Midantanum

Midantanum – a blocker of glutamate NMDA receptors, protivoparkinsonichesky means.

Form of release and structure

Midantanum is released in the form of tablets, film coated: orange color, round, biconvex, with a notch on one of the parties (on 10 tablets in the blister, in a cardboard pack 3 blisters).

Active agent: an amantadina sulfate, in 1 tablet – 100 mg.

Excipients: potato starch, cellulose microcrystallic, gelatin, silicon dioxide colloid, magnesium stearate, croscarmellose sodium, talc, titanium dioxide, povidone, copolymer of butylmethacrylate, lactose monohydrate, dye orange yellow.

Indications to use

Midantanum is applied to treatment of a disease of Parkinson and a syndrome of parkinsonism.

Contraindications

Absolute:

• Psychoses (including in the anamnesis);
• Epilepsy;
• Excitement;
• Arterial hypotonia;
• Predelirium;
• Delirious psychosis;
• Heart failure of the II-III Art.;
• Prostate adenoma;
• Chronic renal failure;
• Liver failure;
• Closed-angle glaucoma;
• Thyrotoxicosis;
• I trimester of pregnancy;
• Lactation period;
• Co-administration of a hydrochlorothiazide and Triamterenum;
• Hypersensitivity to medicine components.

Relative (it is necessary to observe extra care because of risk of development of complications):

• Mental disorders (including in the anamnesis);
• Dermatitis of an allergic origin;
• Orthostatic arterial hypotension;
• Alcoholism;
• II and III trimester of pregnancy;
• Advanced age.

Route of administration and dosage

Midantanum is intended for oral administration, it is necessary to take a pill after food.

Schedule of reception: on the first week the initial daily dose makes the first 3 days 100 mg in stages with an interval of 6 hours (the last dose needs to be accepted before a dinner); from the 4th to the 7th day appoint 200 mg a day; the next 2 weeks – on 300 mg a day; since fourth week of administration of drug – on 300-400 mg a day depending on a condition of the patient.

The highest admissible daily dose – 600 mg.

To patients with renal failures reduce a dose and increase intervals between receptions, depending on a glomerular filtration rate:

• 80-60 ml/min. – on 100 mg each 12 hours;
• 60-50 ml/min. – doses in 200 mg and 100 mg alternate every other day;
• 30-20 ml/min. – on 200 mg 2 times a week;
• 20-10 ml/min. – on 100 mg 3 times a week;
• Less than 10 ml/min. – on 200 mg 1 time/week and 100 mg every second week.

Elderly patients also need a dose decline.

Side effects

• Alimentary system: nausea, dryness in a mouth, dyspepsia, anorexia;
• Cardiovascular system: tachycardia, orthostatic hypotension, heart failure; perhaps – development of aritmogenny action;
• Urinary system: polyuria, nocturia; patients with a hyperplasia of a prostate have an acute ischuria;
• Nervous system: irritability, dizziness, sleeplessness, a headache, a tremor, spasms, mental disorders, the mental and motive excitement which is followed by visual hallucinations;
• Others: decrease in visual acuity, bluish coloring of skin of upper and lower extremities, dermatosis.

Special instructions

Data on an occasion of efficiency of therapy of an amantadin sulfate of the extrapyramidal frustration which appeared owing to treatment by antipsychotic drugs are contradictory.

Sharp drug withdrawal can cause an exacerbation of a disease.

During therapy by Midantanum it is contraindicated to take alcohol, it is necessary to refrain from management of vehicles and performance of potentially dangerous types of activity demanding speed of reactions and the increased concentration of attention.

Medicinal interaction

Midantanum is compatible to other drugs of protivoparkinsonichesky action and the central cholinolytics.

Amantadina sulfate strengthens effect of psychogogic drugs and a levodopa.

In case of the concomitant use of ethanol or means stimulating the central nervous system the risk of development of side effects increases.

Terms and storage conditions

To store at a temperature to 25ºС in the dry place unavailable to children.

Period of validity – 5 years.