Akatinol Memantine pills 20 mg 56 pcs
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Active ingredients
Memantine
Release form
Pills
Composition
Active ingredient: Memantin (Memantin) Active ingredient concentration (mg): 20
Pharmacological effect
Derived adamantane. Being a noncompetitive agonist N-methyl-D-acnaprat (NMDA) receptor, has a modulating effect on the glutamatergic system. It regulates ion transport, blocks calcium channels, normalizes membrane potential, improves the transmission of nerve impulses. Improves cognitive processes, increases daily activity.
Pharmacokinetics
After ingestion is quickly and completely absorbed. Cmax in the blood plasma is reached within 2-6 hours. During normal renal function, no cumulation of the drug is noted. Excretion occurs in two phases. T1 / 2 is in the first phase - 4-9 hours, in the second phase - 40-65 hours. About 80% of memantine is excreted unchanged. Metabolites do not possess their own pharmacological activity. Excreted in the urine. With alkaline urine, excretion slows down.
Indications
Dementia of Alzheimer's type, vascular dementia, mixed dementia of all degrees of severity.
Contraindications
Individual hypersensitivity to the drug, pronounced renal dysfunction, pregnancy, breastfeeding, children under 18 years (due to insufficient data). With caution prescribed for patients with thyrotoxicosis, epilepsy, seizures (including history), with myocardial infarction, cardiac failure.
Precautionary measures
Do not exceed the recommended dose. With caution prescribed to patients with thyrotoxicosis, epilepsy; convulsions (including history), simultaneous use of NMDA receptor antagonists (amantadine, ketamine, dextromethorphan), the presence of factors that increase urine pH (abrupt diet change, for example, switching to vegetarianism, abundant intake of alkaline gastric buffers), severe urinary infections ways, myocardial infarction (in history), heart failure III - IV functional class (according to the NYHA classification), uncontrolled arterial hypertension, renal failure, hepatic failure.
Use during pregnancy and lactation
Do not use the drug during pregnancy and lactation.
Dosage and administration
Adults with dementia are prescribed during the 1st week of therapy at a dose of 5 mg / day, during the 2nd week - at a dose of 10 mg / day. During the 3rd week - at a dose of 15–20 mg / day. If necessary, a further weekly dose increase of 10 mg is possible until a daily dose of 30 mg is reached. The optimal dose is achieved gradually, with an increase in dose every week.
Side effects
Hypersensitivity to the components of the drug, fungal infections, drowsiness, confusion, hallucinations, psychotic reactions, increased hell, venous thrombosis / thromboembolism, heart failure, shortness of breath, constipation, nausea, vomiting, pancreatitis, dizziness, gait disturbance, convulsions.
Overdose
Symptoms: dizziness, tremor, agitation, drowsiness, confusion, agitation, stupor, convulsions, psychosis, aggressiveness, hallucinations, unsteadiness of gait, vomiting, diarrhea. Treatment: gastric lavage, taking activated carbon, symptomatic therapy. There is no specific antidote.
Interaction with other drugs
When used simultaneously with levodopa preparations, dopamine receptor antagonists, m-cholinoblockers, the action of the latter can be enhanced. When used simultaneously with barbiturates, neuroleptics, the action of the latter can decrease. When combined, it can change (increase or decrease) the effect of dantrolene or baclofen; individually. Simultaneous administration with amaptadine, ketamine, should be avoided. Phenntoin and dextromethan due to the increased risk of psychosis. Plasma concentrations of cimetidine, ranitidine, procainamide, quinidine are possible. quinine, and nicotine, while taking with memantine. It is possible to decrease the level of hydrochlorothiazide while taking it with memantine. It is possible to increase MHO in patients taking oral anticoagulants (warfarin). Memantine may increase the excretion of hydrochlorothiazide. and MAO inhibitors require careful monitoring of patients.
special instructions
In patients with Alzheimer's disease at the stage of moderate and severe dementia, the ability to drive vehicles and manage complex mechanisms is usually impaired.In addition, memantine can cause a change in the reaction rate, so patients should refrain from controlling vehicles or working with complex mechanisms. Patients with thyrotoxicosis, epilepsy, seizures (including in history), the simultaneous use of NMDA receptor antagonists (amantadine , ketamine, dextromethorphan), the presence of factors that increase the pH of the urine (abrupt diet change, for example, the transition to vegetarianism, abundant intake of alkaline gastric buffers), severe urinary tract infections, infarks tons of myocardium (in history), heart failure III-IV functional class (according to the NYHA classification), uncontrolled arterial hypertension, renal failure, liver failure.