Medazepam

When ATH:
N05BA03

Characteristic.

"Full-time" anxiolytic agent (1,4-benzodiazepine). White with greenish-yellow tinge crystalline powder. Practically insoluble in water, easily soluble in alcohol.

Pharmacological action.
Anxiolytic, sedation.

Application.

Neuroses, psihopatii, and psihopatopodobnyh state, accompanied by increased excitability, irritability, emotional lability, depressed mood, voltage, anxiously, fear; psychovegetative and psychosomatic disorders, incl. vasoneurosis, sleep disorders, functional disorders of the cardiovascular system and gastrointestinal tract, migraine (prevention of attacks), menopause.

In pediatric practice: mental lability and hyperexcitability in children, "School" neuroses.

B narkologii: alcohol withdrawal syndrome (uncomplicated), complex therapy delayed neurotic disorders, developing the structure of remission of alcoholism and drug addiction.

Contraindications.

Hypersensitivity (incl. other benzodiazepines), zakrыtougolynaya glaucoma, syndrome, sleep apnea, acute liver disease and kidney failure, severe liver and / or kidney failure, myasthenia gravis, alcohol and drug addiction, pregnancy (I trimester), lactation.

Restrictions apply.

Hepatic and / or renal failure, spinalynaya and mozzhechkovaya ataxia, increased intraocular pressure, organic CNS, circulatory and respiratory insufficiency, childhood (Children appoint strictly on the evidence), advanced age, debilitated patient, pregnancy (II and III trimester).

Pregnancy and breast-feeding.

It contraindicated in I trimester of pregnancy (It increases the risk of congenital malformations). In II and III trimester of pregnancy is possible, if the effect of therapy outweighs the potential risk to the fetus, avoid the use for a long time or at high doses. At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: drowsiness, headache (first reaction to the reception, disappears after reducing the dose), dizziness, slackness, weakness, fatigue, dejection (incl. in patients with a previous depressive illness), stupor, confusion, anterogradnaya amnesia, dysarthria, Parez akkomodacii, blurry vision, double, jerking of the eyeball, chest pain, ataxia (in the elderly and debilitated patients); paradoxical reactions (rampage, a sense of fear, suicidal thoughts - often in the elderly and children, sleep disturbance, increased aggressiveness, convulsions various muscle groups).

Cardio-vascular system and blood (hematopoiesis, hemostasis): low blood pressure, tachycardia, bradycardia.

From the respiratory system: depression of the respiratory center (when airway obstruction or brain injury), alveolar hypoventilation (COPD patients when taken in high doses), breathlessness, laringospazm.

From the digestive tract: dry mouth, nausea, vomiting, epigastric pain, dyspepsia, constipation, increase in liver transaminases, jaundice.

Other: urinary retention, myasthenia, Skin and allergic reactions (redness, itch, rash, rash), decreased libido, dysmenorrhoea, chest pain; long-term use - the development of addiction, Depending (Physical and mental), withdrawal.

Cooperation.

It enhances the effect of funds, CNS depressants (incl. hypnotics drugs, neuroleptics, antihistamines with sedative component, for narcosis, narcotic analgesics), muscle relaxants, alcohol and ethanol-containing drugs. In an application with alcohol, In addition to enhancing the inhibitory effect on the central nervous system, possible paradoxical reaction. Medazepam can inhibit the action of levodopa. Theophylline at low doses removes a calming effect medazepama. Cimetidine, omeprazole, disulьfiram, estrogensoderzhaschie oral contraceptives enhance and prolong the action medazepama. Nicotine speeds up the excretion from the body medazepama.

Overdose.

Symptoms: prolonged confusion, drowsiness, feeling tired, ataxia, tachycardia, hypotension, amyotonia; in severe cases - coma, convulsions, respiratory depression, until the complete cessation of breathing and heart.

Treatment: gastric lavage; administration of activated charcoal and laxatives; control and correction of breathing, Heart Rate, FROM, body temperature and blood circulation; simptomaticheskaya therapy. Forced diuresis and hemodialysis are not effective. To eliminate the inhibitory action on the central nervous system can be used by a specific antagonist of benzodiazepines - flumazenil.

Dosing and Administration.

Inside. The mode set individually depending on the evidence, the disease, portability, etc.. Treatment should start with the lowest effective dose, The daily dose distribute 2-3 hours, if necessary, increase the daily dose recommended by increasing the evening dose. The average dose for adults: single - 10-20 mg, the average daily - 20-30 mg, the maximum - 60-70 mg / day. At the beginning of treatment - for 5 mg 2-3 times a day, then gradually increase the dose to 30-40 mg per day. In outpatient settings recommended by 5 mg in the morning and in the afternoon, and 10 mg in the evening. Elderly patients, teenagers, as well as kidney function - 5-10 mg 1-2 times a day, or 10 mg at night. Babies dose depends on the age and body weight. Treatment duration should be as short as possible (about 2 Sun) and should not exceed 2 Months (including the period of gradual reduction of the dose). Before re-rate the break must be at least 3 Sun.

In the treatment of alcoholism appoint 30 mg / day for 1-2 weeks.

Precautions.

With care given to patients, receiving antihypertensive drugs for a long time the central action, beta-blockers, hypoglycemic drugs, means oral contraceptives, anticoagulants and cardiac glycosides (due to the inability to accurately predict the nature of the interaction with medazepamom).

When taken daily medazepama for a few weeks there is a risk of physical and psychological dependence. This effect is not only the abuse medazepamom (particularly with high doses of), but when it is used in usual therapeutic doses. In connection with this continuation of treatment is possible only for health reasons, and only after a careful comparison benefit of therapy with the risk of developing dependence thereon. The risk of drug dependence increases with the use of large doses, increasing the duration of treatment, patients, previously abused drugs or ethanol.

If you have any patients with such unusual reactions, as increased aggressiveness, excitation, a sense of fear, suicidal thoughts, hallucinations, muscle cramps medazepamom treatment should be discontinued.

Long-term use during pregnancy may lead to withdrawal symptoms in the newborn. Use of high-dose immediately before birth or during labor may cause newborn respiratory depression, decrease in blood pressure, gipotermiyu and difficulty sauce ("Syndrome flaccid child").

Omitting receive another dose of the drug should take the missed dose immediately, as soon as the omission was noticed, This is not to take a double dose of the drug at once.

Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention (in the first days of treatment should completely abandon the car and driving performance, requiring quick mental and physical reactions). In the period of treatment is unacceptable consumption of alcoholic beverages.

In the treatment and prevention of abstinence syndrome abolish the drug should be gradually.

During aftereffects may develop severe fussiness.

Cautions.

It should be taken into account, that anxiety or stress, associated with daily stress, usually are not indications for anxiolytics.