Temporary, short-term symptomatic treatment: anxiety syndromes of various origins (accompanying psychoorganic syndromes, psychotic symptoms), anxiety disorders with sleep disorders, acute alcohol withdrawal syndrome, increased muscle tone of various etiologies. Conditions of tension and anxiety associated with everyday problems are not an indication for the use of the drug.
Composition:
1 tabl it contains 5 mg, 10 mg or 25 mg of chlordiazepoxide.
Action:
The drug belongs to the group of benzodiazepine derivatives. It affects many structures o.u.n., above all the limbic system and hypothalamus, that is, the structures associated with the regulation of emotional activities. It intensifies the inhibitory action of GABAergic neurons within the cerebral cortex, thalamus and hypothalamus. The drug increases the affinity of the GABAergic receptor to gamma-aminobutyric acid (GABA), which is an endogenous inhibitory neurotransmitter. The product has an anxiolytic and sedative effect, also moderately hypnotic and reduces skeletal muscle tone, has anticonvulsant properties. The drug is well absorbed from the digestive tract, the maximum concentration in the blood occurs after about 1-2 hours. It is metabolized in the liver to active metabolites. It is mainly excreted in the urine. T0,5 is 6-30 hours.
Contraindications:
Hypersensitivity to chlordiazepoxide, other benzodiazepine derivatives or other ingredients of the preparation. Acute respiratory failure or depression of the respiratory center. Obsessive or phobic syndrome. Chronic psychosis.
Precautions:
Psychological and physical addiction may develop during treatment - particularly cautiously use in patients with an addiction to alcohol, drugs or other medicines in the past. Regular use can lead to the development of tolerance. A few hours after taking the medicine (especially a large dose), you may experience amnesia. If paradoxical reactions occur (more often in elderly patients or addicted to alcohol), the use of the drug should be discontinued. Use in patients with severe hepatic impairment and in patients with psychosis is not recommended. Particularly cautiously used in elderly patients (over 65 years), in patients with symptoms of depression (suicidal risk) and in patients with cerebellar and spinal ataxia and myasthenia gravis. Caution should be exercised in patients with chronic respiratory failure, chronic renal failure, liver disease, porphyria, glaucoma (especially with a narrow angle of perception). It is not recommended to use the drug in children. The preparation contains lactose - should not be used in patients with rare hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome and sucrose - should not be used in patients with rare hereditary disorders associated with fructose intolerance, malabsorption syndrome - galactactic or deficiency of sucrase-isomaltase.
Pregnancy and lactation:
The use of a drug during pregnancy, especially in the first and third trimester, is only permitted in case of absolute necessity, and the use of safer equivalents is not possible. Administration of the drug to pregnant women, especially for a long time, may cause fetal defects, as well as the development of addiction and abstinence syndrome in newborns. In the case of benzodiazepine administered in the third trimester in high doses or in low prolonged periods in the newborn, hypotension, hypothermia, weakness of the sucking reflex may occur. If it is necessary to administer the medicine during lactation, breast-feeding should be discontinued.
Side effects:
Most often at the beginning of treatment: drowsiness, slowing of the reaction, pain and dizziness, confusion, confusion, ataxia; less often (especially at high doses): dysarthria with speech blurred and abnormal pronunciation, memory disorders, libido disorders. Rare: nausea, stomach discomfort, constipation, dryness in the mouth.In addition, you may experience: blurred vision (blurred vision, double vision), slight decrease in blood pressure, bradycardia, chest pain, urinary retention, urinary incontinence, muscle tremors, muscle weakness, loss of appetite, menstrual disorders, general weakness, fainting, allergic skin reactions (rash, pruritus, urticaria), slight increase in aminotransferase, liver dysfunction with jaundice, disturbances in blood morphology, paradoxical reactions (psychomotor anxiety, insomnia, agitation, aggression, muscle tremor, convulsions). Very rare: anaphylactic reactions. Psychological and physical addiction may develop during treatment. Abrupt discontinuation of treatment may cause symptoms of withdrawal syndrome: headache, muscle pain, agitation, emotional tension, restlessness, confusion, confusion, irritability, insomnia; in severe cases: loss of sense of reality, personality disorders, hypersensitivity to touch, acoustic stimuli, light, tingling and limb numbness, hallucinations, convulsions. During therapy, pre-existing undiagnosed depression may appear.
Dosage:
Orally. Dosage and duration of treatment should be determined individually. Adults: for the treatment of anxiety disorders: usually up to 30 mg daily in divided doses, every 6-8 hours; in special situations, higher doses may be used, the maximum daily dose of 100 mg should not be exceeded. In anxiety with accompanying insomnia: 10-30 mg in a single dose before bedtime. In states of agitation in acute alcohol withdrawal syndrome: 25-100 mg if necessary, the dose can be repeated after 2-4 h, not exceeding the dose of 200 mg per day. Then reduce the dose to the supportive, lowest, sufficient to control signs of arousal. In states of increased muscle tone: 10-30 mg daily in divided doses. The drug is used temporarily, long-term use (more than 4 weeks) is not recommended. Elderly, doses should not exceed half the dose for adults. In patients with renal insufficiency, liver disease or chronic respiratory failure, it may be necessary to reduce the doses.Way of giving. The preparation should be taken before or during a meal, washed down with water.
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