Ketotifen - instructions for use, dose, side effects, contraindications

Excipients: lactose monohydrate - 62.46 mg, microcrystalline cellulose - 15.27 mg, giprolose - 9.72 mg, magnesium stearate - 1.00 mg, hypromellose - 0.21 mg.

Description:Round, flat-cylindrical tablets of white or almost white color, with a facet and a risk on one side.

Pharmacotherapeutic group:Antiallergic agent - stabilizer of membranes of mast cells

ATX: & nbsp

S.01.G.X.08 Ketotifen

R.06.A.X.17 Ketotifen

Pharmacodynamics:

Ketotifen belongs to the group of cycloheptathiophenones and has a pronounced antihistamine effect. Does not apply to bronchodilator antiasthmatics.

The mechanism of action is associated with inhibition of the release of histamine and other mediators from mast cells, the blocking of histamine H₁receptors and inhibition of the enzyme phosphodiesterase, resulting in an increased level of cAMP (cyclic adenosine monophosphate) in mast cells. Suppress effects PAF (thrombocyte-activating factor).

It does not stop asthmatic attacks, but prevents their appearance and leads to a decrease in their duration and intensity, and in some cases they completely disappear. It facilitates sputum production.

Pharmacokinetics:

Almost completely absorbed from the gastrointestinal tract, bioavailability is about 50% due to the effect of "first passage" through the liver. The time to reach the maximum concentration (TFROM_mOh) 2-4 hours Binding to plasma proteins is about 75%. Passes through the blood-brain barrier, penetrates into breast milk. The volume of distribution is 2.7 l / kg.

About 60% of the dose is metabolized in the liver in three ways: demethylation, N-oxidation, N-glucurconjugation, to the following metabolites: ketotifen-N-glucuronide (pharmacologically inactive), nor-ketotifen (with pharmacological activity similar to ketotifen), N-Ketotifen oxide and 10-hydroxy-ketotifen (with unknown pharmacological activity).

It is excreted by the kidneys - about 70% in the form of inactive metabolites, 0.8% - in unchanged form. The elimination is biphasic: the half-life of the first phase is 3-5 hours, the second - about 21 hours.

Metabolism in children does not differ from that in adults, except for a faster clearance, so children over 3 years of age need a daily dose for adults.

Indications:

Atopic bronchial asthma (as part of complex therapy), allergic rhinitis, conjunctivitis.

Contraindications:

- Hypersensitivity to the active substance or any of the excipients of the drug;

- I trimester of pregnancy, the period of breastfeeding;

- Children under 3 years old (for this dosage form).

- deficiency of lactase, galactose intolerance, glucose-galactose malabsorption.

Carefully:II and III trimesters of pregnancy, epilepsy, episodes of seizures in the anamnesis, hepatic insufficiency.

Pregnancy and lactation:

In the first trimester of pregnancy, the use of the drug is contraindicated. In the II and III trimesters of pregnancy ketotifen Use with caution and only if the intended benefit to the mother exceeds the potential risk to the fetus.

If it is necessary to use ketotifen during lactation, breastfeeding should be stopped.

Dosing and Administration:

Inside, with food, washing with water.

Adults: 1 tablet (1 mg) 2 times a day, morning and evening. For patients who have a significant sedative effect, a slow increase in dose is recommended during the first week, starting from 0.5 mg in the evening before bedtime, until the therapeutic dose is gradually reached. If necessary, the daily dose can be increased to 4 mg - 2 tablets 2 times a day. At a higher dose, a more rapid onset of therapeutic effect can be expected.

Children over 3 years: 1 tablet (1 mg) 2 times a day, morning and evening, while eating.

Use in elderly patients

For elderly patients, dose adjustment is not required.

Duration of treatment

The treatment is long, the therapeutic effect is achieved after several weeks of therapy. Treatment should be performed for at least 2-3 months, especially in patients who have not had an effect in the first weeks. Discontinue treatment with ketotifen gradually, within 2-4 weeks, to avoid the risk of exacerbation of bronchial asthma.

Side effects:

The following side effects are classified by organs and systems and by frequency.

Side effects are classified by frequency as follows: very often (≥ 1/10), often (≥ 1/100 and <1/10), infrequently (≥ 1/1000 and <1/100), rarely (≥ 1/10000 and <1/1000), very rarely (<1/10000), with an unknown frequency (based on existing data, it is impossible to make an estimate).

Infections: infrequently - Cystitis.

Immune system disorders: rarely - severe skin reactions, multiform erythema exudative, Stevens-Johnson syndrome.

Disorders from the metabolism and nutrition: rarely - increase in body weight.

Mental disorders: often - agitation, irritabilityOnnica, anxiety.

Disturbances from the nervous system: infrequently - dizziness, headache; rarely - sedation (relaxation, slowing down the reaction); very rarely - cramps.

Disorders from the gastrointestinal tract: infrequent - dry mouth, nausea, vomiting, diarrhea.

Hepatobiliary disorders: very rarely - increased activity of hepatic enzymes, hepatitis.

At the beginning of treatment, dry mouth and dizziness may appear, but they usually go away spontaneously during treatment. In rare cases, there are symptoms of central nervous system stimulation, such as irritation, irritability, insomnia and anxiety, especially in children, nervousness, fatigue, drowsiness.

Overdose:

Symptoms: drowsiness, confusion, nystagmus, dizziness, disorientation, brady- or tachycardia, arterial hypotension, nausea, vomiting, dyspnea, cyanosis, increased excitability, coma, children may have seizures.

Treatment: gastric lavage (if a little time has passed since the time of admission), symptomatic treatment, with the development of convulsive syndrome - barbiturates or benzodiazepines.If necessary, symptomatic treatment and monitoring of cardiac activity is recommended. Dialysis is ineffective.

Interaction:

With the simultaneous use of ketotifen and oral antidiabetics, there is a risk of developing reversible thrombocytopenia. Such patients are advised to monitor the number of platelets.

Ketotifen may enhance the effects of other drugs that suppress the central nervous system (sedatives, hypnotics).

The simultaneous use of ketotifen with other antihistamines may lead to a mutual enhancement of their effects.

During treatment with ketotifen, alcohol should be avoided, since it increases the inhibitory effect of ketotifen on the central nervous system.

Special instructions:

It is undesirable to abruptly cancel previous treatment with anti-asthmatic drugs, especially systemic glucocorticosteroids after adherence to ketotifen therapy, and cancel for at least 2 weeks, gradually lowering the dose.

In patients with steroid dependence, adrenal insufficiency may develop.

It is not prescribed for relief of an attack of bronchial asthma.

Ketotifen lowers the threshold of convulsive activity, so it must be administered with extreme caution to patients with episodes of seizures in the anamnesis.

Persons sensitive to sedation, in the first two weeks, the drug is prescribed in small doses.

Patients who simultaneously take oral hypoglycemic drugs should monitor the number of peripheral blood platelets.

Effect on the ability to drive transp. cf. and fur:

During the treatment period it is necessary to refrain from driving motor vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

Form release / dosage:

Tablets, 1 mg.

Packaging:

For 30 tablets in a jar of high density polyethylene with a screw cap made of the same material, with the control of the first autopsy.

One bank along with instructions for use are put in a cardboard box.

Storage conditions:

Store at a temperature not exceeding 25 ° C.

Keep out of the reach of children.

Shelf life:

3 years.

Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:LP-003485

Date of registration:02.03.2016

Expiration Date:02.03.2021

The owner of the registration certificate:ALVILS, LTD. ALVILS, LTD. Russia

Manufacturer: & nbsp

Shanghai Hengshan Pharmaceutical Co. Ltd China

Representation: & nbspAlvils, OOOAlvils, OOO

Information update date: & nbsp07.01.2018

Illustrated instructions

Instructions

Ketotifen (Ketotifen)