Xlordiazepoksid

When ATH:
N05BA02

Characteristic.

Anxiolytic, benzodiazepine derivative.

White or light yellow crystalline powder. Practically insoluble in water, it is soluble in alcohol; as гидрохлорида — растворим в воде.

Pharmacological action.
Anxiolytic, sedation, snotvornoe, miorelaksiruyuschee, central.

Application.

Neurotic state, accompanied by anxiety, excitation, increased irritability, emotional stress, insomnia; nevroticheskaya ataxia, tension headache, kardialgija, esophagism, kauzalgija, front gemispazm, hysterical states (hysterics, amblyopia, mutizm, paralysis), psychogenic stupor, Ikotech; neurosis- and psychopathic disorders in patients with cerebral atherosclerosis, organic brain damage; infective delirium, withdrawal symptoms in patients with alcoholism and drug addiction; increased skeletal muscle tone, giperkinez rheumatic and neurotic; climacteric, premenstrual syndrome, vascular dystonia; premedication (preparing patients for operations and lengthy diagnostic procedures), postoperative period; complex therapy in schizophrenia symptoms with neurosis, as well as diseases, itchy, irritability, insomnia, incl. eczema.

Contraindications.

Hypersensitivity, severe form of myasthenia gravis, respiratory depression, zakrыtougolynaya glaucoma, acute liver disease and / or kidney, pregnancy (I trimester), lactation, Age to 4 years.

Restrictions apply.

Glaucoma, liver dysfunction and / or kidney, sleep apnea syndrome, severe heart and respiratory failure, ataxia (except neurotic), psychoses (perhaps a paradoxical increased symptoms), drug or alcohol dependence (except for the treatment of acute withdrawal syndrome), pregnancy (II and III trimester), advanced age.

Pregnancy and breast-feeding.

It contraindicated in I trimester of pregnancy (It increases the risk of birth defects when administered during this period). In II and III trimester of pregnancy is possible, if the effect of therapy outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: drowsiness, slackness, impaired memory and concentration, mental retardation and motor responses, muscular weakness, gait disturbance, ataxia, confusion, disorientation, dizziness, headache, EEG changes.

Cardio-vascular system and blood (hematopoiesis, hemostasis): tachycardia, palpitations, hypotension (high doses), thrombocytopenia, agranulocytosis.

From the digestive tract: dry mouth, nausea, constipation or diarrhea, kišečnaâ how, abnormal liver function, yellowness of the skin.

Allergic reactions: skin rash, itch, peeling of the skin.

Other: difficulty breathing, urinary retention, menstrual disorders, changes in libido (increase or decrease).

There may be addictive, drug dependence, withdrawal, etc.. (cm. Precautions).

Cooperation.

It enhances the effect of alcohol and funds, CNS depressants (narcotic analgesics, anesthetic, hypnotics, antipsychotics with sedating), muscle relaxants, etc.. Antacids slow induction (but do not reduce the extent of absorption) xlordiazepoksida. Chlordiazepoxide may weaken the effect of levodopa. Cimetidine, estrogensoderzhaschie oral contraceptives, disulfiram erythromycin and slow down the metabolism in the liver chlordiazepoxide, increase its concentration in blood and the excretion of detained. Smoking can weaken the effect of chlordiazepoxide.

Overdose.

Symptoms: CNS depression of varying severity (from drowsiness to coma) — выраженная сонливость, slackness, weakness, decreased muscle tone, prolonged confusion, disorientation, slurred speech, oppression reflexes, coma; also possible respiratory depression, gipotenziya.

Treatment: induction of vomiting, Immediate gastric lavage, monitoring vital functions, simptomaticheskaya therapy, / in infusion solutions (to enhance diuresis), ensuring adequate ventilation; в случае гипотензии — введение норэпинефрина. In the development field should not be used barbiturates. As a specific antidote used benzodiazepine receptor antagonist flumazenil (in hospital). Hemodialysis maloeffyektivyen.

Dosing and Administration.

Inside. Doses (time and daily) and length of treatment are selected strictly individually, depending on the nature of the disease, and, portability, etc.. Treatment should start with the lowest effective dose, corresponding specific form of pathology.

Обычная разовая доза для взрослых — 5–10 мг, обычная суточная — 20–60 мг (receiving 2-4). При состоянии напряжения в сочетании с нарушением сна — 10–20 мг 1 раз в сутки за 1–2 ч до сна. В психиатрии — 50–100 мг/сут, при абстинентном алкогольном синдроме — до 300 мг/сут в 3–4 приема.

Patients in elderly, debilitated patients, Patients with liver and / or kidney disease should be prescribed lower doses (разовая — 2,5–5 мг). The duration of treatment should not exceed 2,5 Months. A second course (if necessary) — не ранее чем через 3 Sun.

Children from the age of 4 Year dose (and duration of treatment) choose individually, depending on the age, body weight, etc..

Precautions.

It should be taken into account, that the combination of anxiety with depression may attempt suicide.

To apply caution in conjunction with other psychotropic drugs. It should not be administered simultaneously with MAO inhibitors and phenothiazines.

With prolonged use (for several months), especially in high doses, may be addictive, drug dependence. Abolition of chlordiazepoxide should be gradual, by reducing the dose, to reduce the risk of withdrawal, characterized by tremor, cramps, abdominal or muscle spasms, vomiting, perspiration. With a sharp lifting also possible agitation, fear, autonomic disorders, insomnia.

Do not take more than chlordiazepoxide 4 weeks without re-evaluation of the patient to decide whether to continue therapy.

The probability of side effects is higher in older people.

Prolonged use should be periodically monitored picture peripheral blood and liver function.

There are reports, that the treatment of chlordiazepoxide mental patients and children with aggressive behavior traits observed paradoxical reactions (psychomotor agitation, rage, and others.). In the case of paradoxical reactions treatment should be stopped immediately.

It will be appreciated, chlordiazepoxide that can reduce mental alertness in children.

It must be borne in mind, there are reports of effects on blood coagulation in patients, while taking oral anticoagulants and chlordiazepoxide (in clinical studies the causes and consequences of this interaction is not installed). There are some reports about the aggravation of porphyria under the influence of chlordiazepoxide. Hypoproteinemia may predispose to increased incidence of sedative side effects.

During treatment and for 3 days after its cancellation should be deleted reception alcohol; drivers of vehicles and people, whose work requires quick mental and physical reactions, and is associated with high concentration of attention, during this period should not engage in professional activities.

Cautions.

Anxiety and stress, associated with everyday life stress, usually does not require treatment with anxiolytics.