Description overdue on 04/21/2014
- Latin name: Tremonorm
- ATC code: N04BA02
- Active substance: Levodopa + Carbidopa (Levodopa + Carbidopa)
- Manufacturer: TEVA, Israel
- 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
- Babies
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
A tablet of 250 mg levodopa and 25 mg carbidopa monohydrate; Excipients - cellulose, magnesium stearate, starch, colorant AB @ C blue Lake 12% N2.
Product form
Tremonorm comes in tablet form levodopa 250 mg carbidopa 25 mg, 50 or 100 pieces. in a cardboard box, 100 pcs. vial.
Pharmacological action
Tremonorm has antiparkinsonian action.
Pharmacodynamics and pharmacokinetics
Parkinson's disease occurs when a lack Dopamine in the brain. It is the metabolic precursor of dopamine Levodopa Which passes through the well blood-brain barrier (BBB) and in the basal ganglia of the brain it is converted into dopamine, thereby facilitating the parkinsonian symptoms. When you receive inside the body Levodopa can quickly turn into a Dopamine in peripheral tissues, and only a small amount of it goes to the brain.
Carbidopa It is an inhibitor of the decarboxylation of aromatic acids, including levodopa In peripheral tissues, without penetrating through BBB . Thus, a joint reception levodopa and carbidopa increases the flow to the brain levodopa .
Levodopa rapidly absorbed in the stomach. Meal slows absorption. A significant portion (75%) excreted in the urine, the rest - through the intestines.
Indications
Indications are:
- Parkinson's disease ;
- parkinsonian syndrome ( postentsefaliticheskogo Due to intoxication, and manganese oxide, carbon, cerebrovascular origin).
Contraindications
- closure form Glaucoma ;
- mental disorders;
- depression ;
- congestive heart failure;
- renal and / or hepatic failure ;
- blood diseases, leukopenia ;
- diseases of the endocrine system;
- pregnancy and lactation;
- melanoma ;
- children under 12 years;
- sensitivity to the constituent components of the drug.
You must use caution in diseases of the heart and blood vessels ( hypertension Expressed atherosclerosis . arrhythmia ), Diseases of the lungs and asthma , Propensity to erosive and ulcerative lesions of the gastrointestinal tract, with seizures.
Side effects
Initiation of therapy may be accompanied by nausea . vomiting . pain in the stomach , Swallowing disorders, worsening stomach ulcer . Sometimes it can be observed Arrhythmia . hypotension .
Prolonged use: spontaneous movement, hyperkinesis , Changes in the blood system, mental disorders, depression , Palpitations, sleep disorders, weight gain.
Instructions for use (method and dosage)
Tremonorm ingested. Titration is carried out individually for each patient. Starting dose - 1 tablet three times a day. Every 2 days the dose is increased to achieve the desired effect. The daily dose, which is the maximum: for levodopa - 2r (8 tablets) for carbidopa - 200 mg. Typically, the effect is achieved within a week.
Instructions on Tremonorm warns that when a Blepharospasm or seizures the dose should be reduced.
Overdose
Excess doses causes hyperkinesis . nausea . vomiting , Increased excitability, appears insomnia . For treatment of overdose symptomatic therapy is shown receiving Activated Carbon , Gastric lavage.
Cooperation
Application to beta-agonists increases the risk of arrhythmias .
Concomitant use with tricyclic antidepressants capable of reducing bioavailability levodopa ; from diazepam, klozepinom, reserpine, clonidine, Mr. holinoblokatorami, papaverine, neuroleptics, pyridoxine decreases antiparkinsonian effect.
Application to lithium preparations increases the likelihood of dyskinesias and hallucinations And reception methyldopa exacerbates the development of side effects.
In the case of MAO inhibitors their acceptance should be discontinued for 2 weeks because while the application there is the possibility of circulatory disorders, manifested in the development of dizziness , Excitation, tachycardia , Facial flushing, increased blood pressure .
Terms of sale
Prescription.
Storage conditions
In the reach of children and protected from light, temperature from 15 ° to 30 ° C.
Shelf life
Tablets in blister - 3 years; in a bottle - 4 years.
Cautions
Abrupt withdrawal of reception of the drug leads to the development of the complex of symptoms resembling neuroleptic malignant syndrome : Mental disorders, muscle stiffness . hyperthermia , Increase of CPK in the blood.
When translated into a combined reception levodopa and carbidopa Preceding reception levodopa stop for 12 hours before the appointment.
During treatment requires monitoring of blood parameters, cardiovascular system, kidneys and liver, the patient's mental state.
Patients should refrain from driving vehicles and work associated with high concentration of attention.
Analogs
Sindopa
Tidomet Forte
Sinemet
Madopar
On whom
On whom . tidomet . sindopa . Sinemet . Stalevo . Price analogues depends on the manufacturer and the number of tablets per pack, ranging from 606 to 2,000 rubles.
Babies
Do not use this to 12 years.
During pregnancy and lactation
Contraindications pregnancy and breastfeeding .
Reviews
In medical forums reviews of patients mostly limited to allegations of drug side effects and the need for long-term dose adjustment. According to doctors - the choice of any drug should be carried out by a specialist with a careful selection of the optimal dose.
Price Tremonorma where to buy
The average price in Russia is 697 rubles. packing 100 tab.
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