Instructions Neuromidin tablets 20 mg blister No. 50
Composition
active ingredient: ipidacrine;
1 tablet contains ipidacrine hydrochloride 20 mg;
Excipients: lactose monohydrate; potato starch; calcium stearate.
Dosage form
Pills.
Main physicochemical properties: flat-cylindrical tablets of white or almost white color with a bevel.
Pharmacotherapeutic group
Other agents acting on the nervous system. Parasympathomimetics. Anticholinesterase agents. ATX code N07A A.
Pharmacological properties
Pharmacodynamics
Neuromidin® is a drug that has a biologically beneficial combination of two molecular effects – blockade of membrane potassium permeability and inhibition of cholinesterase. In this case, blockade of membrane potassium permeability plays a crucial role.
Blockade of potassium permeability of the membrane leads primarily to a prolongation of the repolarization phase of the action potential of the excited membrane and an increase in the activity of the presynaptic axon. This leads to an increase in the entry of calcium ions into the presynaptic terminal, which, in turn, leads to an increase in the release of the mediator into the presynaptic cleft in all synapses. An increase in the concentration of the mediator in the synaptic cleft contributes to a stronger stimulation of the postsynaptic cell due to the mediator-receptor interaction. In cholinergic synapses, inhibition of cholinesterase causes an even greater accumulation of the neurotransmitter in the synaptic cleft and an increase in the functional activity of the postsynaptic cell (contraction, conduction of excitation).
Neuromidin® enhances the effects of acetylcholine, adrenaline, serotonin, histamine, and oxytocin on smooth muscles.
Neuromidin® exhibits the following decisive pharmacological effects:
- stimulation and restoration of neuromuscular transmission;
- restoration of impulse conduction in the peripheral nervous system after its blockade by various agents (trauma, inflammation, the action of local anesthetics, some antibiotics, potassium chloride, toxins, etc.);
- increased contractility of smooth muscle organs;
- specifically moderately stimulates the central nervous system with some manifestations of a sedative effect;
- improving memory and learning ability;
- analgesic effect.
The drug does not have teratogenic, embryotoxic, mutagenic and carcinogenic, as well as allergenic and immunotoxic effects, and does not affect the endocrine system.
Pharmacokinetics
After ingestion, the drug is rapidly absorbed from the digestive tract. The maximum concentration of the active substance is reached in the blood plasma 1 hour after ingestion. From the blood, Neuromidin® quickly enters the tissues, and in the stabilization stage only 2% of the drug is detected in the blood serum, the half-life in the distribution phase is 40 minutes. 40-50% of the active substance binds to plasma proteins. Neuromidin® is absorbed mainly from the duodenum, slightly less from the small and ileum, only 3% of the dose is absorbed in the stomach. Elimination of Neuromidin® from the body is carried out by a combination of renal and extrarenal mechanisms (biotransformation, secretion with bile), with urinary secretion prevailing. Only 3.7% of Neuromidin is excreted in the urine unchanged, which indicates a rapid metabolism of the drug in the body.
Indication
Diseases of the peripheral nervous system (neuropathies, neuritis, polyneuritis and polyneuropathies, myelopolyradiculoneuritis), myasthenia and myasthenic syndrome of various etiologies.
Bulbar palsies and paresis.
Memory impairment of various etiologies (Alzheimer's disease and other forms of senile mental impairment); with delayed mental development in children.
The recovery period of organic lesions of the central nervous system, accompanied by motor disorders.
In the complex therapy of multiple sclerosis and other forms of demyelinating diseases of the nervous system.
Intestinal atony.
Contraindication
Hypersensitivity to ipidacrine and other components of the drug.
Epilepsy.
Extrapyramidal disorders with hyperkinesis.
Angina pectoris.
Marked bradycardia.
Bronchial asthma.
Vestibular disorders.
Mechanical obstruction of the intestines and urinary tract.
Gastric or duodenal ulcer in the acute stage.
Interaction with other medicinal products and other types of interactions
Neuromidin® enhances the sedative effect in combination with drugs that depress the central nervous system. The effect and side effects are enhanced when used together with other cholinesterase inhibitors and m-cholinomimetic drugs.
In patients with myasthenia gravis, the risk of developing a "cholinergic" crisis increases if Neuromidin® is used simultaneously with cholinergic agents. The risk of developing bradycardia increases if β-blockers are used before starting treatment with Neuromidin®.
Neuromidin® can be used in combination with nootropic drugs.
Alcohol increases the side effects of the drug.
Cerebrolysin enhances the mental effects of Neuromidin®.
Application features
Use with caution in patients with a history of peptic ulcer of the stomach and duodenum, respiratory diseases, including acute respiratory diseases, cardiovascular diseases not associated with coronary pain, and thyrotoxicosis.
The drug contains lactose, therefore patients with rare hereditary forms of galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome should not use the drug.
Use during pregnancy or breastfeeding
Neuromidin® increases uterine tone and can cause premature birth, so the use of the drug is contraindicated during pregnancy.
The use of the drug is contraindicated during breastfeeding.
Ability to influence reaction speed when driving vehicles or other mechanisms
Neuromidin® may have a sedative effect, so caution should be exercised when driving vehicles.
Method of administration and doses
Neuromidin® tablets should be taken orally.
For neuritis – 1 tablet 2-3 times a day. The course of treatment is from 10-15 days for acute neuritis, to 20-30 days for chronic neuritis. If necessary, repeat the course of treatment 2-3 times with an interval of 2-4 weeks until the maximum effect is achieved.
For myelopolyradiculoneuritis and paresis – 1 tablet 2-3 times a day for 30-40 days. Repeat the treatment courses several times with a break of 1-2 months. Repeat the treatment courses until the therapeutic effect is achieved.
For myasthenia and myasthenic syndromes – 1-2 tablets 2-3 times a day. For severe forms, the dose can be increased to 200 mg per day (2 tablets 5 times a day after 2-3 hours). Course treatment, alternating with classic anticholinesterase drugs.
For multiple sclerosis and other forms of demyelinating diseases of the nervous system, bulbar paralysis - 1 tablet 3-5 times a day for 60 days 2-3 times a year.
In Alzheimer's disease and other forms of senile mental impairment, start with a dose of 1-2 tablets per day, divided into 2 doses, with a gradual increase in the dose by 2 tablets per week to 6-10 tablets per day (2 tablets 3-5 times a day). Duration of treatment - from 4 months to 1 year. Course therapy is possible - 4-5 months with a break of 1-2 months.
In organic lesions of the CNS, accompanied by motor disorders - 1 tablet 2-3 times a day. The average course of treatment is 30 days. If necessary, the course of treatment can be repeated.
For intestinal atony – from 1 to 3 tablets per day, dividing the dose into 3 doses. The course of treatment is 1-3 weeks.
Children over 12 years of age with mental retardation and peripheral nervous system diseases should be prescribed Neuromidin® 1 tablet (20 mg) 2-3 times a day. The course of treatment is 1-2 months, depending on the clinical picture.
Children
The drug can be used in children over 12 years of age.
Overdose
In severe intoxication, a cholinergic crisis may develop.
Symptoms: bronchospasm, lacrimation, increased sweating, constriction of the pupils, nystagmus, increased peristalsis of the digestive tract, spontaneous defecation and urination, vomiting, jaundice, bradycardia, cardiac conduction disorders, arrhythmias, decreased blood pressure, anxiety, agitation, feelings of fear, ataxia, convulsions, coma, speech disorders, drowsiness, general weakness.
Treatment: symptomatic therapy. Use of m-cholinoblockers (atropine, cyclodol, metacin).
Adverse reactions
Classification of the frequency of adverse reactions: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1000 to < 1/100); rare (≥ 1/10,000 to < 1/1000); very rare (< 1/10,000), including isolated cases; unknown (cannot be estimated from the available data).
Neuromidin® is well tolerated. Possible side effects are related to excitement.
m-cholinoreceptors.
Cardiac disorders: often – palpitations, bradycardia, chest pain.
From the nervous system: infrequently (when using high doses) - dizziness, headache, drowsiness, general weakness, muscle cramps.
From the respiratory system, chest organs and mediastinum: infrequently - increased secretion of bronchial secretions, bronchospasm.
From the gastrointestinal tract: often - salivation, nausea; infrequently (when using high doses) - vomiting; rarely - diarrhea, pain in the epigastric region.
Hepatobiliary disorders: jaundice (frequency unknown).
Skin and subcutaneous tissue disorders: common: increased sweating; uncommon: allergic reactions (including urticaria, angioedema, itching, rash) may occur after taking high doses.
From the reproductive system: increased uterine tone.
Salivation and bradycardia can be reduced by anticholinergics (atropine, etc.). In case of undesirable effects, the dose should be reduced or the drug should be discontinued for a short period (1-2 days).
Expiration date
5 years.
Storage conditions
Store in a dry place, protected from light, at a temperature not exceeding 25 °C.
Keep out of reach of children.
Packaging
10 tablets in a blister. 5 blisters in a cardboard pack.
Vacation category
According to the recipe.
Producer
JSC "Olainfarm"/JSC "Olainfarm".
Location of the manufacturer and its business address
5 Rupnicu street, Olaine, LV-2114, Latvia.
