The preparation improves blood gas parameters in patients with chronic obstructive pulmonary disease (COPD). By stimulation of peripheral aortic and carotid chemoreceptors leads to increased oxygen saturation of arterial hemoglobin (Sa02) and increased arterial pressure of arterial oxygen (Pa02) and lowering the partial pressure of arterial carbon dioxide (PaCO2). This effect is independent of significant changes in ventilation, which is manifested by the absence of changes in lung function parameters (breathing capacity, respiratory quotient, oxygen demand) and improvement of the patient's condition with hypoxemia, observed after oral admission of almitrine by a patient with acute decompensated respiratory insufficiency or artificial ventilation. The observed improvement in blood gas parameters is associated with a corresponding improvement in the ventilation / perfusion coefficient. This effect is associated with the improvement of follicular ventilation contributing to the general improvement of blood oxygenation, which was observed in long-term treatment. Orally, almitrine is rapidly absorbed from the gastrointestinal tract. The maximum concentration is reached 3 hours after the oral administration of the drug. It is metabolised to a large extent in the liver; drug and metabolites are mainly excreted in the bile. To a large extent (approx. 99%) is associated with plasma proteins. Almitrine is excreted in the faeces (to a small extent with urine) in the form of inactive metabolites. After a single oral dose, biological T0,5 in the elimination phase is 40-80 h and 30 days after repeated dosing.
Contraindications:
Hypersensitivity to almitrine or any of the excipients. Severe liver disease - if treatment is indicated in the presence of severe liver disease, the patient should be closely monitored and the laboratory parameters should be monitored. Peripheral neuropathy or peripheral neuropathy. Pregnancy and breastfeeding.
Precautions:
Due to the risk of neuropathy, therapy should be discontinued in the case of weight loss or if tingling, feeling of stinging or numbness of the lower limbs occurs (paraesthesia). Alitrine should not be used to treat asthma. If bronchospasm predominates in the clinical picture, a bronchodilator should be used prior to administration of almitrine in order to increase airway patency. Do not use the product in children. The preparation contains lactose - should not be used in patients with rare hereditary galactose intolerance, lactase deficiency (Lapp type) or malabsorption of glucose-galactose.
Pregnancy and lactation:
The preparation is contraindicated during pregnancy and breastfeeding.
Side effects:
Rare: weight loss, peripheral neuropathy (symptoms from the lower extremities or parasthesia - stinging sensation, tingling, numbness) - these symptoms are usually observed during long-term treatment, lasting a year or more; nausea, burning sensation and heaviness in the stomach, indigestion, constipation, sleep disorders (insomnia, drowsiness), agitation, anxiety, palpitations, dizziness, conscious perception of respiratory movements.
Dosage:
Orally. Adults: 1-2 tabl. daily in 2 divided doses in the morning and evening, during meals. After the initial 3-month treatment, sequential treatment is recommended: 1 month break and 2 months of treatment. If necessary, the dosage should be modified depending on the body weight and the presence of side effects. It is recommended that patients with a less than 50 kg used 1 tabl. per day. No dose adjustment is required in patients with renal insufficiency. Treatment with almitrine can be associated with oxygen therapy.
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