Perinorm

General characteristics. Structure:

Active agent: Metoclopramidum a hydrochloride in 1 ml 5 mg; in 1 amp. 10 mg.

Pharmacological properties:

The antiemetic, promotes reduction of nausea, a hiccups; stimulates a GIT peristaltics. Antiemetic action is caused by blockade of dopamine D2 receptors and increase in a threshold of chemoceptors of a trigger zone, is a blocker of serotoninovy receptors. Believe that Metoclopramidum inhibits the relaxation of smooth muscles of a stomach caused by a dopamine, strengthening thus cholinergic reactions of smooth muscles of a GIT. Promotes acceleration of gastric emptying by prevention of relaxation of a body of a stomach and increase in activity of antral department of a stomach and upper parts of a small bowel. Reduces a contents reflux in a gullet due to increase in pressure of a sphincter of a gullet at rest and increases clearance of acid from a gullet thanks to increase in amplitude of its peristaltic reductions.
Metoclopramidum stimulates secretion of prolactin and causes tranzitorny increase in level of the circulating Aldosteronum that can be followed by a short-term delay of liquid.

Pharmacokinetics. After intake it is quickly absorbed from a GIT. Linkng with proteins of plasma makes about 30%. It Biotransformirutsya in a liver. It is removed preferential by kidneys both in not changed look, and in the form of metabolites. T1/2 makes from 4 to 6 h.

Indications to use:

Vomiting, nausea, hiccups of various genesis. Atony and hypotonia of a stomach and intestines (including postoperative); dyskinesia of biliary tract; reflux esophagitis; meteorism; as a part of complex therapy of aggravations of a peptic ulcer of a stomach and a duodenum; acceleration of a vermicular movement when carrying out X-ray contrast researches GITs.

Route of administration and doses:

The adult inside - on 5-10 mg of 3-4 times/days. At vomiting, severe nausea Metoclopramidum is entered in oil or in/in in a dose of 10 mg. Intranazalno - on 10-20 mg in each nostril of 2-3 times/days.
Maximum doses: one-time at intake - 20 mg; daily - 60 mg (for all ways of introduction).
The average single dose for children over 6 years makes 5 mg 1-3 times / сут.внутрь or parenterally. For children under 6 years the daily dose for parenteral administration makes 0.5-1 mg/kg, reception frequency - 1-3 times/days.

Features of use:

With care apply at patients with bronchial asthma, arterial hypertension, abnormal liver functions and/or kidneys, at Parkinson's disease.

With extra care it is necessary to apply at children, especially early age since at them the risk of emergence of a diskinetichesky syndrome is much higher. Metoclopramidum can be in certain cases effective at the vomiting caused by reception of tsitostatik.

At use for patients of advanced age it must be kept in mind that at prolonged use of Metoclopramidum in high or average doses the most frequent side effect are extrapyramidal frustration, especially parkinsonism and late dyskinesia.

Against the background of use of Metoclopramidum distortions of these laboratory indicators of function of a liver and definition of concentration of Aldosteronum and prolactin in a blood plasma are possible.

Influence on ability to driving of motor transport and to control of mechanisms
During treatment it is necessary to avoid potentially dangerous types of activity requiring special attention, bystry psychomotor reactions.

Side effects:

From the alimentary system: in an initiation of treatment the lock, diarrhea are possible; seldom - dryness in a mouth.
From TsNS: in an initiation of treatment the feeling of fatigue, drowsiness, dizziness, a headache, a depression, an akathisia are possible. Emergence of extrapyramidal symptoms at children and persons of young age is possible (even after single use of Metoclopramidum): a spasm of facial muscles, hyperkinesias, a spastic wryneck (as a rule, pass right after the termination of reception of Metoclopramidum). At prolonged use, is more often at patients of advanced age, the phenomena of parkinsonism, dyskinesia are possible.
From system of a hemopoiesis: in an initiation of treatment the agranulocytosis is possible.
From endocrine system: seldom, at prolonged use in high doses - a galactorrhoea, a gynecomastia, disturbances of a menstrual cycle.
Allergic reactions: seldom - skin rash.

Interaction with other medicines:

At simultaneous use with anticholinergics perhaps mutual easing of effects.

At simultaneous use with neuroleptics (especially fenotiazinovy number and derivatives of phenyl propyl ketone) the risk of emergence of extrapyramidal reactions increases.

At simultaneous use absorption of acetylsalicylic acid, paracetamol, ethanol amplifies.

Metoclopramidum at in introduction increases the speed of absorption of diazepam and increases its maximum concentration in a blood plasma.

At simultaneous use with slowly dissolved dosage form of digoxin reduction of concentration of digoxin in blood serum on 1/3 is possible. At simultaneous use with digoxin in a liquid dosage form or in the form of an instant dosage form of interaction it is noted.

At simultaneous use with zopiklony absorption of a zopiklon accelerates; with kabergoliny - reduction of efficiency of a kabergolin is possible; with ketoprofen - bioavailability of ketoprofen decreases.

Owing to antagonism concerning dopamine receptors Metoclopramidum can reduce protivoparkinsonichesky action of a levodopa, at the same time increase in bioavailability of a levodopa owing to acceleration of its evacuation from a stomach under the influence of Metoclopramidum is possible. Results of interaction are ambiguous.

At simultaneous use with meksiletiny absorption of a meksiletin accelerates; with meflokhiny - the speed of absorption of a meflokhin and its concentration in a blood plasma increases, at the same time reduction of its side effects is possible.

At simultaneous use with morphine absorption of morphine at intake accelerates and its sedative action amplifies.

At simultaneous use with nitrofurantoin nitrofurantoin absorption decreases.

At use of Metoclopramidum just before introduction of a propofol or thiopental reduction of their induction doses can be required.

At the patients receiving Metoclopramidum effects of succinylcholine of chloride amplify and prolonged.

At simultaneous use with tolterodiny efficiency of Metoclopramidum decreases; with fluvoksaminy - the case of development of extrapyramidal disturbances is described; with fluoxetine - there is a risk of development of extrapyramidal disturbances; with cyclosporine - absorption of cyclosporine increases and its concentration in a blood plasma increases.

Contraindications:

Bleedings from a GIT, mechanical intestinal impassability, perforation of a stomach or intestines, a pheochromocytoma, extrapyramidal disturbances, epilepsy, prolaktinozavisimy tumors, glaucoma, pregnancy, a lactation, simultaneous use of anticholinergic drugs, hypersensitivity to Metoclopramidum.

Use at pregnancy and feeding by a breast
It is contraindicated to use at pregnancy.
At use in the period of a lactation (breastfeeding) it is necessary to consider that Metoclopramidum gets into breast milk.
In pilot studies it is not established adverse action of Metoclopramidum on a fruit.

Use at abnormal liver functions
With care apply at patients with abnormal liver functions.

Use at renal failures
With care apply at patients with renal failures.

Use for elderly patients
At use for patients of advanced age it must be kept in mind that at prolonged use of Metoclopramidum in high or average doses the most frequent side effect are extrapyramidal frustration, especially parkinsonism and late dyskinesia.

Use for children
With extra care it is necessary to apply at children, especially early age since at them the risk of emergence of a diskinetichesky syndrome is much higher.

Overdose:

Now about drug overdose cases Perinorm it was not reported.

Storage conditions:

Drug should be stored in the cool, dry, protected from light place.

Issue conditions:

According to the recipe

Packaging:

Solution for in/in and introductions of 10 mg in oil / 2 ml: amp. 10 pieces.