Buy Imodium lozenges 10 pcs

Imodium lozenges 10 pcs

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$33.06

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Active ingredients

Loperamide

Release form

Pills

Composition

1 tablet contains: Active ingredient: loperamide hydrochloride - 2 mg. Adjuvants: gelatin - 5.863 mg, mannitol - 4.397 mg, aspartame - 0.75 mg, mint flavor - 0.3 mg, sodium bicarbonate - 0.375 mg.

Pharmacological effect

Antidiarrheal drug. Loperamide, binding to opioid receptors in the intestinal wall, suppresses the release of acetylcholine and prostaglandins, thereby reducing peristalsis and increasing the time for the contents to pass through the intestines. Increases the tone of the anal sphincter, thereby reducing the incontinence of fecal masses and the urge to defecate.

Pharmacokinetics

Absorption The bioavailability of sodium valproate and valproic acid when administered orally is close to 100%. When taking Depakene Chrono 500 mg pills at a dose of 1000 mg / day, Cmin in plasma is 44.7 ± 9.8 mcg / ml, and Cmax in plasma is 81.6 ± 15.8 mcg / ml. Tmax in plasma is 6.58 ± 2.23 hours. Css in plasma is achieved within 3-4 days of regular use of the drug. The average therapeutic range of serum concentrations of valproic acid is 50-100 mg / l. If there is a reasonable need to achieve a higher concentration of valproic acid in the blood plasma, the ratio of the expected benefits and the risk of side effects, especially dose-dependent, should be carefully weighed. with a valproic acid concentration of more than 100 mg / l, an increase in side effects is expected up to the development of intoxication. With a plasma concentration of more than 150 mg / l, a reduction in the dose of the drug is required. Compared to the enteric-coated dosage form, the drug in the form of a tablet with a sustained release in equivalent doses is characterized by the absence of latent absorption time, prolonged absorption, identical bioavailability, lower Cmax value (a decrease in Cmax by about 25%), but with a more stable plateau phase from 4 to 14 hours after administration, a more linear correlation between dose and drug concentration in plasma. Distributed Plasma protein binding (predominantly with albumin) is high (90-95%), dose-dependent and saturable. Vd depends on age and is usually 0.13-0.23 l / kg of body weight or in young people 0.13-0.19 l / kg of body weight. Valproic acid penetrates into the cerebrospinal fluid and into the brain. The concentration of valproic acid in the cerebrospinal fluid is 10% of the corresponding concentration in plasma. Valproic acid penetrates into breast milk from nursing mothers.In equilibrium, the concentration of valproic acid in breast milk is 1-10% of its concentration in plasma. Metabolism Metabolized by beta, omega-and omega-1 oxidation and conjugation with glucuronic acid. More than 20 metabolites have been identified, metabolites after omega-oxidation have a hepatotoxic effect. Valproic acid does not have an inducing effect on the cytochrome P450 isoenzymes: unlike most other antiepileptic drugs, valproic acid does not affect the extent of both its own metabolism and its degree other drugs, such as estrogens, progestogens, and indirect anticoagulants. ExcretionIt is mainly excreted by the kidneys after beta-oxidation and conjugation from glucuronic to syllable Less than 5% of valproic acid is excreted by the kidneys unchanged. T1 / 2 is 15–17 hours. Plasma clearance of valproic acid in patients with epilepsy is 12.7 ml / min. Pharmacokinetics in special clinical cases. Older patients, patients with renal and hepatic insufficiency. with plasma proteins decreases. In severe renal failure, the concentration of free (therapeutically active) fraction of valproic acid may increase to 8.5–20%. In case of hypoproteinemia, the total concentration of valproic acid (free + protein-bound plasma fraction) may not change, but it may decrease due to an increase in metabolism free (not bound to plasma proteins) fraction of valproic acid. When combined with antiepileptic drugs that induce microsomal liver enzymes, plasma clearance of valproic acid you increase and T1 / 2 decreases, the degree of their change depends on the degree of induction of liver microsomal enzymes by other antiepileptic drugs. T1 / 2 values ​​in children over 2 months of age are close to those in adults. Patients with T1 / 2 liver disease have valproic acid increases. In overdose, an increase in T1 / 2 up to 30 hours was observed. Only the free fraction of valproic acid in the blood (10%) is exposed to hemodialysis. Features of pharmacokinetics during pregnancy When the Vd of valproic acid increases in the third trimester pregnancy, its renal and hepatic clearance increases.At the same time, despite taking the drug in a constant dose, a decrease in the concentration of valproic acid in the plasma is possible. In addition, during pregnancy, the degree of binding of valproic acid to plasma proteins may change, which may lead to an increase in the serum free (therapeutically active) fraction of valproic acid.

Indications

acute and chronic diarrhea; stool regulation in patients with ileostomy

Contraindications

Imodium lyophilized pills should not be used in children under the age of 6 years. Imodium is contraindicated in patients with hypersensitivity to loperamide and / or any of the components of the drug, as well as in the first trimester of pregnancy. Imodium is not recommended for use during breastfeeding. Imodium pills are lyophilized contraindicated in patients with phenylketonuria. Imodium cannot be used as the main therapy: - in patients with acute dysentery, which is characterized by a stool with blood and high fever; - in patients with ulcerative colitis in the acute stage; - in patients with bacterial enterocolitis caused by pathogenic microorganisms, including Salmonella, Shigella and Campylobacter; - in patients with pseudomembranous colitis associated with therapy with broad-spectrum antibiotics. Imodium should not be used in cases where the slowing of peristalsis is undesirable because of the possible risk of serious complications, including intestinal obstruction, megacolon and toxic megacolon. Imodium should be immediately canceled if constipation, abdominal distention or intestinal obstruction occurs.

Dosage and administration

Inside The pill is put on the tongue, it dissolves for a few seconds, after which it is swallowed with saliva, without drinking water. Adults and children over 6 years of age: Acute diarrhea: initial dose - 2 pills (4 mg) for adults and 1 tablet (2 mg) for children, then 1 tablet (2 mg) after each defecation event in the case of liquid stool. Chronic diarrhea: initial dose - 2 pills (4 mg) per day for adults and 1 tablet (2 mg) for children; Further, the initial dose should be adjusted so that the frequency of normal stool was 1-2 times per day, which is usually achieved with a maintenance dose of 1 to 6 pills (2-12 mg) per day.The maximum daily dose should not exceed 6 pills (12 mg); The maximum daily dose in children is calculated on the basis of body weight (3 pills per 20 kg body weight of the child), but should not exceed 6 pills (12 mg). With the normalization of the chair or in the absence of stool more than 12 hours, the drug is canceled. Use in children Do not use Imodium in children under 6 years of age. Use in elderly patients When treating elderly patients, dose adjustment is not required. Use in patients with impaired renal function When treating patients with impaired renal function, dose adjustment is not required. Use in patients with impaired liver function

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