Esperal

Esperal – pharmacological drug for treatment of alcoholism. In many responses to Esperal the fact that regular use of drug promotes formation of lasting negative effect on alcohol is confirmed.

Antabusum, Torpedo, Lidevin, Disulfiramum, Tetlong-250, Teturamum – structural analogs of Esperal on the main active component.

Structure and form of release

According to the instruction Esperal is made in the form of tablets for intake, and also in the form of gel and tablets for hypodermic implantation.

One tablet of Esperal contains 0,5 g of Disulfiramum – active component of drug.

Pharmacological action of Esperal

The principle of action of Esperal consists in atsetaldegidrooksidaza inhibition – the enzyme participating in process of splitting and neutralization of ethanol in a blood plasma. Partial oxidation of ethanol promotes accumulation in blood of its intermediate metabolite – acetic aldehyde that leads to toxic poisoning of an organism. Owing to the general intoxication unpleasant symptoms appear: nausea, tachycardia, vomiting, indisposition, general weakness, feeling of shortage of air, drowsiness and block or superexcitation.

Judging by responses, Esperal as alcoholism medicine is applied at that stage of dependence when the patient cannot control amount of the taken alcoholic drinks any more. After the use in 70-90% of drug it is quickly soaked up from a GIT. The maximum medical effect is reached in 11-12 hours after reception of means inside. Esperal's action continues within 9-14 days after the therapy termination.

Esperal's use in the form of implants allows to maintain constant concentration of Disulfiramum (inhibitor) in an organism.

Before Esperal's use the patient has to abstain within two-three days from reception of alcoholic beverages.

In some responses to Esperal it is said that reaction of an organism to alcohol intake against the background of this means can be both fulminant, and delayed. In the last option at the patient the toxic hepatitis affecting a liver, kidneys, a pancreas can develop.

Indications to Esperal's use

According to the instruction Esperal is applied to prevention of a recurrence during therapy of alcohol addiction, and also as disintoxication means during treatment of an alcoholism (at poisoning with nickel).

The instruction to use

According to the instruction Esperal in the form of tablets accept in a dose 0,5 g once a day (in the morning, during a breakfast). In 8-10 days after the beginning of therapy carry out Teturamum - alcoholic test (25-30 ml of 40% of ethanol after Esperal's reception in a dose 0,5g). At weak reaction the dose of ethanol is increased by 15-20 ml (the most admissible dose of alcohol – 110-120 ml). Test is repeated in one-two days in a hospital and in three-five days on an outpatient basis, with correction of doses of ethanol and/or a medicine (as necessary). Further Esperal is recommended to apply in the supporting daily dose (0,150-0,2g) within 1-3 years.

Implantation tablets of drug enter into muscular tissue on depth of four centimeters. Most often Esperal is implanted into the left ileal area or into an upper part of buttocks. After the preliminary procedure of anesthesia and careful disinfection do a small cut (about 6 mm), move apart hypodermic cellulose by means of a trocar and enter two tablets of Esperal (on 0,1 g) on depth about four centimeters. The procedure is repeated by four times, entering tablets parallel to the surface of skin (crosswisely around the place of a cut). The total dose of a medicine makes 0,8 g (eight tablets). After the end of a procedure of implantation the stitch and a sterile bandage is applied a cut. Period of validity of Esperal is defined by a dosage of drug and is selected for each patient individually (of half a year up to five years).

Esperal in the form of gel is implanted and acts similar to means in the form of tablets.

Contraindications to use

Drug should not be used at hypersensitivity to its components, at heavy pathologies of cardiovascular system (cardiovascular insufficiency, myocarditis), psychological diseases, a liver and/or renal failure, epilepsy, a diabetes mellitus, and also during pregnancy or a lactation.

It is not necessary to use drug at alcohol intake or the medicines containing alcohol within the previous days.

Side effect

In many responses to Esperal the fact that at administration of drug appear metal smack in a mouth, headaches, psychoses, allergic reactions, a polyneuritis of the lower extremities is confirmed. Confusion of consciousness, decrease in memory, gastritis, an optic neuritis is quite often observed. In rare instances thrombosis of vessels of a brain, hepatitis, an adynamy develops.

Medicinal interaction of Esperal

One-time use of Esperal and isoniazid leads to behavior disorders and coordination.

One-time use of drug and derivatives 5 nitroimidazoles – metronidazole, an ornidazol, a seknidazol, Tinidazolum – increases risk of development of delirious frustration, confusion of consciousness.

Combined use of Esperal and peroral anticoagulants strengthens their effect and increases risk of development of bleeding.

Disulfiramum is capable to inhibit oxidizing metabolism of benzodiazepines, strengthening their sedation (especially diazepam and chlordiazepoxide). Doses of benzodiazepines are recommended to be adjusted according to clinical symptoms.