1 tab. inosine pranobex 500 mg. Excipients: mannitol, wheat starch, povidone, magnesium stearate.
Isoprinosine is a synthetic complex derivative of purine, which has immunostimulating activity and non-specific antiviral effect. Restores lymphocyte function under immunodepression conditions, increases blastogenesis in a population of monocytic cells, stimulates the expression of membrane receptors on the surface of T-helper cells, prevents a decrease in the activity of lymphocytic cells under the influence of glucocorticosteroids, and normalizes the inclusion of thymidine in them. Isoprinosine has a stimulating effect on the activity of cytotoxic T-lymphocytes and natural killer cells, T-suppressor and T-helper functions, increases the production of Igg, interferon gamma, interleukins (IL) -1 and IL-2, reduces the formation of proinflammatory cytokines - IL-4 and IL-10, potentiates the chemotaxis of neutrophils, monocytes and macrophages. The drug exhibits antiviral activity in vivo against Herpes simplex viruses, cytomegalovirus and measles virus, human type III T-cell lymphoma virus, polioviruses, influenza A and B, the ECHO-virus (human enterocytopathogenic virus), encephalomyocarditis and equine encephalitis. The mechanism of the antiviral effect of Isoprinosine is associated with the inhibition of viral RNA and the enzyme dihydropteroate synthetase, which is involved in the replication of certain viruses. It enhances viral synthesis of lymphocyte mRNA, which is accompanied by the suppression of the biosynthesis of viral RNA and translation of viral proteins, increases the production of interferon alpha and gamma lymphocytes with antiviral properties. With a combined appointment enhances the action of interferon alpha, antiviral drugs acyclovir and zidovudine.
Suction After oral administration is well absorbed from the gastrointestinal tract. Cmax of the active substance in the blood plasma is determined after 1-2 hours. Metabolism Rapidly metabolized. Metabolized similarly to endogenous purine nucleotides with the formation of uric acid, NN-dimethylamino-2-propranolone is metabolized to the N-oxide, and para-acetamido benzoate to o-acylglucuronide. Not detected cumulation of the drug in the body.Withdrawal of T1 / 2 is 3.5 hours for N-N-dimethylamino-2-propranolone and 50 minutes for para-acetamido benzoate. Excreted by the kidneys. The elimination of the drug and its metabolites from the body occurs within 24-48 hours.
- urolithiasis - gout - arrhythmias - chronic renal failure - children's age up to 3 years (body weight up to 15-20 kg) - hypersensitivity to the components of the drug.
Use during pregnancy and lactation
The safety of using izoprinozin during pregnancy and lactation has not been established, so the use of the drug is not recommended.
Dosage and administration
Tablets are taken after meals with a small amount of water. The recommended daily dose for adults and children aged 3 years and older (with a body weight of 15-20 kg) is 50 mg / kg body weight in 3-4 doses (for adults - 6-8 pills / day, for children - 1/2 tab. per 5 kg of body weight / day). In severe forms of infectious diseases, the dose can be individually increased to 100 mg / kg body weight / day, divided into 4-6 doses. The maximum daily dose for adults 3-4 g / day, for children - 50 mg / kg / day. The duration of treatment for acute diseases in adults and children is usually from 5 to 14 days. Treatment should be continued until the clinical symptoms disappear and for 2 more days in the absence of symptoms. If necessary, the duration of treatment can be increased individually under the supervision of a physician. For chronic recurrent diseases in adults and children, treatment should be continued in several courses of 5-10 days with a break in reception in 8 days. For maintenance therapy, the dose can be reduced to 500-1000 mg / day (1-2 tab.) Within 30 days. In case of herpes infection in adults and children, the drug is prescribed for 5-10 days until the symptoms of the disease disappear, in the asymptomatic period - 1 tab. 2 times / day for 30 days to reduce the number of relapses. For papillomavirus infection for adults, the drug is prescribed in 2 tab. 3 times / day, children - 1/2 tab. on 5 kg / body weight / day in 3-4 doses for 14-28 days as monotherapy. With recurrent genital warts adults drug is prescribed in 2 tab. 3 times / day, children - 1/2 tab. at 5 kg / body weight / day in 3-4 doses, either as monotherapy or in combination with surgical treatment for 14-28 days, then with a threefold repetition of the specified course at intervals of 1 month. In case of cervical dysplasia associated with human papillomavirus, 2 tab.3 times / day for 10 days, then spend 2-3 similar courses with an interval of 10-14 days.
The frequency of side effects after using the drug is classified according to the WHO recommendations: often (1%, less than 10%), sometimes (0.1%, less than 1%). On the part of the gastrointestinal tract: often - nausea, vomiting, epigastric pain, sometimes - diarrhea, constipation. On the part of the liver and biliary tract: often - a temporary increase in the activity of transaminases and alkaline phosphatase in the blood plasma, an increase in the concentration of urea in the blood plasma. Dermatological reactions: often - itching. Of the nervous system: often - headache, dizziness, weakness, sometimes - drowsiness, insomnia. From the urinary system: sometimes - polyuria. On the part of the musculoskeletal system and connective tissue: often - pain in the joints, aggravation of gout.
Cases of overdose of Izoprinozin are not described.
Interaction with other drugs
With simultaneous use of immunosuppressants can reduce the effectiveness of izoprinosin. Xanthine oxidase inhibitors and uricosuric agents (including diuretics) may contribute to the risk of an increase in the level of uric acid in the blood serum of patients taking Isoprinosine.
After 2 weeks of use of izoprinosine, it is recommended to monitor the content of uric acid in serum and urine. With long-term administration after 4 weeks of use, it is advisable to monitor liver and kidney function every month (transaminase activity in the blood plasma, creatinine level, uric acid). It is necessary to control the level of uric acid in the blood serum when prescribing Isoprinosine in combination with drugs that increase the level of uric acid or drugs that affect kidney function. Impact on the ability to drive motor vehicles and control mechanisms There are no special contraindications.