Different forms of schizophrenia and acute psychotic disorders (also catatonic) with accompanying symptoms of psychomotor agitation, mania and delusions.
Composition:
1 tabl contains 25 mg, 50 mg, 100 mg or 200 mg of perazine in the form of dimaleate. (1 table of 25 mg contains 72.45 mg of lactose.)
Action:
A drug from the group of neuroleptics, a piperazine derivative of phenothiazine. The activity of perazine is mainly related to the inhibitory effect on the dopaminergic system o.u.n. It blocks postsynaptic receptors and inhibits the release and uptake of neuronal dopamine. Antipsychotic action is associated with blocking dopaminergic D receptors2, which reduces the severity of delusional symptoms and hallucinations. Peryzine also causes skeletal muscle relaxation and shows weak antihistamine activity. It is quickly absorbed from the gastrointestinal tract, the maximum concentration in the blood reaches after 2-4 h after administration. It binds in 95-98% with plasma proteins. It penetrates the blood-brain barrier, reaching a higher concentration in the brain than in the plasma. Perazine and its metabolites pass through the placenta and into breast milk. Peryzine is metabolized in the liver. It is excreted in the urine and bile mainly in the form of metabolites.
Contraindications:
Hypersensitivity to the active substance, other antipsychotics, especially phenothiazine derivatives or any of the preparation's excipients. Malignant neuroleptic syndrome in an interview. Severe damage to the bone marrow or blood cells. Comatose states. Acute poisoning with one of the following: hypnotics, opioids, other neuroleptics, sedatives, antidepressants, alcohol. Permacin-dependent tumors due to increased prolactin secretion under the influence of perazine. Severe hepatic failure. Depression states. Pregnancy and breastfeeding.
Precautions:
Caution should be exercised in patients with renal insufficiency, as phenothiazine derivatives may cause hypotension. The usefulness of the treatment should be considered, or caution should be exercised when treating patients with: leukopenia or other hematopoietic disorders, history of myocardial infarction, severe hypotension, orthostatic hypotension, history of seizures, Parkinson's disease, narrow-angle glaucoma, during treatment with perazine urinary disorders, pyloric stenosis, prostatic hyperplasia, extrapyramidal system dysfunction, dyskinesias, myasthenia, active peptic ulcer disease and chronic liver disease, pyloric stenosis, hyperthyroidism, adrenal pheochromocytoma, hemopoetic disorder, acute anemia, breast cancer. During treatment with perazine, it is necessary: continuous monitoring of blood Glucose in patients with diabetes mellitus; monitoring cardiovascular function: control of blood pressure and observation of possible arrhythmia (frequent measurements of blood pressure and ECG, this is especially important in elderly patients, ECG monitoring should be performed in patients with heart disease and heart defects); performing liver function tests at the beginning of treatment and then after 6 months. If after application of the preparation there are changes in the blood picture (decrease in the number of leukocytes, decrease in the number of platelets), nosebleeds, delirium, depression, urticaria or skin irritation and increased hepatic enzymes and jaundice, it is advisable to reduce the dose or discontinue the medicine and immediately carry out haematological tests. In the case of a significant reduction in the number of leukocytes, as well as in the case of changes in peripheral blood smears, treatment with perazine should be discontinued and another drug should be used. During long treatment with perazine, a blood test should be performed every 6 months. In the case of a neuroleptic malignant syndrome, immediate discontinuation of the preparation, prevention of hyperthermia by cooling, treatment of water and electrolyte disturbances, symptoms of circulatory failure, respiratory and renal failure is recommended.In the event of early dyskinesia or Parkinson's syndrome, a dose reduction or implementation of anti-Parkinson's therapy is recommended. Avoid intense sunlight and reduce light sensitivity during treatment with perazine, using protective creams with UV filters. Table. 25 mg contain lactose - should not be used in patients with rare hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.
Pregnancy and lactation:
The drug is contraindicated during pregnancy and breastfeeding.
Side effects:
Very often: milker. Common: changes in intraocular pressure, swelling of the nasal mucosa, constipation, difficulty urinating, weight gain, dry mouth, increased thirst, sexual dysfunction (eg erectile dysfunction, ejaculation). Uncommon: dyskinesias, parkinsonism syndrome, sleep disturbances, general anxiety, increased nocturnal nightmare, confusion and dementia. Rare: changes in sensation in the hands and feet, seizures, hypersensitivity of the eyes to light, severe phototoxic reactions accompanied by pigment deposition, vascular collapse, gynecomastia in men, delirium episodes, confusion. Very rare: edema, agranulocytosis, extrapyramidal symptoms (manifested by akathisia, often associated with depression occurring after the manic phase of psychosis), neuroleptic malignant syndrome, breathing disorders, gastrointestinal discomfort, nausea, gangrenous enteritis, lupus erythematosus, cholestasis. Not known: false pregnancy test results, arrhythmia, lower blood pressure, decreased white blood cell count, decreased platelet count, urticaria or irritation, nasal bleeding, increased liver enzymes, jaundice, menstrual disorders, breast enlargement women. The maximum doses may cause severe liver damage.
Dosage:
Orally. The initial dose is 50-100 mg per day, at a later stage of treatment gradually, increasing the dose to 300-600 mg per day in divided doses. The maximum therapeutic dose is 800 mg daily in divided doses. The maintenance dose is 75-300 mg per day. Treatment of ambulatory patients should be started at the lowest effective doses, and then the dose may be increased until the desired response to treatment is obtained. In order to obtain a faster response to treatment in hospitalized patients, treatment can be started at higher doses. Urgent dose changes are not recommended as this increases the risk of side effects. The maximum antipsychotic effect is obtained after 1-3 weeks of treatment. If the optimal dose is administered over a longer period, it should be gradually reduced to the lowest effective dose.Discontinuation of the drug. Treatment of psychotic disorders is a long-term cadaver. If a satisfactory improvement is obtained, it is not advisable to reduce the dose too quickly. Doses should be reduced gradually over several to several months. The doctor's decision to stop treatment can only be based on clinical experience, taking into account the current course of the disease and the patient's condition.Special groups of patients. There is no need to change the dosage in renal failure. In patients with impaired liver function, it is advisable to use half of the adult dose, and in severe liver failure to discontinue the drug. Elderly patients are advised to use half of the adult dose; such dosing generally provides the desired curative effect. Due to the lack of sufficient data to assess the safety of the drug should not be used in patients under 16 years of age.
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