Description overdue on 04/25/2014
- Latin name: Tidomet Forte
- ATC code: N04BA02
- Active substance: L-dopa (Levodopa) + Carbidopa (Carbidopa)
- Manufacturer: Torrent Pharmaceuticals, India
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions for use Tidometa (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Synonyms
- Babies
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
1 tablet contains levodopa 250 mg carbidopa 25 mg.
Product form
Tablets contour packaging; 4, 10 and 100 pieces. in the box.
Pharmacological action
Antiparkinsonian action .
Levodopa - An amino acid, which is formed from dopamine with the participation of amino acid decarboxylase. Levodopa can be converted already into dopamine in peripheral tissues, which can not penetrate blood-brain barrier (BBB).
Carbidopa a decarboxylase inhibitor, prevents the conversion of levodopa to dopamine in peripheral tissue composition; It does not pass through the blood-brain barrier and does not affect the synthesis of the levodopa, dopamine in the CNS. Therefore, the combination of levodopa, carbidopa and levodopa increases the amount delivered to the brain. Carbidopa 2 times increases the bioavailability of levodopa.
Pharmacodynamics and pharmacokinetics
Food intake slows the absorption of levodopa. The maximum possible level of concentration in the blood after administration is determined after 1 -2 hours. About 75% of an L-dopa is metabolized in the intestine.
Half-life of levodopa in combination with carbidopa - 3 hours. Excreted in urine.
Carbidopa does not pass through the BBB. Maximum blood concentration - about 2-4 hours. Approximately 50% of carbidopa is output through the intestine, and kidneys.
Indications
- Parkinson's syndrome (postentsefaliticheskogo parkinsonism, after poisoning by carbon monoxide or manganese);
- Parkinson's disease .
Contraindications
- closure form Glaucoma ;
- mental disorders;
- melanoma ;
- skin diseases of unknown origin;
- Huntington's chorea ;
- essential tremor ;
- reception non-selective monoamine oxidase inhibitors;
- secondary Parkinsonism Caused by the use of antipsychotic drugs (neuroleptics)
- children under 18 years of age due to a lack of data on safety and efficacy;
- idiosyncrasy.
Be wary appoint gastric and duodenal ulcers . epilepsy . Heart Failure . myocardial infarction and heart rhythm disturbances, severe liver and kidney, endocrine diseases, mental disorders, asthma .
Side effects
Often : nausea . dyskinesia . When the muscle twitches and Blepharospasm the drug should be discontinued.
Nervous system : Delirium, hallucinations , Neuroleptic malignant syndrome, bradykinesia, agitation, paresthesia , Headache, dizziness, nightmares, insomnia ; confusion, depression . Dementia , Increase sexual desire.
Digestive system Vomiting, eating disorders, indigestion, changes in taste, dryness of the oral mucosa, diarrhea . constipation , Bleeding from the gastrointestinal tract, duodenal ulcer .
Cardiovascular system : Heartbeat, Arrhythmia . orthostatic hypotension .
Hematopoietic system : hemolytic anemia , Thrombocytopenia, leukopenia , Agranulocytosis.
Allergic reactions : hives , Hemorrhagic vasculitis, pruritus, reactions similar to pemphigus, angioedema .
Respiratory system : Respiratory infections, breathlessness .
Skin : Sweating, skin rash, hair loss.
The urinary system : Frequent urination, urinary tract infections.
Laboratory findings : Increased ALT (alanine aminotransferase) and AST (aspartate aminotransferase), alkaline phosphatase, lactate dehydrogenase, increased levels of urea, bilirubin, hyperglycemia . hematuria , Leukocyturia, bacteriuria.
Instructions for use Tidometa (method and dosage)
Inside, during or after a meal. Tablets do not chew, wash down with water. During treatment is not recommended drinking large amounts of protein. The maximum daily dose of levodopa - 2000 mg carbidopa - 100 mg.
Treatment begins with the initial dose - 1/2 Tab. twice a day. Then, if necessary, increase the dose of 0, 5 tab. 2 times a day. At the beginning of therapy daily dose - not more than 3 tablets, divided into 3 doses. The daily dose can be increased, but not more than 8 tablets were divided into 8 stages. When assigning a dose exceeding 6 tablets daily, strict control of the physician.
Instructions on Tidomet Forte It recommends that before beginning therapy to stop for 12 hours levodopa and in the treatment of prolonged forms - for 24 hours. Supporting dose is 6 tablets per day.
Overdose
In case of overdose gastric lavage is performed, ECG control and monitoring for the diagnosis of arrhythmia; in the case of arrhythmias - Antiarrhythmic therapy.
Cooperation
While the use of antihypertensive drugs with caution because of the risk orthostatic hypotension .
Application to monoamine oxidase inhibitors (MAO) can cause circulatory disorders - increased blood pressure, tachycardia, facial flushing. Therefore, MAO inhibitors cease 14 days before the start of therapy.
Reception in conjunction with tricyclic antidepressants may cause hypertension . dyskinesia , Reducing the bioavailability of levodopa.
The drug can increase the effects of agonists Therefore the dose should be reduced. Application of levodopa beta-agonists It may increase the risk of cardiac arrhythmias.
Amantadine with levodopa cause mutual potentiating effect.
L-dopa in combination with methyldopa increase the risk of side effects of each other.
Simultaneous with the appointment diazepam . phenytoin Derived phenothiazines . butirofenona . thioxanthene . clonidine . papaverine . pyridoxine . reserpine . M-holinoblokatorami antiparkinsonian can reduce the effect of the drug.
Application with lithium increases the likelihood of hallucinations and dyskinesias .
Iron supplements reduce the bioavailability of the drug.
Terms of sale
Prescription.
Storage conditions
Keep away from children, dry and protected from light, temperature below 30 ° C.
Shelf life
3 years.
Cautions
Do not apply when Parkinsonism Caused by the use of neuroleptics.
Discontinue drug treatment should be gradual, in order to avoid the development of symptoms similar to neuroleptic malignant syndrome (muscle rigidity, elevated creatine phosphokinase in the blood, increased body temperature).
At reception Tidometa Forte requires constant monitoring of the mental status and activity of the heart.
Patients with open-angle glaucoma prescribed the drug with caution; requires constant monitoring Intraocular pressure .
During treatment is not recommended driving and performance of work requiring attention.
We must remember that in elderly patients absorption of levodopa is better than the young.
Analogs
Sindopa
Sinemet
Tremonorm
Madopar
On whom
The main analogues are madopar . Stalevo.
Synonyms
On whom . tremonorm . Sinemet.
Babies
Data on the safety of children under 18 years is not enough.
During pregnancy and lactation
Application in case the expected benefit of therapy to the mother outweighs the risk to the fetus. In applying the drug during lactation breast-feeding stopped.
Reviews of Forte Tidomete
Patients and their relatives say the side effects of the drug in the form of spikes in blood pressure, nausea and insomnia . There is a review of the progression of the disease in the patients receiving the drug. In any case, the selection of therapy for Parkinsonism It must be carried out by experts.
Price Tidometa Forte, where to buy
The price of the drug in Russia is on average 625 rubles, you can buy in a pharmacy.
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