Neuromidine, ampoules 5mg/ml 1ml, 10pcs

Composition

1 ml of the solution contains:

Active ingredient:

ipidacrine hydrochloride monohydrate 5 mg (based on ipidacrine hydrochloride)

excipients:

concentrated hydrochloric acid-up to pH 3;

water for injection – up to 1 ml

Pharmacological action

Neuromidin® has a direct stimulating effect on the conduction of impulses through nerve fibers, interneuronal and neuromuscular synapses of the central nervous system and peripheral nervous system. The pharmacological action of Neuromidin® is based on a combination of two mechanisms of action: blockade of potassium channels in the membrane of neurons and muscle cells; reversible inhibition of cholinesterase in synapses.

Neuromidin® enhances the smooth muscle effects of not only acetylcholine, but also epinephrine, serotonin, histamine, and oxytocin.

Neuromidin® has the following pharmacological effects:

– improves and stimulates the conduction of impulses in the nervous system and neuromuscular transmission;

– increases the contractility of smooth muscle organs under the influence of agonists of acetylcholine, adrenaline, serotonin, histamine and oxytocin receptors, with the exception of potassium chloride;

– improves memory, inhibits the progressive course of dementia.

In preclinical studies, Neuromidin® did not have teratogenic, embryotoxic, mutagenic, carcinogenic and immunotoxic effects, and did not affect the endocrine system.

Pharmacokinetics

After oral use, intramuscular and subcutaneous use, it is rapidly absorbed. Cmax in blood plasma is reached 1 h after oral use and 25-30 minutes after intravenous or subcutaneous use. Binding to plasma proteins is 40-50% of the Active ingredient. It quickly enters the tissues, with a half-life of 40 minutes. It is metabolized in the liver. It is excreted through the kidneys (mainly by tubular secretion and only 1/3 – by glomerular filtration) and extrarenally (through the gastrointestinal tract). T_1/2 Neuromidine® with parenteral use is 2-3 h. After parenteral use,34.8% of the drug dose is excreted unchanged in the urine.

Indications

• diseases of the peripheral nervous system (mono-and polyneuropathy, polyradiculopathy, myasthenia gravis and myasthenic syndrome of various etiologies);
• diseases of the central nervous system (bulbar paralysis and paresis; recovery period of organic CNS lesions accompanied by motor and / or cognitive disorders)

Contraindications

• hypersensitivity to any component of the drug;
• epilepsy;
• extrapyramidal hyperkinesis disease;
• angina;
• bradycardia;
• bronchial asthma;
• mechanical obstruction of the intestine or urinary tract;
• vestibular disorders;
• stomach ulcer or duodenal ulcer in the acute stage;
• pregnancy (the drug increases the tone of the uterus);
• lactation;
• children up to age 18 years (there are no systematic data on the application).

With caution: in patients with peptic ulcer of the stomach and duodenum, thyrotoxicosis, diseases of the cardiovascular system, as well as in patients with a history of obstructive respiratory diseases or acute respiratory diseases.

Side effects

Caused by the excitation of m-cholinergic receptors: salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased bronchial secretions, bronchospasm, convulsions. Salivation and bradycardia can be reduced with m-holinoblockers (atropine, etc. ). Increased uterine tone, allergic skin reactions.

Rarely (after higher doses) dizziness, headache, pain behind the sternum, vomiting, general weakness, drowsiness, skin reactions (pruritus, rash) were observed. In these cases, reduce the dose or stop taking the drug for a short time (for 1-2 days). These side effects are observed in less than 10% of patients.

Interaction

Neuromidine ® enhances the sedative effect in combination with agents that depress the central nervous system.

The effect and side effects are enhanced when combined with other cholinesterase inhibitors and m-cholinomimetic agents. In patients with myasthenia gravis, the risk of developing a cholinergic crisis increases if Neuromidin® is used simultaneously with other cholinergic agents.

The risk of developing bradycardia increases if beta-blockers were used before starting treatment with Neuromidin®.

Neuromidin® can be used in combination with nootropic drugs.

Alcohol increases the side effects of the drug.

Weakens the inhibitory effect on the neuromuscular transmission and conduction of excitation along the peripheral nerves of local anesthetics, aminoglycosides, and potassium chloride.

How to take, course of use and dosage

of Diseases of the peripheral nervous system:

– mono – and polyneuropathy of various origins — p/or/m 5-15 mg 1-2 times a day, the course — 10-15 days (in severe cases up to 30 days); then the treatment continues tablet form of the drug;

– myasthenia gravis and myasthenic syndrome — p/or/m 15-30 mg 1-3 times a day with the further transition to the tablet form. The general course of treatment is 1-2 months. If necessary, the treatment can be repeated several times with a break between courses of 1-2 months.

Diseases of the central nervous system:

– bulbar paralysis and paresis — p/or/m 5-15 mg 1-2 times a day for 10-15 days; if possible, move on to the tablet form;

– rehabilitation with organic lesions of the Central nervous system — /m 10-15 mg 1-2 times a day, the course — up to 15 days, then, if possible, go in tablet form.

If the next dose was not taken on time, then it is not taken additionally.

The maximum daily dose is 200 mg.

Overdose

Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, pupil constriction, nystagmus, increased gastrointestinal motility, spontaneous defecation and urination, vomiting, jaundice, bradycardia, intracardiac conduction disorders, arrhythmias, decreased blood pressure, anxiety, anxiety, agitation, fear, ataxia, convulsions, coma, speech disorders, drowsiness, general weakness. Treatment: in case of overdose of tablets — gastric lavage. use of m-cholinolytics, including atropine, cyclodol, metacin, etc. ; symptomatic therapy.

Special instructions

There are no systematic data on the use of Neuromidin® in children.

Alcohol should be excluded for the duration of treatment (increases the side effects of the drug).

Influence on the ability to drive a car or perform work that requires an increased rate of physical and mental reactions. During treatment, you should refrain from driving a car, as well as engaging in potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.

Form of production

Solution for intramuscular and subcutaneous use

Storage conditions

The drug should be stored in a dry place protected from light at a temperature not exceeding 25°C.

Shelf

life is 5 years.

Active ingredient

Ipidacrine

Conditions of release from pharmacies

By prescription

Dosage form

solution for injection

Description

For adults as directed by your doctor

Indications

Polyneuropathy, Neuritis