Finlepsinum 200 ретард

General characteristics. Structure:

One tablet ретард (the prolonged action) contains 200 mg of active ingredient of carbamazepine.

Other components: methacrylate copolymers, triacetin, talc, microcrystallic cellulose, high-disperse silicon dioxide, magnesium stearate, кросповидон.

Pharmacological properties:

The antiepileptic means (derivative dibenzazepine) rendering also normotimichesky, anti-maniacal, antidiuretic (at patients with not diabetes mellitus) and analgeziruyushchy (at patients with neuralgia) action. The mechanism of action is connected with blockade of potentsialzavisimy Na+-channels that leads to stabilization of a membrane of neurons, inhibition of emergence of serial categories of neurons and decrease in synoptic carrying out impulses. Prevents repeated formation of Na+-dependent action potentials in the depolarized neurons. Reduces release of exciting neuromediator amino acid of a glutamate, raises a reduced convulsive threshold and thus reduces risk of development of an epileptic attack. Increases conductivity for K+, modulates potentsialzavisimy Ca2+-channels that can also cause anticonvulsant effect of drug. Adjusts epileptic changes of the personality and eventually increases skill to communicate of patients, promotes their social rehabilitation. The HP and in combination with other anticonvulsant HP can be appointed as the basic therapeutic. It is effective at the focal (partial) epileptic attacks (simple and complex) which are followed or not followed by secondary generalization, at generalized toniko-clonic epileptic attacks, and also at a combination of the specified types (it is usually inefficient at small attacks - petit mal, absentias epileptica and myoclonic attacks). At patients with epilepsy (in particular at children and teenagers) positive influence on symptoms of uneasiness and a depression, and also decrease in irritability and aggression is noted. Influence on cognitive function and psychomotor indicators depends on a dose and is very variable. The beginning of anticonvulsant effect varies from several hours to several days (sometimes up to 1 month owing to a metabolism autoinduktion). At an essential and secondary epileptiform neuralgia in most cases prevents emergence of painful attacks. Effktiven for simplification of a neurogenic pain at tabes, posttraumatic paresthesias and post-herpetic neuralgia. Easing of pains at an epileptiform neuralgia is noted in 8-72 h. At a syndrome of alcoholic abstinence raises a threshold of convulsive readiness (which at this state is usually lowered) and reduces expressiveness of clinical manifestations of a syndrome (a hyperexcitability, a tremor, gait disturbances). At patients with not diabetes mellitus leads to bystry compensation of a water balance, reduces a diuresis and feeling of thirst. Antipsychotic (anti-maniacal) action develops in 7-10 days, can be caused by oppression of metabolism of a dopamine and noradrenaline. The prolonged dosage form provides maintenance of stabler concentration of carbamazepine in blood without "peaks" and "failures" that allows to reduce the frequency and expressiveness of possible complications of therapy, to increase efficiency of therapy even when using rather low doses. Other important advantage of the prolonged form is the possibility of reception 1-2 times a day.

Indications to use:

• epilepsies: partial attacks with elementary symptomatology (focal attacks); partial attacks with difficult symptomatology (psychomotor attacks); big attacks, generally focal genesis (big attacks during sleep, diffusion big attacks); the mixed epilepsy forms;
• epileptiform neuralgia;
• the pristupoobrazny pains of the unknown reason arising on the one hand a root of language, a throat and a soft palate (genuinical glossofaringealny neuralgia);
• pains at defeats of peripheral nerves at a diabetes mellitus (pain at a diabetic neuropathy);
• epileptiform spasms at multiple sclerosis, as, for example, spasms of facial muscles at an epileptiform neuralgia, tonic spasms, pristupoobrazny disturbances of the speech and movements (a paroxysmal dysarthtia and an ataxy), unpleasant feelings (paroxysmal paresthesias) and pain attacks;
• the prevention of development of convulsive attacks at an alcoholic abstinence syndrome;
• psychoses (generally at maniac-depressive states, hypochiondrial depressions). Secondary prevention of affective and schizoaffective psychoses.

Precautionary instruction: to the prevention of development of convulsive attacks at an alcoholic abstinence syndrome Finlepsinum is applied only in the conditions of a hospital.

Route of administration and doses:

Without special instructions of your attending physician for Finlepsinum 200 ретард the following modes of doses are valid. Please, adhere to the doses ordered by the doctor since differently Finlepsinum 200 ретард will not have medical effect!

What quantity and as often you have to accept Finlepsinum 200 ретард

Treatment with Finlepsinum 200 ретард is begun carefully, appointing drug in low doses individually for each patient, depending on character and weight of a picture of a disease. Then the dose is slowly raised to achievement of the most effective maintenance dose. An optimum dose of drug for the patient, especially at a combination therapy, determine by level it in a blood plasma. By the accumulated experience therapeutic concentration of Finlepsinum 200 ретард in a blood plasma makes 4–12 mkg/ml.

Replacement of one antiepileptic means with Finlepsinum 200 ретард should be made gradually, reducing a dose of earlier used drug. Whenever possible antiepileptic means is applied only to monotherapy. Behind the course of treatment establish observation from the specialist doctor.

The standard range of doses makes 400–1200 mg of Finlepsinum 200 ретард in days which distribute on 1–2 single doses a day. Exceeding of the general daily dose making 1200 mg does not make sense. The maximum daily dose should not exceed 1600 mg since higher doses can promote increase in number of side effects.

In some cases the dose, necessary for treatment, can deviate considerably the recommended initial and maintenance dose, for example, because of the accelerated metabolism in connection with induction of microsomal enzymes of a liver or because of interactions of medicines at a combination therapy.

Without special instructions of the doctor are guided by the following indicative scheme of use of drug:

Anticonvulsant treatment

Generally, at adults the initial dose making 1–2 tablets ретард (there correspond 200–400 mg of carbamazepine), slowly raise to the maintenance dose equal to 4-6 tablets ретард (there correspond 800–1200 mg of carbamazepine).

Generally, the maintenance dose of carbamazepine for children on average makes 10-20 mg/kg of body weight a day.

 

The following scheme of dosing is recommended
 
The adult appoint in the morning/evening    200–300 mg in the evening
                                                               on 200–600 mg on 400–600 mg    
To children appoint                                   watch the instruction    
from 6 to 10 years in the evening                           on 200 mg in the evening                   on 200 mg in the morning on 200–400 mg 
from 11 to 15 years in the morning/evening               on 200 mg in the evening                   on 200–400 mg on 400–600 mg 

Instruction

For children up to 6 years for the initial and supporting treatment on hand there are tablets of not prolonged action. Due to the insufficient experience accumulated with tablets ретард children are not recommended to appoint them at this age.

The prevention of development of convulsive attacks at an alcoholic abstinence syndrome in the conditions of a hospital

The average daily dose makes 1 tablet ретард in the morning, appoint 2 tablets ретард in the evening (there correspond 600 mg of carbamazepine). In hard cases in the first days the dose can be raised to 3 tablets ретард 2 times a day (there correspond 1200 mg of carbamazepine).

Finlepsinum 200 ретард should not be combined with sedative and hypnotic means. According to clinical requirements, however, if necessary Finlepsinum 200 ретард can be combined with other substances applied to treatment of alcoholic abstinence.

During treatment it is regularly necessary to control the maintenance of Finlepsinum 200 ретард in a blood plasma.

Due to the development of side effects from central and the autonomic nervous system (watch the phenomena of alcoholic abstinence in the section "Side effects") for patients establish careful clinical observation.

Epileptiform neuralgia, genuinical glossofaringealny neuralgia

The initial dose makes 1–2 tablets ретард (there correspond 200–400 mg of carbamazepine), which up to total disappearance of pains is raised on average on 2–4 tablets ретард (there correspond 400–800 mg of carbamazepine), which distribute on 1–2 single doses a day. After that at a certain part of patients treatment can be continued by lower maintenance dose which just still can warn attacks of the pain making 1 tablet ретард 2 times a day (there correspond 400 mg of carbamazepine).

The elderly and sensitive patient Finlepsinum 200 ретард is appointed in the initial dose making 1 tablet ретард 1 time a day (there correspond 200 mg of carbamazepine).

Pains at a diabetic neuropathy

The average daily dose makes 1 tablet ретард in the morning and 2 tablets ретард in the evening (there correspond 600 mg of carbamazepine). In exceptional cases ретард it is possible to appoint Finlepsinum 200 in a dose on 3 tablets ретард 2 times a day (there correspond 1200 mg of carbamazepine).

Epileptiform spasms at multiple sclerosis

The average daily dose makes 1–2 tablets ретард 2 times a day (there correspond 400–800 mg of carbamazepine).

Treatment and prevention of psychoses

The initial dose which is, as a rule, also sufficient as a maintenance dose makes 1–2 tablets ретард in days (there correspond 200–400 mg of carbamazepine). If necessary this dose can be raised to 2 tablets ретард 2 times a day (there correspond 800 mg of carbamazepine).

Instruction

The patient with a serious cardiovascular illness, damages of a liver and kidneys, and also to elderly people appoint lower doses of drug.

How and when you have to accept Finlepsinum 200 ретард

Tablets ретард are supplied with a dividing groove, accept them in time or after food, washing down with enough liquid (for example, a glass of water).

ретард it is possible to take a pill after preliminary disintegration them in water (in the form of suspension). The prolonged action remains also after disintegration of a tablet in water.

In certain cases especially effective was a distribution of a daily dose to 4–5 single doses in day. Dosage forms of drug of not prolonged action are for this purpose best of all suitable.

As long you have to accept Finlepsinum 200 ретард

Duration of use depends on the indication and individual reaction of the patient to drug.

Treatment of epilepsy is carried out long. About transfer of the patient into Finlepsinum 200 ретард, duration of use and cancellation in each separate case the specialist doctor has to solve it. Generally, the dose of a medicine can try to be lowered or to absolutely stop treatment not earlier, than after 2-3-year absence of attacks.

Treatment is stopped gradual decrease in a dose of drug within 1–2 years. At the same time at children it is necessary to consider increase of body weight. EEG indicators at the same time should not worsen.

At treatment of neuralgia useful was a purpose of Finlepsinum 200 ретард in a maintenance dose, just still sufficient for removal of pains, within several weeks. Careful decrease in a dose it is necessary to find out whether there occurred spontaneous remission of symptoms of a disease. When resuming the painful attacks treatment continues to be carried out by a former maintenance dose.

Duration of treatment of pains at a diabetic neuropathy and epileptiform spasms at multiple sclerosis is established same, as well as at neuralgia.

Treatment of an alcoholic abstinence syndrome Finlepsinum 200 ретард is stopped a gradual dose decline within 7–10 days.

Prevention of maniac-depressive phases is carried out it is long.

Features of use:

Due to the possible emergence of side effects, and also hypersensitivity reactions to drug it is recommended, especially at long reception, to periodically carry out analyses of a picture of blood and to check function of a liver and kidneys. It is done prior to treatment, then in the first month of treatment once a week, and after that once a month. After the first 6 months of treatment these control do 2–4 times a year.

In the same way it is regularly necessary to control concentration of Finlepsinum 200 ретард and other antiepileptic means in a blood plasma when carrying out a combination therapy and if necessary to lower daily doses.

The treatment termination by Finlepsinum 200 ретард at patients with epilepsy and transfer them on other antiepileptic means is done not suddenly, and gradually lowering a dose it.

At patients with glaucoma regularly control intraocular pressure. It is necessary to consider that side effects of Finlepsinum 200 ретард at treatment of an alcoholic abstinence syndrome have similarity to the phenomena of abstinence and can be easily confused with them.

If in exceptional cases for prevention of maniac-depressive phases at insufficient efficiency of one lithium Finlepsinum 200 ретард has to be appointed together with it, then in order to avoid undesirable interactions (watch "Interactions with other medicines") it is necessary to watch that a certain concentration of carbamazepine in a blood plasma (8 mkg/ml) was not exceeded, the content of lithium was supported in the low therapeutic range (0,3–0,8 ¼Ý¬ó¿ó/l), treatment by neuroleptics was carried out more than 8 weeks ago, and also behind that it was not carried out at the same time.

Use of drug at service of cars and when working without observance of rules according to safety measures

Due to the emergence in an initiation of treatment of such side effects from the central nervous system as dizziness, drowsiness, uncertainty of gait and headaches, at use of drug in high doses and/or at a combination with other medicines influencing the central nervous system, Finlepsinum 200 ретард even at the correct use — irrespective of influence on a treated basic disease — can change so your reactive ability that you cannot actively participate more in traffic or service cars.

You also cannot more quickly enough and is concentrated to react to unexpected events. You should not drive the car or other transport! You should not use electric cutting instruments or service cars! You should not perform work without observance of rules on safety measures! Especially you remember that alcohol can weaken your ability quickly even more to react with participation in traffic.

Side effects:

Observed side effects arose at the combined treatment more often, than at monotherapy. Depending on a dose and generally in an initiation of treatment there can be following side effects:

Central nervous system / Mentality

There can often be a consciousness oglushyonnost, disorder of consciousness (drowsiness), dizziness, fatigue, disturbance of gait and movements (a cerebellar ataxy) and headaches. At patients of advanced age confusion of consciousness and concern can develop.

In isolated cases the depressive bad mood, an agressive behavior, block of thinking, depletion of motives, and also disorders of perception (hallucination) and a sonitus are observed. At treatment by Finlepsinum 200 ретард latent psychoses can be activated.

Seldom there are involuntary movements as, for example, a krupnorazmashisty tremor, reductions of muscles or twitching of an eyeglobe (nystagmus). Besides, patients of advanced age and with damages of a brain can have such frustration of coordinate motive acts as, for example, the involuntary movements in rotolitsevy area in the form of grimacings (rotolitsevy dyskinesia), rotary motions (choreoathetosis). It was reported about separate cases of disturbances of the speech, false sensations, weakness of muscles, inflammations of nerves (peripheral neuritis), and also displays of paralysis of the lower extremities (paresis) and disorders of perception of taste.

The majority of these phenomena disappear in itself in 8–14 days or after temporary decrease in a dose. Therefore whenever possible Finlepsinum 200 ретард is dosed carefully, beginning treatment with low doses, then gradually raising them.

Eyes

In some cases there were inflammations of a connecting cover of an eye (conjunctivitis), sometimes passing visual disturbances (disturbances of accommodation of an eye, doubling in eyes, a vision vagueness). It was reported about phacoscotasmus cases.

At patients with glaucoma it is necessary to measure intraocular pressure regularly.

Motive system

In isolated cases spasms of muscles were observed a joint pain and muscles (an arthralgia, a mialgiya), and also. These phenomena disappeared after cancellation of a medicine.

Skin and mucous membranes

It was reported about cases of allergic skin reactions with fever or without it as, for example, seldom or often arising urticaria (urtikariya), a skin itch, sometimes macrolaminar or scaly inflammations of skin (exfoliative dermatitis, an erythrosis), a necrosis of superficial sites of skin with formation of bubbles (Lyell's disease), a photosensitivity (photosensitization), erubescences with polymorphic rashes in the form of spots and formation of nodes, with hemorrhages (an exudative mnogoformny erythema, a knotty erythema, Stephens-Johnson's syndrome), petekhialny hemorrhages in skin and a lupus erythematosus (the red disseminated lupus).

In isolated or exceptional cases the hair loss (alopecia) and perspiration were noted (диафорез).

Circulatory and lymphatic system

Due to hypersensitivity reactions at treatment the following disturbances of a picture of blood can arise Finlepsinum 200 ретард, besides: increase (a leukocytosis, an eosinophilia) or reduction (leukopenia) of number of leukocytes or thrombocytes (thrombocytopenia) in peripheral blood is rare or frequent. According to literature most often there is a high-quality form of a leukopenia (approximately in 10% of cases passing, and in 2% of cases persistent).

It was reported about isolated cases of diseases of blood, sometimes even life-threatening the patient as an agranulocytosis, aplastic anemia along with other forms of anemia (hemolitic, megaloblastichesky), and also about increase in a spleen and lymph nodes.

At emergence of leukopenias (most often neutropenias), trombotsitopeniye, allergic rashes on skin (dieback) and fever Finlepsinum 200 ретард is cancelled.

Digestive tract

Sometimes there are an appetite loss, dryness in a mouth, nausea and vomiting, seldom develops a diarrhea or a lock. It was reported about isolated cases of abdominal pains and inflammations of mucous membranes of a cavity of a stomatopharynx (stomatitis, an ulitis, a glossitis). These phenomena undergo treatments, in itself in 8–14 days, or after temporary decrease in a dose of drug. They can be avoided initial purpose of low doses of drug with their gradual increase.

In literature instructions on the fact that carbamazepine can sometimes cause a pancreas inflammation (pancreatitis) meet.

Liver and bile

Sometimes changes of indicators of a functional trial of a liver are found, in rare instances appears jaundice in isolated cases there are different forms of hepatitis (cholestatic, hepatocellular, granulyomatozny, mixed).

Two cases of an acute intermittent porphyria were described.

Hormonal, water and salt metabolism

It was reported about separate cases of increase in mammary glands at men (gynecomastia) and the spontaneous expiration of milk from mammary glands at women (galactorrhoea).

Finlepsinum 200 ретард can influence parameters of function of a thyroid gland (triiodothyronine, thyroxine, thyritropic hormone and free thyroxine), especially at its combination with other antiepileptic means.

Due to the action of Finlepsinum 200 ретард, reducing removal of urine from an organism (antidiuretic effect) in rare instances the decrease in content of sodium in blood serum (hyponatremia) accompanied with vomiting, a headache and confusion of consciousness can be noted.

Separate cases of emergence of hypostases and increase of body weight were observed. Finlepsinum 200 ретард can lower calcium level in blood serum. In isolated cases it leads to a softening of bones (osteomalacy).

Respiratory organs

Separate cases of hypersensitivity reactions of the lungs to drug accompanied with fever, short wind (диспноэ), pneumonia and pneumoscleroses are described.

Urinogenital path

Seldom there are renal failures which are expressed the increased urine protein content (proteinuria), the emergence of blood in urine (hamaturia) reduced by release of urine (oliguria) in isolated cases they develop up to insufficiency of kidneys. Perhaps, these disturbances are caused by own antidiuretic effect of medicinal substance. Sometimes there are a dysuria, a pollakiuria and an ischuria.

Besides, cases of sexual frustration as, for example, impotence and decrease in sexual desire are known.

Cardiovascular system

In exceptional or isolated cases, generally elderly people or at patients with the known dysfunctions have hearts, there can be a lowered heart rate (bradycardia), disturbances of a heart rhythm, and also deterioration in a coronary disease of heart.

Disturbances of carrying out excitement in heart (atrioventricular block), in isolated cases accompanied with a faint are seldom noted. Besides, in some cases blood pressure strongly goes down or increases. Falling of arterial pressure generally happens at use of drug in high doses.

Besides, the vasculitis, thrombophlebitis and a thrombembolia were observed.

Hypersensitivity reactions

Seldom the slowed-down hypersensitivity reactions to drug proceeding with fever, skin rash, the inflammation of vessels, a hyperadenosis, joint pains changed by number of leukocytes in peripheral blood, increase in a liver and spleen, change of indicators of a functional trial of a liver which can arise in different combinations develop and also involve in process other bodies, for example lungs, kidneys, a pancreas and a myocardium.

In isolated cases acute generalized reaction and an aseptic inflammation of a meninx with myoclonias and an eosinophilia was observed.

If you notice at yourself by-effects which are not mentioned in this summary, then, please, report about it to your attending physician or the druggist.

What measures should be undertaken at side effects

If you notice at yourself the above-named side effects, then at once report about it to your doctor who will establish severity them and will carry out measures for fight against them (watch also the section "Precautionary Measures at Use"). Especially at emergence of fever, pharyngalgias, allergic reactions on skin in the form of rashes with a hyperadenosis and/or grippopodobny painful symptoms when performing treatment by Finlepsinum 200 ретард it is necessary to ask immediately for the help the doctor and to analyze a blood picture.

At development of heavy allergic reactions Finlepsinum 200 ретард at once is cancelled.

At emergence of certain changes of a picture of blood (leukopenias, are more often than a neutropenia, thrombocytopenia), allergic rashes on skin (dieback) and fever Finlepsinum 200 ретард is cancelled.

At emergence of signs of damage of a liver or its dysfunction, such as slackness, lack of appetite, nausea, yellow coloring of skin or increase in a liver, immediately ask for the help the doctor.

Interaction with other medicines:

What medicines change action of Finlepsinum 200 ретард or what action of medicines changes Finlepsinum 200 ретард?

Due to the development of side effects from the central nervous system it is necessary to avoid the combined use of Finlepsinum 200 ретард with monoaminooxidase inhibitors (means against depressions). Upon transition from one drug to another do a 14-day break in treatment!

Influence of Finlepsinum 200 ретард on concentration of other medicines in a blood plasma

Finlepsinum 200 ретард can increase activity of certain enzymes of a liver and by that to lower the level of other medicines in a blood plasma.

Therefore action of some other at the same time applied medicines, on a chemical structure close to Finlepsinum 200 ретард, can weaken or not be shown even absolutely.

At simultaneous use of Finlepsinum 200 ретард according to clinical requirements if necessary korrigirut doses of the following active ingredients: clonazepam, Ethosuximidum, Primidonum, valproic acid, ламотриджин (other means for treatment of epilepsy), to alprazola, klobaza (the medicines removing sensation of fear), corticosteroids (for example, Prednisolonum, dexamethasone), cyclosporine (means for suppression of a host defense of an organism after organ transplantation), digoxin (means for treatment of heart troubles), tetracyclines, as, for example, doxycycline (antibiotic), фелодипин (the means lowering blood pressure), a haloperidol (medicine for treatment of mental diseases), Imipraminum (antidepressive means), methadone (anesthetic), theophylline (medicine for treatment of a serious illness of respiratory tracts), anticoagulative means, as, for example, warfarin, фенпрокоумон, дикумарол. As well as 200 ретард action of hormonal contraceptives can weaken other antiepileptic means, Finlepsinum (medicines for protection from pregnancy, so-called "pill"). Emergence of intermenstrual bleedings speaks about insufficient hormonal protection against pregnancy. Therefore in such cases it is recommended to apply other non-hormonal contraceptives.

Finlepsinum 200 ретард can both raise, and to lower concentration of Phenytoinum in a blood plasma therefore in exceptional cases there can come conditions of confusion of consciousness up to development of a coma.

Decrease in concentration of Finlepsinum 200 ретард in a blood plasma other medicines

Level of Finlepsinum 200 ретард in a blood plasma can be lowered: phenobarbital, Primidonum, valproic acid, theophylline.

On the other hand, valproic acid and Primidonum can increase level pharmacological of an active metabolite (a product of metabolism of Finlepsinum 200 ретард) carbamazepine-10,11-epoxide in blood serum.

Due to the mutual influence at each other, in particular at the combined use of several antiepileptic drugs, it is recommended to control contents them in a blood plasma and if necessary to korrigirovat a dosage of Finlepsinum 200 ретард.

Increase in concentration of Finlepsinum 200 ретард in a blood plasma other medicines

The following active agents can increase concentration of Finlepsinum 200 ретард in a blood plasma: antibiotics macroleads, as, for example, erythromycin, йозамицин (active agents for treatment of bacterial infections), an isoniazid (medicine for treatment of tuberculosis), antagonists of calcium as, for example, verapamil, diltiazem (medicines for treatment of stenocardia), acetazoleamide (medicine for treatment of glaucoma), вилоксазин (antidepressive means), даназол (medicine for suppression of secretion of a sex hormone of a gonadotrophin), niacinamide in high doses at adults (group B vitamin), it is possible also Cimetidinum (medicine for treatment of a peptic ulcer of digestive tract) and desipramine (antidepressive means).

The increased level of Finlepsinum 200 ретард in a blood plasma can promote development of the symptoms mentioned in the section "Side effects" (for example, dizziness, feeling of fatigue, uncertainty of gait, doubling in eyes). Therefore at emergence of such symptoms control concentration of carbamazepine in a blood plasma and if necessary lower a dose.

Other interactions

Simultaneous use of Finlepsinum 200 ретард and neuroleptics (medicines for treatment of mental diseases) or Metoclopramidum (medicine for treatment of gastrointestinal frustration) can promote emergence of neurologic by-effects.

On the other hand, at patients, treated neuroleptics, Finlepsinum 200 ретард can lower the level of these medicines in a blood plasma and by that to worsen a disease picture. Therefore the doctor can consider necessary to raise a dose of the corresponding neuroleptic.

It is specified that especially at simultaneous use of lithium (medicine for treatment and prevention of certain mental diseases) and Finlepsinum 200 ретард the effect of both active agents striking a nervous system can amplify. Therefore in such cases it is necessary to control carefully the content of both medicines in a blood plasma. The previous treatment by neuroleptics has to be stopped in 8 weeks prior to therapy by these drugs, and also should not be carried out together with them. It is necessary to monitor emergence of the following signs of neurotoxic side effects: uncertainty of gait (ataxy), twitchings or starts of eyeglobes (a horizontal nystagmus), the raised muscular proprioceptive reflexes, bystry reductions of separate muscle fibers (fibrillar twitchings), involuntary reductions of separate bunches of muscle fibers (fastsikulyation).

Finlepsinum 200 ретард can strengthen the action of an isoniazid injuring a liver.

The combined use of Finlepsinum 200 ретард with some diuretics (Hydrochlorthiazidum, furosemide) can cause decrease in content of sodium in blood serum.

Finlepsinum 200 ретард can influence efficiency of the medicines relaxing muscles (muscle relaxants) as, for example, pankuroniya. As a result of it perhaps more bystry elimination of neuromuscular blockade. Therefore behind sick, treated muscle relaxants, establish observation and if necessary raise doses of these medicines.

At simultaneous use of an izotretinoin (active agent for treatment of an acne) and Finlepsinum 200 ретард it is necessary to control the maintenance of Finlepsinum 200 ретард in blood serum.

Finlepsinum 200 ретард probably strengthens release (elimination) of hormones of a thyroid gland and increases the need for them at patients with reduced function of a thyroid gland. Therefore at these patients receiving replacement therapy at the beginning and at the end of treatment 200 ретард determine by Finlepsinum indicators of function of a thyroid gland. If necessary korrigirut a dose of drugs of hormones of a thyroid gland.

At simultaneous use of antidepressive means like blockers of the return serotonin reuptake (antidepressive medicines as, for example, fluoxetine) and Finlepsinum 200 ретард the toxic serotoninovy syndrome can develop.

Remember that these data can be also urgent for the medicines accepted shortly before an initiation of treatment by Finlepsinum 200 ретард.

What use of stimulants, dishes and drinks you should refuse

During treatment by Finlepsinum 200 ретард you should refuse alcohol intake as it it is unpredictable can change and strengthen action of Finlepsinum 200 ретард.

Contraindications:

When you do not accept Finlepsinum 200 ретард?

200 ретард it is contraindicated to apply Finlepsinum at: existence of damage of marrow, disturbances of carrying out excitement in heart (atrioventricular block), the known hypersensitivity to active ingredient, tricyclic antidepressive means or to one of other components, and also at the acute alternating porphyria (a certain hereditary defect in exchange of porphyrines). Finlepsinum 200 ретард should not be applied along with lithium drugs (watch "Interactions with other medicines"). As Finlepsinum 200 ретард can provoke new or strengthen already existing special forms of attacks (so-called absentias epileptica), it is not recommended to appoint it the patient suffering from these forms of attacks.

In what cases only after consultation with the doctor you can accept Finlepsinum 200 ретард?

It is provided below when you can accept Finlepsinum 200 ретард only in certain conditions and only carefully. Please, consult about it to your doctor. It concerns also those cases when the called states already took at you place.

Finlepsinum 200 ретард should not be applied along with MAO inhibitors. The carried-out therapy by MAO inhibitors is stopped not later than 14 days prior to treatment by Finlepsinum 200 ретард.

Only after careful comparison of risk of therapy and the expected favorable effect, and also at observance of the appropriate measures of precaution Finlepsinum 200 ретард can be applied at diseases of the hemopoietic bodies (hematologic diseases), heavy dysfunctions of heart, liver and kidneys (look "Side effects" and "Dosage"), the broken sodium exchange.

Use during pregnancy and feeding by a breast

During pregnancy Finlepsinum 200 ретард is applied only after careful comparison of risk of therapy and the expected favorable effect from the attending physician.

At the pregnancy which is already existing or just come, especially between the 20 and 40 day of pregnancy, Finlepsinum 200 ретард is appointed in the low dose which is most controlling attacks. A daily dose, in particular in the most sensitive period of pregnancy, distribute on several small doses, accepted during the day. It is recommended to control the level of active ingredient in blood serum.

In rare instances in connection with use of active ingredient of carbamazepine it was reported about fruit malformations as well about inborn splitting of a backbone.

Whenever possible it is necessary to avoid a combination of Finlepsinum 200 ретард with other antiepileptic means or other medicines since at the same time the risk of formation of malformations of a fruit increases.

Due to the fermentoindutsiruyushchy properties of carbamazepine purpose of folic acid before approach and during pregnancy can be reasonable.

In order to avoid hemorrhagic complications at the newborn preventive administration of vitamin K, mother in recent weeks is recommended to pregnancy or the newborn at once after the birth. At desire to give birth to the child surely consult about it to your attending physician.

Finlepsinum 200 ретард passes into mother's milk, however in such insignificant quantities that at use in therapeutic doses, generally, does not constitute danger to the child. Only if at the baby note bad addition in weight or the increased drowsiness (sedation), stop breastfeeding.

Use of drug for children and elderly patients

Due to the high content of active ingredient and lack of experience using tablets ретард 200 ретард children under 6 years should not appoint Finlepsinum.

The elderly patient Finlepsinum 200 ретард is appointed in lower doses.

Overdose:

If you forgot to accept one single dose of drug, then as soon as you notice it, at once accept it. If soon after that you have to accept the following ordered dose, then you pass it, and after that try to enter your correct mode of a drug dosing again. After one forgotten dose do not accept a double dose of Finlepsinum 200 ретард at all. In case of doubt ask, please, for the help your attending physician!

What you have to consider if you want to interrupt for some time or to prematurely stop treatment

Independent change of a dose or even the termination of administration of drug without medical control is dangerous! At the same time symptoms of your disease can become aggravated again. Before most to interrupt reception of Finlepsinum 200 ретард, consult about it to your doctor better.

What should be undertaken if Finlepsinum 200 ретард was accepted in very large numbers

The overdose of drug demands urgent medical intervention. The picture of overdose of Finlepsinum 200 ретард is characterized by strengthening of such side effects as, for example, trembling (tremor), the convulsive attacks arising at excitement of a brain (toniko-clonic spasms), excitement and also disturbances of breath and function of cardiovascular system with often lowered (sometimes also raised) blood pressure, the increased heart rate (tachycardia) and disturbances of carrying out excitement in heart (an atrioventricular block, changes of an ECG), disorders of consciousness up to an apnoea and heart. In isolated cases the leukocytosis, a leukopenia, a neutropenia, a glucosuria or an acetonuria which were established on the changed indicators of laboratory analyses were observed.

There is no specific antidote for treatment of acute poisonings with Finlepsinum 200 ретард for the present. Treatment of overdoses of Finlepsinum 200 ретард, as a rule, is carried out depending on painful manifestations in the conditions of a hospital.

Storage conditions:

Medicine period of validity 3 years.
The period of validity of tablets ретард is specified on a foil of a blister strip packaging and on a cardboard box.
After the specified term do not use more tablet ретард this packaging.

Medicines keep in the place, unavailable to children!

Finlepsinum 200 ретард is delivered in the packaging which is reliably insured from children with more dense foil for a covering. If it is difficult for you to squeeze out a tablet ретард, then before to make it, we advise you slightly to make an incision a foil for a covering.

Drug is stored usual conditions.

Issue conditions:

According to the recipe

Packaging:

Finlepsinum 200 ретард is released in packagings on 50, 100 and 200 tablets ретард.