and to control of mechanisms
During treatment the patient has to refrain from driving of motor transport, and also the occupations potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions.

Side effects:

The reactions caused by stimulation of m-holinoretseptorov: <10% - hypersalivation, the strengthened sweating, heartbeat, nausea, diarrhea, jaundice, bradycardia, pain in epigastriums, the strengthened allocation of a secret of bronchial tubes, spasms. Hypersalivation and bradycardia it is possible to reduce m-holinoblokatorami (atropine and others).
At use of drug in high doses: <10% - dizziness, a headache, pain behind a breast, vomiting, the general weakness, drowsiness, skin allergic reactions (an itch, rash). In these cases reduce a dose or quickly (for 1-2 days) interrupt administration of drug.
Others: <10% - increase in a tone of a uterus, skin manifestations of allergic reactions.

Interaction with other medicines:

Нейромидин® strengthens sedation in a combination with means, the oppressing TsNS.
Effect of drug and side effects amplify at combined use with other inhibitors of cholinesterase and m - cholinomimetic means.
At patients with a myasthenia the risk of development of cholinergic crisis at simultaneous use of Neyromidin with other cholinergic means increases.
The risk of development of bradycardia increases if beta adrenoblockers were applied prior to treatment by Neyromidin.
Drug can be used in a combination with nootropic drugs.
Ethanol strengthens side effects of drug.
Нейромидин® weakens the oppressing action on neuromuscular transmission and carrying out excitement on peripheral nerves of local anesthetics, aminoglycosides, chloride potassium.

Contraindications:

— epilepsy;
— vestibular frustration;
— extrapyramidal diseases with hyperkinesias;
— stenocardia;
— the expressed bradycardia;
— bronchial asthma;
— a peptic ulcer of a stomach or duodenum in an aggravation phase;
— mechanical impassability of intestines or urinary tract;
— pregnancy (drug raises a uterus tone);
— period of a lactation (breastfeeding);
— children's and teenage age up to 18 years (there are no systematized data on use);
— hypersensitivity to drug components.

With care to use drug at a peptic ulcer of a stomach and duodenum, a thyrotoxicosis, diseases of cardiovascular system, and also at patients with obstructive diseases of respiratory system in the anamnesis or at acute respiratory diseases. Drug in the form of tablets should be used with care at a lactose intolerance, a lactose intolerance, a lactose/isomaltose sprue since lactose is their part.

Use of the drug NEYROMIDIN® at pregnancy and feeding by a breast
Use of drug at pregnancy and in the period of a lactation (breastfeeding) is contraindicated.
Drug has no teratogenic, embriotoksichesky effect.

Overdose:

Symptoms: a loss of appetite, a bronchospasm, dacryagogue, the strengthened sweating, narrowing of pupils, a nystagmus, strengthening of a vermicular movement of a GIT, spontaneous defecation and an urination, vomiting, jaundice, bradycardia, disturbance of endocardiac conductivity, arrhythmia, decrease in the ABP, concern, alarm, excitement, sensation of fear, an ataxy, spasms, a coma, disturbances of the speech, drowsiness, the general weakness.

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

Storage conditions:

Drug in the form of solution for in oil and п / to introductions (list A) should be stored in the unavailable to children, protected from light place at a temperature not above 25 °C.

Issue conditions:

According to the recipe

Packaging:

1 ml - ampoules glass (10) - packs cardboard.