Active substanceAmlodipine + NebivololAmlodipine + Nebivolol
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  • Nebilong AM
    pills inwards 
  • Dosage form: & nbsppills
    Composition:

    Each tablet contains:

    I layer: active substance: Amlodipine besylate in terms of amlodipine 5.0 mg; Excipients: cellulose microcrystalline 97.550 mg, calcium hydrophosphate 49,000 mg, sodium carboxymethyl starch 4,000 mg, magnesium stearate 2,000 mg;

    II layer: active substance: nebivolol hydrochloride in terms of nebivolol 5.0 mg; Excipients: cellulose microcrystalline 57,000 mg, lactose 60,190 mg, betadex 30,000 mg, croscarmellose 24,000 mg, docusate sodium 2,000 mg, povidone - 5,000 mg, silicon dioxide colloid 2,000 mg, talc 2,000 mg, magnesium stearate 2,000 mg, dye quinoline yellow - 0.250 mg.

    Description:Ploskotsilindrichesky round two-layer tablets (one layer of white color, another layer of yellow color) with a facet, on one side of risk.
    Pharmacotherapeutic group:The hypotensive agent combined (the blocker of "slow" calcium channels + beta-blocker selective)
    ATX: & nbsp

    C.07.F.B   Selective beta-1 blockers in combination with other antihypertensive drugs

    Pharmacodynamics:

    Nebilong AM is a combined remedy that includes amlodipine and nebivolol.

    Amlodipine

    The blocker of "slow" calcium channels (BCCC), a derivative of dihydropyridine. renderedt antianginal and antihypertensive action. It blocks calcium channels, reduces the transmembrane transition of calcium ions to the cell (more degree in the smooth muscle cells of the vessels than in the cardiomyocytes).

    Antianginal effect is due to the expansion of coronary and peripheral arteries and arterioles: with angina decreases the severity of myocardial ischemia; expanding peripheral arterioles, reduces the overall peripheral vascular resistance (OPSS), reduces afterload on the heart, reduces the need for myocardium in oxygen. Expanding coronary arteries and arterioles in unchanged and ischemic zones of the myocardium, increases the flow of oxygen into the myocardium (especially with vasospastic angina); prevents spasm of the coronary arteries (including caused by smoking). In patients with stable angina, a single daily dosota increases exercise tolerance, slows the development of angina pectoris and the "ischemic" depression of the segment ST reduces the incidence of angina attacks and consumption of nitroglycerin and other nitrates.

    Has a long-term dose-dependent antihypertensive affect. Antihypertensive action is due to direct vasodilating effect on smooth muscle vessels. When hypertension single dose provides a clinically significant decrease in blood pressure (BP) over 24 hours (with the patient "lying" and "standing"). Orthostatic hypotension with appointment Amlodipine is rare. Does not cause a decrease in tolerance to physical activity, fraction of the ejection of the left ventricle. Reduces the degree of myocardial hypertrophy of the left ventricle. Does not affect the contractility and conductance of the myocardium, does not cause a reflex increase in heart rate (HR), inhibits platelet aggregation, increases the rate of glomerular filtration, has a weak natriuretic effect.

    Nebivolol

    Nebivolol is a lipophilic, cardioselective beta-adrenoblocker with vasodilating properties. It has antihypertensive, anti-anginal and antiarrhythmic effects. Reduces elevated blood pressure (BP) at rest, with physical stress and stress.Competitively and selectively blocks synaptic and postsynaptic beta-1 adrenergic receptors, making them inaccessible to catecholamine, modulates the release of the endothelial vasodilating factor of nitric oxide (NO).

    Nebivolol is a racemate consisting of two enantiomers: SRRR- nebivolol (Dnebivolol) and RSSSNebivolol (LNebivolol), combining two pharmacological actions:

    - DNebivolol is a competitive and highly selective blocker beta1-receptors (affinity for beta1-adrenoceptors is 293 times higher than for beta2-adrenergic receptors).

    - L- Nebivolol has a mild vasodilating effect due to the modulation of the release of the relaxing factor from the vascular endothelium.

    Antihypertensive effect develops on the 2nd-5th day of treatment, stable effect is observed after 1 month. This effect persists with long-term treatment. Antihypertensive effect is also due to a decrease in the activity of the renin-angiotensin-aldosterone system (does not directly correlate with changes in renin activity in the blood plasma).

    The use of nebivolol improves performance - systemic and intracardiac hemodynamics. Nebivolol reduces the heart rate (heart rate) and blood pressure to mowing and at physical exertion, reduces the end diastolic pressure of the left ventricular, reduces the overall peripheral vascular resistance, bettert the diastolic function of the heart (reduces the filling pressure), increases the fraction ejection. Reducing the need for myocardium in oxygen (decreasing heart rate, reducing preload and afterload), reduces the number and tensiontangina attacks and improves the tolerance of exercise.

    Pharmacokinetics:

    Amlodipine

    After oral administration amlodipine slowly absorbed from the gastrointestinal tract (GIT). The average absolute bioavailability is 64%, the maximum concentration (Cmax) in the blood serum is observed after 6-9 hours. The equilibrium concentrations (Css) are achieved after 7-8 days of therapy.

    Food intake does not affect the absorption of amlodipine. The average volume of distribution is 21 l / kg body weight, indicating that most of the drug is in the tissues, and the smaller - in the blood. 95% contact with blood plasma proteins. Amlodipine is subjected to a slow but active metabolism in the liver in the absence of a significant "primary transmission" effect. Metabolites do not have significant pharmacological activity.

    After a single administration, the elimination half-life (T1 / 2 varies ot 35 to 50 hours, with the repeated appointment of T1 / 2 is approximately 45 hours. About 60% ot The dose taken internally is excreted by the kidneys mainly in the form of metabolites, 10% unchanged, and 20-25% - through the intestine with bile. The total clearance of amlodipine is 0.116 ml / s / kg (7 ml / min / kg, 0.42 l / h / kg).

    In elderly patients (over 65 beds) Removal of amlodipine is delayed (T1 / 2 is 65 hours) compared with young patients, but this difference is not clinically relevant. Elongation of T1 / 2 in patients with hepatic insufficiency assumes that with prolonged administration, the cumulation of the drug in the body will be higher (T1 / 2 - up to 60 hours).

    Renal failure does not significantly affect the kinetics of amlodipine. In patients with impaired renal function, changes in amlodipine concentration in the blood plasma do not correlate with the degree of renal failure. Perhaps a slight increase in T1 / 2.

    Amlodipine penetrates the blood-brain barrier. When hemodialysis is not removed.

    Nebivolol

    After oral administration nebivolol quickly absorbed from the digestive tract. Eating does not affect suction, so nebivolol can be taken independently ot reception of poverty.Bioavailability averages 12% in patients with a "fast" metabolism and is almost complete in patients with a "slow" metabolism. The effectiveness of nebivolol does not depend on the metabolic rate.

    Clearance in the blood plasma in most patients (with a "fast" metabolism) is achieved within 24 hours, and for hydroxy metabolites - in a few days. Concentrations in blood plasma of 1-30 mcg / l are proportional to the dose.

    Connection with blood plasma proteins (mainly with albumin) for DNebivolol is 98.1%, and for L97.9% of nebivolol.

    Nebivolol is actively metabolized, partly with the formation of active hydroxymetabolites. Metabolized by acyclic and aromatic hydroxylation, partial N-dealkylation. The rate of metabolism of nebivolol by aromatic hydroxylation is genetically determined by oxidative polymorphism and depends on isoenzyme CYP2D6.

    After the administration of 38% (the amount of unchanged active substance is less than 0.5%), the dose is excreted by the kidneys and 48% by the intestine.

    In patients with "fast" metabolism, the T1 / 2 values ​​of the enantiomers of nebivolol from plasma are on average 10 hours.In patients with a "slow" metabolism, these values ​​increase 3-5 times.

    In patients with "fast" metabolism, the T1 / 2 values ​​of the hydroxy metabolites of both enantiomers from plasma are on average 24 hours, in patients with "slow" metabolism these values ​​are approximately 2-fold.

    The pharmacokinetics of nebivolol is not affected by age and sex of patients.

    Indications:

    Arterial hypertension (patients who are shown combined therapy).

    Contraindications:

    - increased sensitivity to nebivolol and other beta-blockers, amlodipine and other dihydropyridine derivatives, as well as to other components of the drug;

    - severe violations of liver function;

    - acute heart failure;

    - cardiogenic shock;

    - chronic heart failure (CHF) in the stage of decompensation (requiring inotropic therapy);

    - syndrome of weakness of the sinus node, including sinoatrial block;

    - atrioventricular block II and III degree (without artificial pacemaker):

    - severe forms of bronchial asthma and chronic obstructive pulmonary disease (COPD);

    - pheochromocytoma (without simultaneous use of alpha-blockers):

    - depression;

    - metabolic acidosis;

    - bradycardia (heart rate less than 60 beats per minute);

    - severe arterial hypotension (systolic blood pressure less than 90 mm Hg)

    - severe violations of peripheral circulation ("intermittent" lameness, Raynaud's syndrome);

    - age under 18 years (effectiveness and safety not established);

    - lactose intolerance, lactase deficiency or glucose-galactose malabsorption (the preparation contains lactose);

    - simultaneous administration with floktaphenin, sultopride (see Interactions with other drugs);

    - acute myocardial infarction (within the first 28 days);

    - unstable angina (with the exception of Prinzmetal's stenocardia);

    - obstruction of the outflow tract of the left ventricle;

    - clinically significant aortic stenosis;

    Carefully:

    renal failure, violations of the liver, diabetes, hyperthyroidism. episodes of bronchospasm in the anamnesis, allergic diseases in the anamnesis (possibly an increase in sensationthe to allergens, weighting allergiesand a decrease in the therapeutic response to adrenaline), psoriasis, atrioventricular blockade I degree, Prinzmetal angina, COPD, in elderly patients (older 65 years old), peripheral atherosclerosis, pheochromocytoma (against alpha-adrenoblocker therapy), arterial hypotension, aortic stenosis, mitral stenosis, CHF of non-ischemic etiology III-IV functional class by classification NYHA, acute myocardial infarction (after the first 28 days).

    Pregnancy and lactation:

    Amlodipine

    In experimental studies fetotoxic and embryotoxic effects of the drug have not been established, but use in pregnancy is possible only if the benefit to the mother exceeds the potential risk to the fetus.

    There is no evidence that amlodipine is excreted in breast milk. However, it is known that other BCCC - dihydropyridine derivatives are excreted in breast milk. In this connection, if it is necessary to prescribe the drug during lactation, the question of stopping breastfeeding should be solved.

    Nebivolol

    In pregnancy, the drug is prescribed only on strict indications, when the benefit to the mother exceeds the risk for the fetus (due to the possible development of a newborn bradycardia, arterial hypotension, hypoglycemia and respiratory paralysis).Treatment should be interrupted for 48-72 hours before delivery. AT those cases where this is not possible, it is necessary to ensure strict observation of the newborn within 48-72 hours after delivery.

    There is no data on the isolation of nebivolol in breast milk. Therefore, preparation is not recommended for women during lactation. If the application preparation Nebivolol during lactation is necessary, then breastfeeding should be discontinued.

    Dosing and Administration:

    Inside, 1 time per day, without chewing and drinking with a sufficient amount of liquid. At the beginning of therapy should take 1 tablet in essence.

    If the therapeutic effect is not enough, after 2 weeks the dose can be increased to 2 tablets.

    The maximum daily dose is 2 tablets per day.

    Side effects:

    The frequency of adverse reactions listed below was determined according to the following (classification of the World Health Organization): very often - not less than 10%; often - not less than 1%, but less than 10%; infrequently - not less than 0.1%, but less than 1%: rarely not less than 0.01%, but less than 0.1%; very rarely - less than 0.01%., including individual messages.

    Amlodipine

    From the central nervous system: often - headache (especially at the beginning of treatment), dizziness, fatigue, drowsiness; infrequently - general malaise, hypoesthesia, paresthesia, peripheral neuropathy, tremor, insomnia. labiletmoods, unusual dreams, increased excitability, depression, anxiety; very rarely - migraine, apathy, agitation, ataxia, amnesia, luck, increased sweating.

    From the digestive system: often - nausea, pain in the abdomen; infrequently vomiting, constipation or diarrhea, flatulence, dyspepsia, anorexia, dryness of the oral mucosa, thirst; rarely - gingival hyperplasia, increased appetite; very rarely - pancreatitis, gastritis, jaundice (caused by cholestasis), hyperbilirubinemia, increased activity of "liver" transaminases, hepatitis.

    From the cardiovascular system: often - a feeling of palpitations, "tides" of blood to the skin of the face; infrequent reduction of blood pressure; very rarely - fainting, shortness of breath, vasculitis, orthostatic hypotension, development or exacerbation of the course XCH, cardiac arrhythmias (including bradycardia, ventricular tachycardia and atrial fibrillation), heart attack, chest pain, pulmonary edema, swelling of the lower extremities.

    From the hematopoietic and lymphatic systems: rarely - thrombocytopenic purpura, leukopenia, thrombocytopenia.

    From the urinary system: infrequently - frequent urination, painful urination, nocturia; very rarely - dysuria, polyuria.

    On the part of the reproductive system and mammary glands: infrequently gynecomastia, impotence.

    From the respiratory system: infrequently - shortness of breath, rhinitis; very rarely - cough.

    From the musculoskeletal system: infrequently muscle cramps, myalgia, arthralgia, back pain, arthrosis; rarely - myasthenia gravis.

    From the skin: rarely - dermatitis; very, rarely - alopecia, xeroderma, - cold sweat, a violation of skin pigmentation.

    Allergic reactions: very rarely - skin itching, rash (including erythematous, maculopapular rash, urticaria), angioedema, erythema multiforme.

    From the sense organs: infrequent - ringing in the ears, diplopia, disruption of accommodation, xerophthalmia, conjunctivitis, pain in the eyes; very rarely parasymia.

    From the side of metabolism: very rarely - hyperglycemia.

    Other: infrequently - weight loss, weight gain, nosebleeds.

    Nebivolol

    From the nervous system: often: headache, dizziness, fatigue, weakness, paresthesia; infrequently: depression, bright dreams, confusion, insomnia; rarely: syncope, hallucinations, amnesia.

    From the gastrointestinal tract: often: nausea, constipation / diarrhea; infrequently - flatulence, indigestion, vomiting.

    From the cardiovascular system: infrequently: bradycardia, cardiac atrioventricular blockade, orthostatic hypotension, peripheral circulation disorders (cold sensation in the extremities, cyanosis), shortness of breath, heart rhythm disturbances, Raynaud's syndrome, peripheral edema, cardialgia, worsening of the course of chronic heart failure, marked decrease in blood pressure.

    From the skin: infrequently: skin rash of erythematous nature, itchy skin, hyperemia of the skin; rarely: aggravation of psoriasis, alopecia:

    In some cases: angioedema.

    From the respiratory system: infrequently: bronchospasm (including in the absence of obstructive pulmonary disease in the anamnesis), bronchospasm in patients with bronchial asthma or airway obstruction in an anamnesis.

    Other: photodermatosis, hyperhidrosis, visual impairment (dry eyes), sexual dysfunction.

    Overdose:

    Amlodipine

    Symptoms: marked decrease in blood pressure with possible development of reflex tachycardia and excessive peripheral vasodilation (risk of development of severe and persistent arterial hypotension, including with the development of shock and legal outcome).

    Treatment: gastric lavage, the appointment of activated charcoal (especially in the first 2 hours after an overdose), maintaining the function of the cardiovascular system, elevating the position of the lower limbs, monitoring the heart and lung function, monitoring the volume of circulating blood (BCC) and diuresis. To restore the vascular tone - the use of vasoconstrictor (in the absence contraindications to their use); to eliminate the effects of calcium channel blockade - intravenous calcium gluconate. Hemodialysis is not effective.

    Nebivolol

    Symptoms: marked decrease in blood pressure, bradycardia, severe disorders intracardiac conduction, shock, asystole, respiratory arrest, bronchospasm, loss of consciousness, convulsions, coma, nausea, vomiting, cyanosis, hypoglycemia, hyperkalemia.

    Treatment: gastric lavage, reception of activated carbon.In the case of a marked decrease in blood pressure, it is necessary to give the patient a horizontal position with raised legs, if necessary, with / in the administration of liquid and vasopressors.

    With bradycardia, I / O is injected with 0.5-2 mg of atropine, in the absence of a positive effect, a transvenous or intracardiac artificial pacemaker can be staged. When AV blockade (II-III The introduction of beta-adrenomimetics is recommended intravenously, if they are ineffective, consider the question of staging an artificial pacemaker. With heart failure treatment begins with the introduction of cardiac glycosides and diuretics, in the absence of effect, it is advisable to administer dopamine, dobutamine or vasodilators. When bronhospazme enter intravenously beta2-adrenomimetiki. With convulsions - intravenous diazepam. With ventricular extrasystole - lidocaine (antiarrhythmic drugs can not be administered IA class).

    Interaction:

    Amlodipine

    Amlodipine can safely be used for the therapy of arterial hypertension along with thiazide diuretics, alpha-adrenoblockers or angiotensin-converting enzyme (ACE) inhibitors.

    Unlike other BCCC, clinically significant interaction of amlodipine was not detected when combined with non-steroidal anti-inflammatory drugs (NSAIDs), including indomethacin.

    It is possible to strengthen the anti-anginal and antihypertensive action of BCCC when combined with thiazide and loop diuretics, ACE inhibitors and nitrates, as well as enhance their antihypertensive action in a joint application with alpha1-adrenoblokagorami, neuroleptics.

    Erythromycin in a joint application increases CmOh Amlodipine in young patients by 22%, and in the elderly by 50%.

    Beta-adrenoblockers with simultaneous administration with amlodipine may be caused by exacerbation of chronic heart failure.

    Although in the study of amlodipine negative inotropic action, usually ns observed, however, some BCCI can enhance the severity of the negative inotropic effect of antiarrhythmic agents that cause lengthening of the interval QT (eg, amiodarone and quinidine).

    A single dose of 100 mg of sildenafil in patients with arterial hypertension does not affect the pharmacokinetics of amlodipine.

    The repeated use of amlodipine in a dose of 10 mg and atorvastatin at a dose of 80 mg is not accompanied by significant changes in the pharmacokinetics of atorvastatin.

    Ethanol (drinks containing alcohol): amlodipine with a single and repeated application in a dose of 10 mg ns affects the pharmacokinetics of ethanol.

    Antiretroviral agents (ritonavir) increases plasma concentrations of BCCC, including amlodipine.

    Neuroleptics and isoflurane - increased antihypertensive action of dihydropyridine derivatives.

    Calcium preparations can reduce the effect of BCCC.

    When amlodipine is used together with lithium preparations, it is possible to intensify manifestations of neurotoxicity (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus). Amlodipine does not change the pharmacokinetics of cyclosporine.

    Hc influences serum concentration of digoxin and its renal clearance.

    There is no significant effect on the effect of warfarin (prothrombin time). Cimetidine does not affect the pharmacokinetics of amlodipine.

    In studies in vitro Amlodipine does not affect the binding to plasma proteins of the digoxine, phenytoin, warfarin and indomethacin.

    Grapefruit juice: simultaneous single intake of 240 mg of grapefruit juice and 10 mg of amlodipine inwards is not accompanied by a significant change in the pharmacokinetics of amlodipine.

    Aluminum - or magnesium-containing antacids: their single dose does not have a significant effect on the pharmacokinetics of amlodipine.

    Nebivolol

    Floktaphenin: in the case of shock or arterial hypotension caused by floktaphenin, beta-adrenoblockers weaken the compensatory mechanisms of the cardiovascular system.

    Sultopride: increased risk of ventricular arrhythmia, especially as pirouette.

    With the simultaneous use of beta-blockers with BCCC (verapamil and diltiazem) increases the negative effect on myocardial contractility and AV conductivity. Contraindicated in / in the administration of verapamil on the background of nebivolol. With simultaneous use with antihypertensive drugs, nitroglycerin or BCCC, severe arterial hypotension may develop (special caution is necessary when combined with prazosin).

    With simultaneous use with antiarrhythmic drugs, we increase the risk of cardiodepressive action and bradycardia when combined withany antiarrhythmic drug. Amiodarone also increases the risk of atrioventricular blockade. The risk of ventricular arrhythmia caused by sotalol is increased by amiodarone, dropidarone, procainamide and quinidine (avoid joint use).

    With the simultaneous use of nebivolol with cardiac glycosides, nc revealed an increase in the effect on the slowing down AV conductivity.

    Simultaneous use of nebivolol and preparations for general anesthesia can cause suppression of reflex tachycardia and increase the risk of developing arterial hypotension.

    Clinically significant interaction of nebivolol and NSAIDs is not established. Acetylsalicylic acid as an antiplatelet agent can be used concomitantly with nebivolol.

    Glucocorticosteroids and estrogens, gestagens weaken the antihypertensive effect of beta adrenoblockers.

    The simultaneous use of tricyclic antidepressants, barbiturates and derivatives of phenothiazine, ethanol, anxiolytics, hypnotics can enhance the antihypertensive effect of nebivolol.

    Allergens used for immunotherapy,or allergen extracts for skin tests increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving nebivolol.

    Iodine-containing radiopaque agents for intravenous administration increase the risk of anaphylactic reactions.

    Pharmacokinetic interaction

    When used simultaneously with drugs that inhibit serotonin reuptake, or other means, biotransforming with the participation of isoenzyme CYP2D6, the metabolism of nebivolol slows down, which can lead to a risk of bradycardia.

    With simultaneous application nebivolol ns had effects on the pharmacokinetic parameters of digoxin.

    With simultaneous application with cimetidine, the concentration of nebivolol in the blood plasma increases (data on the effect on the pharmacological effects of the drug are absent). The simultaneous use of ranitidine had no effect on the pharmacokinetic parameters of nebivolol.

    With simultaneous use of nebivolol with picardipine concentrations of active substances in the blood plasma increased slightly, but this has no clinical significance.

    Simultaneous administration of ethanol, furosemide or hydrochlorothiazide did not affect the pharmacokinetics of nebivolol.

    Clinically significant interactions of nebivolol and warfarin have not been established.

    With simultaneous application of sympathomimetic agents suppress activity nebivolol.

    When combined with nebivolol with insulin and hypoglycemic agents for oral administration, symptoms of hypoglycemia (tachycardia, tremor) can be masked.

    Special instructions:

    During the period of Nebelong therapy AM it is necessary to control body weight and consumption of table salt, the purpose of the appropriate diet is indicated (the composition of the drug is included amlodipine).

    It is necessary to maintain oral hygiene and follow-up at the dentist (for prevention of soreness, bleeding and gingival hyperplasia).

    Control of blood pressure and heart rate at the beginning of the drug should be daily.

    Older patients need control of kidney function (1 time in 4-5 months). Patients using contact lenses should take into account that the use of beta-blockers may reduce the production of tear fluid. Nebivolol does not affect the concentration of glucose in blood plasma in patients with diabetes mellitus. Nevertheless, care should be taken when treating these patients, since nebivolol can mask certain symptoms of hypoglycemia (eg, tachycardia) caused by the use of hypoglycemic agents.

    Controlling the concentration of glucose in the blood plasma should be done 1 time in 4-5 months (in patients with diabetes mellitus).

    Beta-adrenoblockers should be used with caution in patients with COPD, as bronchospasm may worsen.

    With hyperfunction of the thyroid gland, the drug levels tachycardia.

    The effectiveness of beta-blockers in smokers is lower than in non-smoking patients.

    Ha the background of therapy with beta-blockers may exacerbate the course of psoriasis. Patients with this disease Niebelong AM should be administered with caution.

    In patients with impaired peripheral circulation, caution should be exercised when prescribing Nebilong AM.

    Patients with pheochromocytoma should not be prescribed Nebelong AM until treatment with alpha-blockers is prescribed. In this case, it is necessary to monitor blood pressure.It is recommended to stop Nebilong therapy AM with the development of depression caused by the use of beta-adrenoblocker (due to the content of nebivolol in it).

    Particular attention is required in cases of surgical intervention under general anesthesia in patients taking beta-blockers. To such patients, please abolish Niebelong AM 48 hours before the surgery, warn the anesthesia doctor that the patient is taking the drug Niebelong AM. As a means for general anesthesia, a drug with a minimal fromritsathoseinotropic action.

    In case of anamnesis on anaphylactic reactions, regardless of the cause of their occurrence, especially when conducting desensitizing therapy, treatment with Nebilong AM (due to the content of nebivolol in it) may increase the risk of allergic reactions and promote the development of resistance to epinephrine (adrenaline) treatment in usual doses.

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

    During therapy, care must be taken when driving vehicles and engaging in other potentially hazardous activities,requiring increased concentration of attention and speed of psychomotor reactions.

    Form release / dosage:Tablets of 5.0 mg + 5.0 mg.
    Packaging:10 tablets per blister of Aluminum / Aluminum. By 1, 3, 5 or 10 blisters together with the instruction but application in a cardboard box.
    Storage conditions:

    In the dark place at a temperature of no higher than 25 ° C.

    Keep out of the reach of children.

    Shelf life:

    3 years.

    Do not use after the expiry date printed on the package.

    Terms of leave from pharmacies:On prescription
    Registration number:LP-001084
    Date of registration:02.11.2011
    The owner of the registration certificate:Micro Labs LimitedMicro Labs Limited India
    Manufacturer: & nbsp
    Representation: & nbspMICRO LABS LIMITED MICRO LABS LIMITED India
    Information update date: & nbsp29.12.2012
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