Instructions for use: Mexicor solution for injection 5%, ampoule 2 ml, No. 10
Composition
active ingredient: ethylmethylhydroxypyridine succinate;
1 ml of solution contains ethylmethylhydroxypyridine succinate – 50 mg;
Excipients: succinic acid, disodium edetate, water for injection.
Dosage form
Solution for injection.
Main physicochemical properties: clear, colorless or slightly colored liquid.
Pharmacotherapeutic group
Cardiological drugs. ATX code C01E B.
Pharmacological properties
Pharmacodynamics.
Mexicor® improves the functional state of the ischemic myocardium during myocardial infarction, improves cardiac contractile function, and also reduces manifestations of systolic and diastolic dysfunction of the left ventricle.
The basis of the drug's action is its antioxidant activity, the ability to inhibit free radical processes (the intensification of which is observed during ischemia and myocardial necrosis, especially during the period of reperfusion), and to reduce the damaging effect of free radicals on cardiomyocytes.
In conditions of critical reduction of coronary blood circulation, Mexicor® helps to preserve the structural and functional organization of cardiomyocyte membranes, stimulates the activity of membrane enzymes - phosphodiesterase, adenylate cyclase, acetylcholinesterase. The drug enhances the activation of aerobic glycolysis, which develops during acute ischemia, and promotes the restoration of mitochondrial redox processes in conditions of hypoxia, increases the synthesis of ATP and creatine phosphate. These mechanisms ensure the integrity of morphological structures and physiological functions of the ischemic myocardium.
Mexicor® normalizes metabolic processes in ischemic myocardium, reduces the area of necrosis, restores and/or improves electrical activity and myocardial contractility, and also increases coronary blood flow in the ischemic area, increases the antianginal activity of nitro-containing drugs, improves the rheological properties of blood, and reduces the consequences of reperfusion syndrome in acute coronary insufficiency.
Mexicor® has a neuroprotective effect, stabilizes cerebral blood flow in conditions of hyperperfusion, improves cerebral blood supply in the reperfusion period after ischemia. The drug promotes adaptation to the damaging effects of ischemia, inhibits postischemic reduction in glucose and oxygen utilization by the brain and prevents progressive accumulation of lactate. Mexicor® improves and stabilizes cerebral metabolism and cerebral blood supply, supports functional brain activity both during ischemia and in the postischemic period. Mexicor® has a selective, anxiolytic effect, which is not accompanied by sedation and muscle relaxation, eliminates anxiety, fear, mental tension, and restlessness. Mexicor® has a nootropic effect, prevents and reduces learning and memory impairments that occur in vascular diseases of the brain, in mild and moderate cognitive disorders, exhibits an antihypoxic effect, increases concentration and performance. The inclusion of Mexicor® in the complex therapy of patients with acute cerebral circulation disorders reduces the manifestation of clinical symptoms and improves the course of the rehabilitation period.
Pharmacokinetics.
When administered intravenously, the drug quickly (within 0.5-1.5 hours) enters the organs and tissues, due to which its concentration in the blood in an unchanged form quickly decreases. When administered intramuscularly in therapeutic doses, the maximum concentration of the drug in the blood plasma is reached after 30-40 minutes and is 2.5-3 μg / ml, while its metabolites are determined in the blood plasma for 7-9 hours. The drug is biotransformed in the liver by glucuronidation.
The drug is excreted from the body in the urine in glucuronide conjugated form and in small amounts in unchanged form.
Indication
In complex therapy:
acute myocardial infarction (from the first day);
ischemic stroke;
dyscirculatory encephalopathy (including atherosclerotic genesis);
mild and moderate cognitive disorders of various genesis.
Contraindication
Increased individual sensitivity to the drug, hepatic or renal failure.
Interaction with other medicinal products and other types of interactions
Enhances the effect of benzodiazepine anxiolytics, anticonvulsants (carbamazepine), antiparkinsonian drugs (levodopa), potentiates the effect of nitro-containing drugs, antihypertensive drugs. Reduces the toxic effects of ethanol.
Application features
Special attention should be paid to the appointment of Mexicor® to patients with a severe allergic history. After completion of parenteral administration, to maintain the achieved effect, it is recommended to continue using Mexicor® orally in the form of 100 mg capsules 3 times a day.
Use during pregnancy or breastfeeding
Contraindicated.
The ability to influence the reaction speed when driving or working with other mechanisms
At the beginning of treatment with the drug, it is advisable to refrain from driving or engaging in hazardous activities that require increased concentration and speed of psychomotor reactions.
Method of administration and doses
Administered intravenously or intramuscularly for 14 days against the background of traditional therapy for myocardial infarction.
In the first 5 days, to achieve maximum effect, it is advisable to administer Mexicor® intravenously, in the next 9 days the drug can be administered intramuscularly.
Intravenously, the drug is administered by drip infusion, slowly (to avoid side effects) in 100-150 ml of 0.9% sodium chloride solution or 5% dextrose (glucose) solution for 30-90 minutes. If necessary, a slow jet injection of the drug is possible for a duration of at least 5 minutes.
The drug is administered (intravenously or intramuscularly) 3 times a day, every 8 hours.
The daily therapeutic dose is 6-9 mg/kg, 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 acute cerebral circulation disorders (ischemic stroke), Mexicor® is used in complex therapy in the first 2-4 days intravenously drip 200-300 mg 2-3 times a day, then intramuscularly 100 mg 3 times a day. The treatment period is 10-14 days. Subsequently, the drug is prescribed in capsules 100 mg 2 times a day for 14 days and 100 mg 3 times a day for 7 days. The frequency and duration of repeated courses is determined by the doctor depending on the course of the disease.
In case of dyscirculatory encephalopathy in the decompensation phase, Mexicor® is administered intravenously by jet or drip at a dose of 100 mg 2-3 times a day for 14 days. Subsequently, the drug is administered intramuscularly at 100 mg per day for 2 weeks, then it is prescribed in capsules at 100 mg 2-4 times a day. For course prophylaxis, the drug is administered intramuscularly at 100 mg 2 times a day for 10-14 days.
In the treatment of mild and moderate cognitive disorders, Mexicor® is prescribed intramuscularly at 100-300 mg per day for 2 weeks, if necessary, the drug is then prescribed in capsules at 100 mg 2-4 times a day. The frequency and duration of treatment courses is determined by the doctor depending on the course of the disease.
Children
The drug should not be used in children under 18 years of age (efficacy and safety have not been established).
Overdose
In case of overdose, sleep disorders such as insomnia may develop, in some cases drowsiness; with intravenous administration, in some cases, a short-term and slight increase in blood pressure is possible.
The development of overdose symptoms, as a rule, does not require the use of antihypertensive agents. These symptoms of sleep disturbance disappear independently within a day. In especially severe cases, the use of one of the tableted hypnotics and anxiolytics (nitrazepam 10 mg, oxazepam 10 mg or diazepam 5 mg) is recommended. In case of excessive increase in blood pressure, antihypertensive agents are used under the control of blood pressure and/or therapy is supplemented with nitro-containing drugs.
Side effects
With intravenous administration, especially jet, dryness and metallic taste in the mouth, a feeling of heat throughout the body, unpleasant odor, scratching in the throat and discomfort in the chest, shortness of breath, palpitations, tachycardia, short-term decrease or increase in blood pressure, headache, tremor, facial flushing, distal hyperhidrosis 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 use of the drug, the following side effects may occur:
Gastrointestinal tract: nausea, flatulence, dyspeptic disorders, diarrhea;
Central nervous system: sleep disturbances (drowsiness or difficulty falling asleep), weakness, anxiety, emotional reactivity, coordination disorders, dizziness, peripheral edema.
In case of individual hypersensitivity to the drug, allergic reactions may occur, including skin rashes, urticaria, itching, angioedema, and bronchospasm.
Expiration date
3 years. Do not use the drug after the expiration date indicated on the package.
Storage conditions
Store in a place protected from light, out of reach of children, at a temperature of 0-25 °C.
Incompatibility
It is not recommended to administer in the same syringe with other medications.
Use only solvents specified in the instructions.
Packaging
2 ml of solution in an ampoule; 5 ampoules in a contour blister pack; 2 contour packs in a cardboard pack.
Vacation category
According to the recipe.
Producer
PJSC "Lekhim-Kharkiv".
Address
Ukraine, 04114, Kyiv, Avtozavodska St., 54/19 Lit. A, office
Applicant
LLC "ZDRAVO".
