Esperal

Description overdue on 07/09/2014

• Latin name: Esperal
• ATC code: N07BB01
• Active substance: Disulfiram (Disulfiram)
• Manufacturer: Sanofi-Aventis France (France)

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• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• Instructions for use esperal (method and dosage)
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Analogs
• Babies
• With alcohol
• During pregnancy (and lactation)
• Reviews
• Price, where to buy

Composition

As part of the funds contained disulfiram And optional ingredients: polyvidone K30 . magnesium stearate . carmellose sodium . microcrystalline cellulose .

Product form

The drug is available in tablets Which are round, white color with cream shade. On one side of the tablet - Phillips-risk, on the other - engraved " ESPERAL ". The tablets are packed in polypropylene bottles with cork of 20 pieces. The bottle is packed in a cardboard box.

Also Esperal medicine comes in the form of special gel Used for implantation beneath the skin.

Pharmacological action

Pills   and Gel Esperal   Treatments for Alcoholism . Active ingredient disulfiram   acts providing atsetaldegidrogenazy blockade, takes part in the metabolism of ethanol. As a result, the concentration in the body rises acetaldehyde , A metabolite of ethanol. This provokes a human manifestation of negative feelings ( tachycardia Pressure-lowering nausea . vomiting and etc.). Therefore, alcohol becomes a source of extremely negative feelings. As a result, it produced conditional reflex aversion to the smell and taste of alcohol.

The greatest therapeutic effect observed after 12 hours after eating the tablets. Effect of the drug can be maintained for 10-14 days after treatment was discontinued.

Esperal implant   It makes it possible to maintain a constant level of the human body disulfiram . It is important to observe the following conditions: before implantation is carried out, the person for several days should not take alcoholic beverages.

Pharmacodynamics and pharmacokinetics

Influence of disulfiram based on the blockade of acetaldehyde dehydrogenase involved in the metabolism of ethanol.

After receiving orally absorbed from the gastrointestinal tract from 70 to 90% of disulfiram. Further, there has been rapid metabolism, the substance is reduced to dithiocarbamate That is either excreted from the body in the form glucuronyl conjugate Or is converted into diethylamine and carbon sulfide. The last part is output through your lungs (from 4 to 53%).

Indications

The drug is used for the following indications:

• prevention and treatment of chronic relapse Alcoholism ;
• as an additional remedy for detoxification nickel poisoning Which is chronic in nature.

Contraindications

The categorical contraindication to receiving the drug are the following diseases and conditions:

• severe form hepatic insufficiency ;
• diabetes ;
• epilepsy   and convulsions   any origin;
• mental illness ;
• pregnancy and lactation;
• sensitiveness to the components of the drug.

Relative contraindications are:

• hypothyroidism ;
• renal failure .

Side effects

Before starting treatment with this drug, a person must clearly understand what it is, and what side effects may occur during treatment.

Side effects that occur due to properties disulfiram : Feeling of metallic taste in the mouth, the manifestation of unpleasant odor in people with colostomy . In rare cases can develop optic neuritis . hepatitis . polyneuritis of lower limbs , Memory impairment, display confusion , headache, asthenia Allergic to the skin.

Side effects that occur as a result of the combination of disulfiram and ethanol: the manifestation of respiratory failure, collapse, neurological disorders, cardiac arrhythmias, angina . swelling of the brain .

Prolonged treatment means may be observed: psychoses Similar to alcohol, gastritis . hepatitis , Worsening polyneuritis . In people suffering from cardiovascular disease, may develop cerebral thrombosis . If paresthesia in the face and extremities should immediately cancel means.

If the intake of funds was adopted by the dose of alcohol in excess of 50-80 ml (counting 40% ethanol), perhaps a manifestation of serious disturbances in the functions of the respiratory and cardiovascular systems, cramps, edema. In this case, detoxification treatment is carried out immediately.

Instructions for use esperal (method and dosage)

Before you start treatment, the patient should undergo a thorough examination. In addition, it should be clearly understood how the drug works, and what the consequences and complications may occur in the course of his administration.

Instructions on Esperal follows: Tablets taken orally at 500 mg. Admission is carried out once in the morning, while eating. Instructions for use Esperal provides for a gradual reduction in dose to 250 mg or 125 mg per day. How to take the vehicle and adjust the dose, the doctor will tell more detail.

After the start of treatment in 7-10 days alcohol test carried out 20-30 ml of 40% ethanol is taken after consuming 500 mg Esperal funds. If the reaction is weak, the dose of alcohol increases. The maximum dose can be up to 100-120 ml of 40% alcohol. Further, another sample is held in a hospital after 1-2 days and 3-5 days on an outpatient basis. Later, the drug is used in a daily maintenance dose of 150-200 mg for 1-3 years.

Inserting Implant held in muscle tissue to four centimeters deep. Typically, binding is carried out in the upper part of the buttocks, or to the left iliac region. Initially, disinfection and anesthesia, then made an incision size of about 6 mm. Subcutaneous tissue is expanded special tool, and then injected the drug. Total patient is administered 0, 8 g product. After implantation is completed, sutured and dressings. After the suturing Esperal can operate from six months to five years. Encoding is continued in that depending on the dose that has been applied.

Overdose

In case of overdose (combining disulfiram-ethanol ) perhaps oppression of consciousness . coma . cardiovascular collapse , Neurological complications. In this case, a symptomatic treatment.

Cooperation

Contraindications to receiving money from alcohol, as in this case, there is a reaction of intolerance.

It is undesirable to combine Esperal Isoniazid As may impair behavior and coordination.

With simultaneous use of funds from 5-nitro-imidazoles likely to develop confusion . delirious disorders .

Together with the admission Phenytoin   there may be a rapid increase in plasma concentrations of phenytoin, toxic symptoms.

With careful preparation with the following drugs:

• Theophylline As disulfiram inhibits its metabolism. So the theophylline dose should be adjusted.
• Warfarin   and a number of other oral anticoagulants. There is a risk of bleeding, since the effectiveness of oral anticoagulants increases. You should regularly monitor the level of prothrombin in the blood and adjust the dose of anticoagulants for eight days after discontinuation of disulfiram.
• Benzodiazepines As disulfiram increases the sedative effects of benzodiazepines by inhibiting their oxidative metabolism.
• Tricyclic antidepressants   disulfiram for the treatment vastly increase alcohol intolerance.

Terms of sale

Sold by prescription.

Storage conditions

The tool should be protected from the reach of children, store in a dry place with the temperature should not be above 25 ° C.

Shelf life

Keep Esperal can be 3 years.

Cautions

During that time, while the person takes pills Esperal can not take alcoholic beverages, as well as to take any medicines that contain alcohol.

If the patient uses a gel Esperal tablets from alcoholism, the reaction of his body on the simultaneous reception of alcohol can be both fast and stitched. In the latter case, may develop toxic hepatitis That affects the kidneys, liver, pancreas.

Analogs esperal

Match code ATC 4th level:

• Proproten 100
• Lidevin
• Metadoksil

Analogs of the preparation for the main active component - a drug Torpedo . Antabuse . Disulfiram . Lidevin . Teturam . Tetlong-250 . Is it appropriate to apply analogues, be sure to check with your doctor.

Which is better: Esperal Esperal or gel?

What form of the drug is advisable to choose depends on the preferences of the patient. If the tablets should be consumed by the scheme, the Inserting the gel provides a lasting effect without the need for further receiving means. However, it should be noted that the subcutaneous injection esperal provides a constant high concentration of disulfiram in the body. Therefore, the use of alcohol intoxication possible.

To eliminate the drug from the body must be carried neutralization with antidote used for this purpose.

Babies

Not used to treat children.

With alcohol

If at the same time taking Esperal and alcohol, the consequences can be very serious. A marked intolerance reactions in parallel taking alcohol. It should completely eliminate alcohol and medicines that contain alcohol.

When pregnancy

Esperal treatment is contraindicated during pregnancy and breastfeeding.

Reviews esperal

Reviews Esperal tablets indicate that patients who use them could give up alcohol during treatment and often stick to a sober way of life after it. However, it should be noted that the gel, and the drug in pill form is really a very strong negative reaction when taking alcohol, as evidenced by the reviews. People who have been made Inserting or injections, there are manifestations of metallic taste in the mouth, recurrent headaches, allergic reactions and other side effects. It is noted that even with the use of small doses of alcohol side effects can be very serious.

Price Esperal where to buy

Buy Esperal tablets can be priced at an average of 1,000 rubles per 20 pieces.

In Ukraine, the price of tablets Esperal ranges from 70 to 100 hryvnia.

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