Instructions Dinar solution for injection 50 mg/ml ampoule 2 ml in blister No. 10
Composition
active ingredient: ethylmethylhydroxypyridine succinate;
1 ml of solution contains ethylmethylhydroxypyridine succinate (calculated on 100% dry matter) - 50 mg;
Excipients: sodium metabisulfite, water for injections.
Dosage form
Solution for injection.
Main physicochemical properties: clear, colorless or slightly yellowish liquid.
Pharmacotherapeutic group
Drugs affecting the nervous system. ATX code N07X X.
Pharmacological properties
Pharmacodynamics.
Dinar is an inhibitor of free radical processes, a membrane protector, has antihypoxic, stress-protective, nootropic, anticonvulsant and anxiolytic effects. The drug increases the body's resistance to the action of various damaging factors, to oxygen-dependent pathological conditions (shock, hypoxia and ischemia, cerebral circulation disorders, intoxication with alcohol and antipsychotics (neuroleptics)).
The drug improves cerebral metabolism and blood supply to the brain, improves microcirculation and rheological properties of blood, reduces platelet aggregation. Stabilizes membrane structures of blood cells (erythrocytes and platelets) during hemolysis. Has a hypolipidemic effect, reduces the content of total cholesterol and low-density lipoproteins (LDL). Reduces enzymatic toxemia and endogenous intoxication in acute pancreatitis.
The mechanism of action is due to its antioxidant and membrane protective properties. It inhibits lipid peroxidation, increases the activity of superoxide oxidase, increases the lipid-protein ratio, reduces membrane viscosity. Modulates the activity of membrane-bound enzymes (calcium-independent phosphodiesterase, adenylate cyclase, acetylcholinesterase), receptor complexes (benzodiazepine, gamma-aminobutyric acid (GABA), acetylcholine), which increases their ability to bind to ligands, contributes to the preservation of the structural and functional organization of biomembranes, the transport of neurotransmitters and the improvement of synaptic transmission. Dinar increases the content of dopamine in the brain. Causes increased compensatory activation of aerobic glycolysis and a decrease in the degree of inhibition of oxidative processes in the Krebs cycle under conditions of hypoxia with an increase in the content of adenosine triphosphate (ATP) and creatine phosphate, activation of energy-synthesizing functions of mitochondria, stabilization of cell membranes.
Dinar normalizes metabolic processes in ischemic myocardium, reduces the area of necrosis, restores and improves electrical activity and myocardial contractility, and also increases coronary blood flow in the ischemic area, reduces the effects of reperfusion syndrome in acute coronary insufficiency. Increases the antianginal activity of nitro drugs. Dinar contributes to the preservation of retinal ganglion cells and optic nerve fibers in progressive neuropathy, the consequences of which are chronic ischemia and hypoxia. Improves the functional activity of the retina and optic nerve, increasing visual acuity.
Pharmacokinetics.
When administered intramuscularly, the drug is detected in the blood plasma within 4 hours after administration. The time to reach maximum concentration is 0.45-0.5 hours. The maximum concentration at doses of 400-500 mg is 3.5-4.0 μg/ml. Dinar quickly passes from the bloodstream into organs and tissues and is quickly eliminated from the body. The drug is excreted from the body with urine, mainly in the glucuronide conjugated form and in small quantities - in unchanged form.
Incompatibility.
The drug should not be mixed with other medications. Use only the solvents specified in the instructions.
Indication
Acute cerebral circulatory disorders; traumatic brain injury, consequences of traumatic brain injuries; dyscirculatory encephalopathy; neurocirculatory dystonia; mild cognitive disorders of atherosclerotic genesis; anxiety states in neurotic and neurosis-like conditions; acute myocardial infarction (from the first day), as part of complex therapy; primary open-angle glaucoma of various stages, as part of complex therapy; relief of withdrawal syndrome in alcoholism with a predominance of neurosis-like and neurocirculatory disorders; acute intoxication with antipsychotic drugs; acute purulent-inflammatory processes in the abdominal cavity (acute necrotic pancreatitis, peritonitis), as part of complex therapy.
Contraindication
Acute hepatic or renal failure, increased individual sensitivity to the drug. Pregnancy and breastfeeding. Children's age.
Interaction with other medicinal products and other types of interactions
Dinar enhances the effect of benzodiazepine anxiolytics, anticonvulsants (carbamazepine), antiparkinsonian drugs (levodopa). Potentiates the effect of nitro-containing drugs, antihypertensive drugs. Reduces the toxic effect of ethyl alcohol.
Application features
In some cases, especially in predisposed patients, in patients with bronchial asthma, with increased sensitivity to sulfites, the development of severe hypersensitivity reactions is possible. It should be used with caution in patients with diabetic retinopathy (the course should not exceed 7-10 days) due to the property of potentiating proliferative processes.
After completion of parenteral administration, it is recommended to continue using the drug orally in tablet form to maintain the achieved effect.
Use during pregnancy or breastfeeding
Strictly controlled clinical studies of the safety of the drug during pregnancy and breastfeeding have not been conducted, therefore Dinar should not be used during this period.
Ability to influence reaction speed when driving vehicles or other mechanisms
During treatment, caution should be exercised when driving or operating other machinery, given the possibility of side effects that may affect reaction speed and ability to concentrate.
Method of administration and doses
Dinar is administered intramuscularly or intravenously (by jet or drip). When administered by infusion, the drug should be diluted in saline (200 ml). Adults should begin treatment with a dose of 50-100 mg 1-3 times a day, gradually increasing the dose until a therapeutic effect is obtained. Dinar should be administered by jet slowly over 5-7 minutes, drip - at a rate of 40-60 drops per minute. The maximum daily dose should not exceed 800 mg.
In acute cerebral circulation disorders, Dinar is prescribed as part of complex therapy in the first 2-4 days intravenously or drip to adults 200-300 mg once a day, then intramuscularly 100 mg 3 times a day. The treatment period is 10-14 days.
In case of traumatic brain injury and consequences of traumatic brain injury, Dinar should be used for 10-15 days by intravenous drip injection of 200-500 mg 2-4 times a day.
In case of dyscirculatory encephalopathy in the decompensation phase, Dinar should be administered intravenously by jet or drip at a dose of 100 mg 2-3 times a day for 14 days. Then the drug should be administered intramuscularly at 100 mg per day for the next 2 weeks.
For course prevention of dyscirculatory encephalopathy, the drug is administered intramuscularly at a dose of 100 mg 2 times a day for 10-14 days.
For mild cognitive impairment in elderly patients and anxiety states, the drug should be administered intramuscularly in a daily dose of 100-300 mg for 14-30 days.
In acute myocardial infarction as part of complex therapy, Dinar should be administered intravenously or intramuscularly for 14 days against the background of traditional myocardial infarction therapy, which includes nitrates, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, thrombolytics, anticoagulants and antiplatelet agents, as well as symptomatic agents according to indications. In the first 5 days, intravenous administration of Dinar is desirable to achieve maximum effect, in the next 9 days, intramuscular administration of Dinar is possible. Intravenous administration should be carried out by drip infusion, slowly (to avoid side effects), in 0.9% sodium chloride solution or 5% dextrose (glucose) solution in a volume of 100-150 ml for 30-90 minutes. If necessary, a slow jet injection of Dinar is possible for at least 5 minutes.
Dinar should be administered (intravenously or intramuscularly) 3 times a day every 8 hours. The daily therapeutic dose is 6-9 mg per kilogram of body weight, a single dose is 2-3 mg/kg of body weight. The maximum daily dose should not exceed 800 mg, a single dose is 250 mg.
In open-angle glaucoma of various stages, as part of complex therapy, Dinar should be administered intramuscularly in a daily dose of 100-300 mg 1-3 times a day for 14 days.
For alcohol withdrawal syndrome, Dinar should be administered at a dose of 100-200 mg intramuscularly 2-3 times a day or intravenously drip 1-2 times a day for 5-7 days.
In acute purulent-inflammatory processes of the abdominal cavity (acute necrotic pancreatitis, peritonitis), the drug is prescribed on the first day both in the preoperative and postoperative periods. Doses depend on the form and severity of the disease, the prevalence of the process, and the clinical course. The drug should be discontinued gradually, only after a stable positive clinical and laboratory effect. In acute edematous (interstitial) pancreatitis, Dinar is prescribed 100 mg 3 times a day intravenously drip (in isotonic sodium chloride solution) and intramuscularly. Mild degree of necrotic pancreatitis: 100-200 mg 3 times a day intravenously drip (in isotonic sodium chloride solution) and intramuscularly. Moderate degree: 200 mg 3 times a day intravenously drip (in isotonic sodium chloride solution). Severe course: in pulse dosing 800 mg on the first day with a double injection; then - 300 mg 2 times a day with a gradual decrease in the daily dose. Very severe course: in the initial dose - 800 mg per day until stable relief of the manifestation of pancreatogenic shock, after stabilization of the condition - 300-400 mg 2 times a day intravenously drip (in isotonic sodium chloride solution) with a gradual decrease in the daily dose.
Children
Strictly controlled clinical studies of the safety of the drug in children have not been conducted, therefore Dinar should not be used in this category of patients.
Overdose
In case of overdose, drowsiness or insomnia is possible, in case of intravenous administration, in some cases, a short-term and slight increase in blood pressure is possible. Treatment is detoxification therapy.
Adverse reactions
From the cardiovascular system: increased blood pressure, decreased blood pressure.
From the nervous system: dizziness, drowsiness, sleep disturbance, feeling of anxiety, emotional reactivity, headache, coordination disorder.
Gastrointestinal: nausea, dry mouth.
On the part of the immune system: allergic reactions, including hyperemia, skin rash, itching, urticaria, angioedema, possible severe hypersensitivity reactions, bronchospasm.
Skin and subcutaneous tissue disorders: distal hyperhidrosis, injection site changes.
With intravenous administration, especially jet, a metallic taste in the mouth, a feeling of heat throughout the body, an unpleasant odor, a scratchy throat and discomfort in the chest, shortness of breath, a feeling of palpitations, tachycardia, tremor, facial flushing may occur. As a rule, these phenomena are associated with excessive speed of drug administration and are short-term in nature.
Against the background of long-term administration of the drug, the following side effects may occur: flatulence, weakness, peripheral edema.
Expiration date
2 years.
Do not use after the expiry date stated on the packaging.
Storage conditions
Store in the original packaging at a temperature not exceeding 25 °C.
Keep out of reach of children.
Packaging
2 ml in an ampoule.
10 ampoules per pack.
5 ampoules in a blister.
2 blisters per pack.
Vacation category
According to the recipe.
Producer
PJSC "Farmak".
Location of the manufacturer and its business address
Ukraine, 04080, Kyiv, Frunze St., 74.
