Composition
of 1 amp. : Tolperisone hydrochloride-100 mglidocaine hydrochloride-2.5 mgcompetitive substances: methyl parahydroxybenzoate-0.6 mg, diethylene glycol monoethyl ether-0.3 ml, concentrated hydrochloric acid-up to pH 3.0-4.5, d/i water – up to 1 ml
Pharmacological action
Tolperisone hydrochloride is a central-acting muscle relaxant. It has a membrane-stabilizing, local anesthetic effect, inhibits the conduction of nerve impulses in primary afferent fibers and motor neurons, which leads to blocking of spinal mono – and polysynaptic reflexes.
It probably mediates the blocking of the release of mediators by inhibiting the entry of calcium ions into synapses. Inhibits the conduction of excitation along the reticulospinal pathway in the brain stem.
Regardless of its effect on the central nervous system, it increases peripheral blood flow. A weak antispasmodic and antiadrenergic effect of Tolperisone may play a role in the development of this effect.
Lidocaine hydrochloride has a local anesthetic effect and does not have a systemic effect when dosed according to the instructions.
Indications
— hypertonicity and spasm of striated muscle, arising from organic diseases of the Central nervous system (including the defeat of the pyramidal pathways, multiple sclerosis, stroke, myelopathy, encephalomyelitis), musculoskeletal system (including spondylosis, spondylosis, cervical and lumbar syndromes, arthritis of large joints);
— rehabilitation treatment after orthopedic and trauma surgery.
As part of complex therapy:
— with obliterating vascular diseases (obliterating atherosclerosis, diabetic angiopathy, obliterating thrombangiitis, Raynaud’s disease, diffuse scleroderma);
— with diseases that occur on the basis of vascular innervation disorders (acrocyanosis, intermittent angioedema).
Use during pregnancy and lactation
It is contraindicated to use the drug during pregnancy and lactation.
Contraindications
-severe myasthenia gravis;
– pregnancy;
– lactation;
– children and adolescents under 18 years of age;
– hypersensitivity to the components of the drug, including lidocaine.
The drug should be used with caution in patients with renal and hepatic insufficiency (no dose adjustment is required).
Side effects
Frequency of side effects: very common (≥1/10), common (≥1/100 to <1/10), infrequent (≥1/1000 to <1/100), rare (≥1/10,000 to <1/1000), very rare (
From the hematopoietic system: Â very rarely – anemia, lymphadenopathy.
From the immune system: Â rarely-hypersensitivity reactions, anaphylactic reactions; very rarely-anaphylactic shock.
From the side of metabolism and nutrition: Â infrequently – anorexia; very rarely-polydipsia.
Mental disorders: Â infrequently – insomnia, sleep disorders; rarely – loss of activity, depression.
Nervous system disorders: Â infrequently-headache, dizziness, drowsiness; rarely-attention deficit disorder, tremor, convulsions, loss of sensitivity, sensitivity disorders, lethargy.
From the side of the visual organ: Â rarely-visual perception disorders.
Hearing disorders and labyrinth disorders: Â rarely-ringing in the ears, vertigo.
From the cardiovascular system: Â infrequently-hypotension; rarely-angina, tachycardia, rapid heartbeat; very rarely-bradycardia, hot flashes.
Respiratory system disorders: Â rarely-shortness of breath, nosebleeds, rapid breathing.
From the digestive system: Â infrequently – gastrointestinal discomfort, diarrhea, dry mouth, dyspepsia, nausea; rarely-epigastric pain, constipation, flatulence, vomiting, liver function disorders.
Skin and subcutaneous tissue disorders: Â rarely-allergic dermatitis, sweating, pruritus, urticaria, skin rash.
Musculoskeletal disorders: Â infrequently-muscle weakness, myalgia, pain in the extremities; rarely – discomfort in the extremities; very rarely-osteopenia.
From the urinary system: Â rarely-enuresis, proteinuria.
General disorders and disorders at the injection site: Â often – redness of the injection site; infrequently-asthenia (weakness), malaise, fatigue; rarely-a feeling of intoxication, a feeling of heat, irritability, thirst; very rarely-a feeling of discomfort in the chest.
Laboratory and instrumental data: Â rarely-a decrease in blood pressure, an increase in bilirubin concentration, a violation of liver function tests, a decrease in the number of platelets, an increase in the number of white blood cells; very rarely – an increase in creatinine levels.
Interaction
There are no data on drug interactions limiting the use of Calmirex®.
Although Tolperisone has an effect on the central nervous system, the drug does not cause sedation, so it can be used in combination with sedatives, sleeping pills and drugs containing ethanol.
It does not enhance the effect of ethanol on the central nervous system.
Increases the effect of NSAIDs, so when used simultaneously, it may be necessary to reduce the dose of the latter.
How to take, course of use and dosage
For adults, the drug is prescribed daily in / m at 100 mg 2 times/day or in / v at 100 mg 1 time/day.
Overdose
Symptoms: Â ataxia, tonic and clonic seizures, dyspnoea, respiratory arrest.
Treatment: Â symptomatic and supportive care is recommended. There is no specific antidote.
Special instructions
Influence on the ability to drive vehicles and mechanisms
Caution should be exercised when driving vehicles and engaging in other potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.
Form of production
The solution for intravenous and intramuscular use is clear, colorless or slightly greenish, with a specific odor.
Storage conditions
The drug should be stored out of the reach of children, protected from light at a temperature of 8°C to 15°C.
Shelf
life is 2 years.
Active ingredient
Lidocaine, Tolperisone
Conditions of release from pharmacies
Prescription
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Side effects of Calmirex solution for intramuscular and intravenous use 2.5mg/ml+100mg/ml ampoules, 10pcs.
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