Remantadinum

General characteristics. Structure:

Active ingredient: 50 mg of Rimantadinum of a hydrochloride in 1 tablet.

Excipients: potato starch, сахао milk (lactose), поливинилприрролидон (povidone), calcium stearate.

Pharmacological properties:

Pharmacodynamics. Rimantadinum is active concerning various influenza strains And Being the weak basis, Rimantadinum works due to increase in pH of the endosomes having a meme - to a bran of vacuoles which surround virus particles after their penetration into a cell. Prevention of an atsidifikation in these vacuoles blocks merge of a viral envelope to an endosome membrane, preventing, thus, pe-a redacha of virus genetic material in cell cytoplasm. Rimantadinum also oppresses an exit of virus particles from a cell, i.e. interrupts a transcription of a virus genome.

People have a use of Rimantadinum in a daily dose of 200 mg within 2-3 days to and 6-7 days after vozniknove-the niya of clinical displays of flu A of type reduces you - a razhennost of symptoms of a disease and degree serologiche-sky reaction. Some therapeutic action can be also shown if Rimantadinum is appointed within 18 hours after emergence of the first symptoms of flu.

Pharmacokinetics. After intake Rimantadinum almost completely vsa-syvatsya in intestines. Absorption - slow. Communication with it is white - Kami of plasma - about 40%. Distribution volume: adult - 17-25 l/kg, children - 289 l/kg. Concentration in a nasal secret is 50% higher, than plasma. The maximum concentration of Rimantadinum in a blood plasma (Cmax) at reception of 100 mg of 1 times a day - 181 ng/ml, on 100 mg 2 times a day - 416 ng/ml.

It is metabolized in a liver. An elimination half-life (T1/2) - 24-36 h; it is removed by kidneys of 15% - in not changed look, 75-85% - in the form of metabolites.

At a chronic renal failure of T1/2 took away - it chivatsya twice. At persons with a renal failure and at elderly people can collect in toxic concentration if the dose is not adjusted proportsio-nalno to reduction of clearance of creatinine.

Indications to use:

Early treatment and prevention of flu A at adults and children is more senior than 7 years.

Route of administration and doses:

Ремантадин® accept inside (after food), washing down with water. Treatment of flu should be begun during 24-48 h after emergence of symptoms of a disease. The adult in the first day on 100 mg 3 times a day; in the second and third days on 100 mg 2 times a day; in the fourth and fifth day of 100 mg once a day. In the first day of therapy drug use once in a dose of 300 mg is possible.

To children aged from 7 up to 10 years on 50 mg 2 times a day; from 10 to 14 years - 50 mg 3 times a day; 14 years - doses for adults are more senior. Course of 5 days.

For prevention of flu: at adults on 50 mg once a day during to 30 - days; at children 7 years on 50 mg once a day up to 15 days depending on an epidemiological situation are more senior.

For treatment and prevention of flu at a heavy liver failure, epilepsy, to elderly patients of 100 mg once a day.

Features of use:

Use during pregnancy and in the period of a lactation. Ремантадин® it is contraindicated during pregnancy and in the period of a lactation.

At use of the drug Remantadin® the exacerbation of chronic associated diseases is possible. At patients of advanced age with arterial hypertension the risk of development of a hemorrhagic stroke increases. At instructions in the anamnesis on epilepsy and the carried-out anticonvulsant therapy against the background of use of the drug Remantadin® the risk of development of an epileptic seizure increases. In such cases of Remantadin® apply in a dose 100 mg a day along with anticonvulsant therapy.

Preventive reception is effective at contacts with the diseased, at spread of an infection in the closed collectives and at high risk of developing of a disease during a flu epidemic.

Emergence of viruses, resistant to drug, is possible.

Influence on ability to manage motor transport and to work with mechanisms. Ремантадин® reduces ability to concentration of attention and speed of psychomotor reaction. During treatment it is necessary to abstain from driving by vehicles and occupations potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions.

Side effects:

From the central nervous system: a headache, dizziness, sleeplessness, nervousness, narushe-ny concentration of attention, drowsiness, uneasiness, hypererethism, fatigue, an ataxy, depres-this, euphoria, a hyperkinesia, a tremor, hallucinations, it is confused - a nost of consciousness, a spasm.

From the alimentary system: pains in epiga-striya, a meteorism, dryness of a mucous membrane of an oral cavity, anorexia (lack of appetite), nausea, vomiting, diarrhea, dyspepsia.

From cardiovascular system: pallor of integuments, heart consciousness, arterial hypertension, cerebrovascular frustration, heart block, tachycardia, syncope.

From sense bodys: a ring in ears, taste change, a perversion of sense of smell.

From respiratory system: asthma, bronchospasm, cough.

Allergic reactions: skin rash, itch, small tortoiseshell.

Others: adynamy, hyperbilirubinemia.

Interaction with other medicines:

Ремантадин® reduces efficiency of antiepileptic drugs.

The adsorbents knitting and enveloping means reduce drug Remantadin® absorption.

The means (acetazoleamide, Natrii hydrocarbonas) alkalinizing urine increase efficiency of the drug Remantadin® owing to reduction of its removal by kidneys.

Paracetamol and acetylsalicylic acid reduce the maximum concentration of the drug Remantadinum in a blood plasma by 11%.

Cimetidinum reduces clearance of the drug Remantadin® by 18%.

Contraindications:

• hypersensitivity to Rimantadinum, drug components;
• hereditary lactose intolerance, deficit of lactase or glyukozo-galaktozny malabsorption;
• acute diseases of a liver;
• acute and chronic diseases of kidneys;
• thyrotoxicosis;
• pregnancy and lactation;
• children's age up to 7 years.

With care. To apply at arterial hyper - tenziya, epilepsies (including in the anamnesis), atherosclerosis of vessels of a brain, at a liver failure, to patients of advanced age, at digestive tract diseases.

Overdose:

Symptoms: excitement, hallucinations, arrhythmia, stomach aches, irritability, sleeplessness, tremor, spasms.

Treatment: gastric lavage, symptomatic therapy: actions for maintenance of the vital functions. Rimantadinum is partially removed at a hemodialysis.

Storage conditions:

To store in the dry, protected from light place at a temperature not above 25 °C. To store in the place, unavailable to children. A period of validity - 5 years. Not to use drug after expiry date.

Issue conditions:

Without recipe

Packaging:

Tablets of 50 mg. On 10 tablets in blister strip packagings. 1, 2 planimetric packagings with the application instruction place in a pack from a cardboard.