LIDEVIN

Active material: Adenine, Disulьfiram, Nicotinamide
When ATH: N07BB01
CCF: Drug for the treatment of alcohol dependence
ICD-10 codes (testimony): F10.2
When CSF: 02.18.01
Manufacturer: Laboratory TRADIPHAR (France)

Pharmaceutical form, composition and packaging

Pills round, Valium, white with Valium a color shade, with possible inclusions, chamfered, Phillips line on one side.

Excipients: povidone, microcrystalline cellulose, sodium carboxymethylcellulose, magnesium stearate.

10 PC. – blisters (2) – packs cardboard.

Pharmacological action

Combined medication for the treatment of alcohol dependence, It is a combination of disulfiram with B vitamins.

Disulfiram is an inhibitor atsetaldegiddegidrogenazy. Blocking atsetaldegiddegidrogenazy increases the concentration of acetaldehyde, ethanol is a metabolite of. Acetaldehyde causes negative feelings (incl. flushing, nausea, vomiting, taxikardiju, low blood pressure), which make it extremely unpleasant alcohol after taking Lidevina. This leads to a conditioned reflex aversion to the taste and odor of alcoholic beverages.

The maximum therapeutic effect is achieved through the 12 hours after ingestion and can last for 10-14 days after cessation of treatment.

The combination of disulfiram with vitamins B₃ (nicotinamide) and B₄ (adenine) It provides a pronounced clinical effect while taking even small doses of alcohol, It has minimal side effects, reduces the toxicity of disulfiram, It provides for prevention of alcohol neuropathy and gipovitaminozov.

Pharmacokinetics

After oral administration, absorption from the gastrointestinal tract of disulfiram 70-90%. Disulfiram is rapidly metabolized, vosstanavlyvayas to dytyokarbamata, which is output as glucuronic conjugates, or converted into diethylamine and carbon sulfide, of which (4-53%) light outputted via.

Testimony

- Treatment and prevention of relapse of alcoholism.

Dosage regimen

The drug is prescribed after careful examination of the patient and the prevention of the consequences and complications of therapy.

The dose is set based on disulfiram, and the inside of 125-500 mg 2 times / day for an individual scheme. Through 7-10 days of therapy trial conducted disulfiramalkogolnuyu (20-30 ml 40% after receiving vodka 500 mg), with a weak response to increasing dose of alcohol 10-20 ml (The maximum dose is 100-120 ml). The sample was repeated after 1-2 days in the hospital and after 3-5 outpatient days, if necessary – correction doses of alcohol and / or drug. Further it is possible to use a maintenance dose 125-200 mg / day for 1-3 years.

Side effect

Effects, due to the action of disulfiram: metallic taste in mouth, unpleasant smell in patients with colostomy (associated with carbon sulfide), polyneuropathy of the lower extremities, optic neuritis, memory impairment, confusion, asthenia, headache, allergic skin reactions; in some cases – hepatitis (in patients with nickel eczema, not suffering from chronic alcoholism).

Effects, due to the interaction of disulfiram and ethanol: possible arrhythmia, angina; sometimes – myocardial infarction, neurological disorders; in a few cases – respiratory insufficiency, cardiovascular collapse, swelling of the brain.

Effects, associated with prolonged use of the drug: rarely – psychoses (resembling alcoholic), hepatitis, gastritis; in patients with cardiovascular disease – thrombosis of the brain vessels, aggravation polyneuritis.

The consumption of alcohol in the amount of, exceeding 50-80 ml 40% vodka, possible development of serious disorders of the cardiovascular and respiratory systems, edema, seizures. At the same time urgently conduct detoxication therapy, introduced analeptics, if necessary, shows an additional symptomatic treatment.

Contraindications

Absolute:

- Diseases of the cardiovascular system in the stage of decompensation;

- Neuritis of the auditory nerve;

- Glaucoma;

- Optic neuritis;

- Bronchial asthma;

- Emphysema;

- Pulmonary tuberculosis;

- Severe hepatic impairment;

- Violation of hematopoiesis;

- Diabetes;

- Thyrotoxicosis;

- Epilepsy and convulsions of any origin;

- Mental illness;

- A stomach ulcer in the acute phase;

- Kidney disease;

- Malignant neoplasms;

- Polinevrit various etiologies;

- Pregnancy;

- Hypersensitivity to the drug.

Relative:

- Cardiovascular diseases in the compensation stage;

- Old age (senior 60 years);

- Gastric ulcer and duodenal ulcer in remission;

- Residual effects after a cerebrovascular accident;

- Disulfiramovye (precipitates a) psychosis history.

FROM caution should use the drug in patients with hypothyroidism, especially when the risk of a possible combination with alcohol.

Pregnancy and lactation

Lidevin is contraindicated during pregnancy.

Cautions

It is necessary to warn patients about the possible consequences of the simultaneous use of alcohol or medication, containing ethanol.

Overdose

Currently, cases of drug overdose were reported Lidevin.

At the same time taking the drug and alcohol are possible depression of consciousness up to coma, cardiovascular collapse, neurological complications.

Treatment: symptomatic therapy.

Drug Interactions

Combinations contraindicated

Together with the admission of alcohol develops intolerance reactions (hot flushes, эritema, vomiting, tachycardia). Avoid drinks reception and drugs, containing ethanol.

Undesirable combinations

In an application Lidevina and isoniazid may cause behavioral disturbances and Coordination.

While the use of drugs from the group of nitro-5-imidazole (metronidazol, ornidazol, seknidazol, tinidazol) may develop delirium disorders, confusion.

In an application with phenytoin may develop toxic effects of phenytoin (due to slowing its metabolism and increased plasma concentration).

Combinations, require caution

With simultaneous use of warfarin and Lidevina (or other oral anticoagulants) increased risk of bleeding due to increased warfarin (slowing biotransformation last).

Lidevin slows the biotransformation of theophylline, therefore, while the application requires a reduced dose of theophylline as a function of clinical symptoms and its concentration in blood plasma.

In an application Lidevin potentiates the sedative effect of benzodiazepines by inhibiting oxidative pathway past, chlordiazepoxide and diazepam especially. Benzodiazepine dose should be adjusted according to the clinical manifestations.

In an application Lidevina and tricyclic antidepressants may increase the reactions of intolerance to alcohol, especially if the patient while taking Lidevina drink alcohol.

Conditions of supply of pharmacies

The drug is released under the prescription.

Conditions and terms

List B. The drug should be stored out of reach of children, at a temperature no higher than 25 °. Shelf life – 3 year.