- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions for use (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
As a part of tablets is 25 mg hydrochloride klopiramida + Corn starch, stearic acid, glycerol 85%, talc, copovidone, crystalline sucrose, disperse yellow colorant, microcrystalline cellulose, lactose monohydrate, colloidal anhydrous silica, magnesium stearate, hypromellose, titanium dioxide, polyvinylpyrrolidone K30, polyethylene glycol 8000.
One solution for injection ampoule It contains: 25 mg hydrochloride klopiramida , Water, glycerol.
Product form
- The drug is released in the form of light-yellow tablets , Round, convex. 10 pieces in blister, 2 or 3 blisters in a carton box.
- Also agent is sold in a clear, colorless Injection Solution . The ampoules of 2 mL, 10 vials per bundle.
Pharmacological action
Antidepressant.
Pharmacodynamics and pharmacokinetics
Anafranil (Anafranil) - tricyclic antidepressant . Its main action is to inhibit reuptake noradrenaline and Serotonin . This process is carried out by changing the concentration monoamines in the central nervous system and blocking H2 gistaimnovyh receptors.
Clomipramine eliminates psychomotor confusion, anxiety, bad mood. The active substance is able to eliminate night enuresis Which is not defined in the physiology of disturbances, it reduces appetite. There is the establishment of the transfer Serotonin and adrenaline . The therapeutic effect is evident after the first week of dosing, effective reaches its maximum after 2-3 weeks.
With / m the introduction of the drug is well and fully digested. 97% of funds is bound to plasma proteins.
The equilibrium concentration of drug reaches a maximum after 2 weeks of systemic administration. About 2% of the material is found in cerebrospinal liquid. The drug penetrates well into the breast milk.
The preparation metabolized by demethylation With the participation of enzymes CYP3A4, CYP2C19, CYP1A2 i Generated active metabolites. The duration of excretion from the body means 18 to 25 hours, depending on the method of administration.
Output metabolites the urine and feces.
In elderly patients, the plasma concentration of the drug due to slow metabolism may differ materially.
Indications
Anafranil is prescribed:
- treatment depression various origins ( Endogenous, neurotic, masked, involutional, reactive, organic depression );
- for depression in the elderly, due to constant severe pain or somatic diseases;
- in depressive states have psychopaths or schizophrenics ;
- in mood disorders neurotic, psychopathic or Reactive nature;
- treatment Panic Attacks and various phobias ;
- at catalepsy ( Narcolepsy );
- at presenile and senile depression ;
- for prophylaxis migraine ;
- for the treatment of night enuresis Not associated with other diseases.
Contraindications
The drug is not prescribed:
- at allergies on tricyclic antidepressants Groups dibenzazepine or clomipramine ;
- if you recently had a myocardial infarction ;
- Children up to 5 years;
- pregnant and lactating women;
- when receiving MAO inhibitors (two weeks before and after) MAO-A inhibitors reversible action;
- the syndrome of QTc QT .
Care should be taken:
- brain trauma;
- at epilepsy ;
- when combined with the drug neuroleptics ;
- persons with cardiovascular failure or arrhythmia ;
- at glaucoma or urinary retention;
- the elderly;
- adolescents;
- at tumors of the adrenal medulla ;
- people who have a tendency to rise constipation Particularly for bedridden or elderly people;
- in case of serious liver or hyperthyroidism ;
- at neuroblastoma or pheochromocytoma .
When using the drug should be continuously monitored arterial pressure , To monitor intraocular pressure.
If the patient uses contact lenses, you should remember that the drug can reduce the intensity of lacrimation. This can result in damage to the cornea.
Particular caution should be observed with intravenous medications to avoid potential anaphylactic shock .
Side effects
Side effects Anafranil often mild, somewhat similar to the symptoms depression . Generally, the effects of such tested during treatment or after reduction and achievement of the minimum active dosage.
If serious adverse reactions and endanger the patient's life, the medication should be stopped.
Especially often and obviously side effects occur in the elderly.
There may be:
- drowsiness , Dry mucous membranes, fatigue, sweating, increased appetite, tremor ;
- constipation . myoclonus . headache , Visual disturbances, nausea, weight gain;
- paresthesia . tides , Palpitations, increased muscle tone, or weakness, speech disorders, mydriasis ;
- tachycardia , A strong decline BP Minor distortion ECG . vomiting . diarrhea , Epigastric pain, increased liver enzymes;
- hives . galactorrhea , Tinnitus, itching and rashes on the skin, breast enlargement, distortion of taste;
- violation of sleep, disorientation . hallucinations , Anxiety and aggression, delirium Memory problems;
- cramping, fever, ataxia , Changes in the electroencephalogram ;
- glaucoma , Violations intracardiac conduction , Urinary retention, swelling, burning and swelling at the injection site;
- pneumonitis . anaphylactic and anaphylactoid reaction purpura . leukopenia . thrombocytopenia etc.
In a dramatic use means there is a withdrawal. Nausea, diarrhea, vomiting, irritability and anxiety, headaches, insomnia . The dosage should be reduced gradually.
Instructions for use (method and dosage)
If the patient hypokalemia Then before taking the drug it is necessary to eliminate.
The dosage and method of taking the medicine must be diagnosed by a doctor. Should be given the minimum active dose and gradually increase it until the desired effect is achieved. Older people and adolescents in the process should be treated with great caution.
Instructions on Anafranil tablets
The tablets are taken orally.
With depression, phobias and obsessive compulsive syndrome appoint one tablet 2-3 times a day. Dosage increases for 7 days on a tablet every 2-3 days. It is necessary to achieve a dosage of 100-150 mg. The maximum daily 250 mg. After achieving the necessary improvements in the patient's condition, he was transferred to 2-4 tabeltki per day (50-100 mg).
In chronic pain syndrome dosage is determined individually for each patient (10-150 mg per day). This should reduce the number of analgesics .
When the fear of open spaces and panic attacks initial dosage is 10 mg per day. Further, continuous improvement is achieved by the daily dosage of 25-100 mg. Minimum course of treatment - six months (with a reduction in dosage).
With catalepsy and Narcolepsy recommended amount of medication a day - 25-75 mg.
For elderly patients initial dosage administered 10 mg and then increased to 50 mg.
For children and adolescents initial dose - 25 mg per day. Number of Anafranil increase within 14 days and 100 mg. Further, for an additional 2 weeks the dosage is increased up to 200 mg. It is also possible to calculate the daily dosage of the principle of 3 mg of active ingredient per kg body weight.
At night enuresis : For children 5-8 years Dosage - 20 or 30 mg per day, between 9 and 12 - 25 or 50 mg, more than 12 years - 75 mg. A further increase in dosage is possible in the event that after a week of receiving a means of improving not come.
Tablets are better to drink before going to bed. The course of treatment - from three to three months. By the end of the course is necessary to gradually return to the original dosage and stop taking.
Instructions for use in injections Anafranil
Intramuscular injections
Treatment begins with the introduction of 25 to 50 mg, that is 1-2 ampoules. Thereafter, the dosage can be increased every day for one vial, the maximum dosage - 6 ampoules per day. Then, after the improvement in the state, the dosage should be reduced and replaced with tablets.
Intravenous
At the beginning of the treatment drug is administered drip, 2-3 capsules per day at a time. Duration infusion from a half to 3 hours, the drug is diluted in 250-500 ml sodium chloride or Glucose . During the procedure, the patient should be closely monitored to control the level Blood Pressure .
The treatment, even after the improvements need to keep 3-5 days, then the patient is transferred to the tablet.
This method of administration is not recommended for children and adolescents.
Overdose
Overdose means may suffer serious consequences, especially in children. Symptoms are similar for all groups of drugs tricyclic antidepressants .
Overdose symptoms appear within 4 hours after being hit by means of the body, the maximum number and severity occurs within hours. Within 5-6 days, the patient should be supervised.
In case of overdose occur: drowsiness , Anxiety, ataxia . convulsions , Increased body temperature, coma . delirium , Vomiting, respiratory depression, fever, severe drop in blood pressure, arrhythmia and tachycardia . shock , Stupor, heart failure even in full cardiac arrest. FEATURES: anuria . cyanosis or oliguria .
As the treatment is necessary to urgently perform gastric lavage. If the patient is conscious - cause vomiting, if not, to produce washing tracheal intubation . Call an ambulance, give the victim chelators ( Activated carbon ). Perform the above operations it is advisable, even if after an overdose of more than 12 hours.
Specific antidote formulation has not, hemodialysis and peritoneal dialysis not applicable. Therefore, use of modern methods of intensive care, eliminate cramps, make artificial respiration.
Cooperation
Estrogens . cimetidine and Methylphenidate increase the plasma concentration clomipramine .
When combined with the drug ephedrine and ethanol Their efficiency is increased, but increased the number and frequency of occurrence of adverse reactions.
Carbamazepine . rifampicin . phenytoin and nicotine reduce the concentration clomipramine in blood plasma.
The drug is able to enhance the effect of antiparkinsonian .
In combination with the following drugs is the process of potentiation:
- from antithrombotic Drug ;
- beta-agonists ;
- from vitamin K antagonists ;
- from antihistamine drugs ;
- from isoprenaline and biperidenom ;
- from norepinephrine ;
- from selective serotonin reuptake inhibitors .
Phenothiazines when taken with the means to increase the burden of the central nervous system, intestine, bladder and increase the likelihood of seizure.
If you combine antidepressant from opioid analgesic . zolpidem and other means, oppressive CNS It may develop dangerous for the life of the patient's lethargy.
The drug enhances the effect on the body for drugs anesthesia .
Hormonal contraceptives increase the likelihood of depression .
Levodopa and furazolidon in combination with means can greatly increase arterial pressure .
Preparations lithium lower the threshold for seizure activity.
Simultaneous treatment with the drug betanidinom . clonidine It can significantly reduce the effectiveness of the latter.
The combination and Anafranil atropine enhances efficacy and adverse reactions of Mr. holinoblokatorov .
Precautions should be combined antidepressant from disulfiram Since it contributes delirium .
MAO inhibitors When combined with the drug can cause whom . fever . hypertensive crisis and convulsions .
Procainamide . quinidine and thyrotropic drugs increase the likelihood of abnormal heart rhythm.
The solution for injection should not be combined with reception diclofenac in the same manner.
When combined with hepatotoxic drugs Anafranil increases the load on the liver.
Terms of sale
Prescription.
Storage conditions
The drug is stored in a cool, dark place. No way to avoid getting money to the children.
Shelf life
5 years.
Cautions
In individuals predisposed to psychosis and the elderly drug can cause night delirious psychosis . After discontinuation of funds side effects of this kind take place.
During treatment, you can change the level of leukocytes , In connection with the need to monitor blood counts.
Caution should be exercised if the patient has a predisposition to constipation.
Patients with panic attacks in the first days of treatment may be observed degradation usually feel adjusted in a week.
To combine the drug with electroshock therapy It is only in the case of a thorough control of the state of health of the patient.
Receiving Antidepressants increases the likelihood of suicidal thoughts , Attempts to suicide . This should be remembered by family members and the patient environment (guardian). Also, if such tendencies in a patient not previously observed, the drug should be discontinued.
While prescription should specify the minimum required at the moment the number of pills in order to avoid accidental overdose means.
Analogs
Match code ATC 4th level: 
Amitriptyline
Analogues: Klofranil, Doxepin, Anafranil Wed, amitriptyline, Melipraminum .
During pregnancy and lactation
The experience of the drug in pregnant women is limited. Cases of when the medication has caused malformations of the fetus. Therefore, the means may be imposed as a last resort, when it is impossible to do without it.
Infants may experience withdrawal symptoms if receiving funds was terminated later than 7 weeks before the birth.
The active substance passes into breast milk, so during breast-feeding the drug should be discontinued (pre gradually reduce the dosage).
Reviews Anafranile
Reviews Anafranile forums for good. The tool helps to cope with intrusive thoughts and ideas, depression , Returned to the patient's will to live. However, the drug has a lot of side effects, and it has the right to appoint a doctor.
Price Anafranil
Price Anafranil tablets is about 300 rubles for 30 pieces of 25 mg.
Cost solution for injection - 640 rubles for 10 pieces of 2 ml.
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