Included in the formulation
АТХ:N.06.A.X.17 Milnacipran
Pharmacodynamics:Non-selective inhibitor of neuronal capture of monoamines (norepinephrine and serotonin). Normalizes the emotional sphere, aligns the pathologically changed, depressed mood.
Does not have anticholinergic, adrenoblocking and antihistamine action. Has no sedative effect, nevertheless, improves sleep. When depression increases the concentration of attention and improves the thinking processes.
Pharmacokinetics:After oral ingestion, up to 85% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is reached after 2 hours. The connection with plasma proteins is 13%.
Metabolism in the liver by glucuronization.
The half-life is 8 hours. Elimination by the kidneys (90% unchanged).
Indications:It is used to treat depression of varying severity.
V.F30-F39.F31 Bipolar affective disorder
V.F30-F39.F32 Depressive episode
V.F30-F39.F33 Recurrent depressive disorder
V.F40-F48.F41.2 Mixed anxiety and depressive disorder
Contraindications:Benign prostatic hyperplasia, simultaneous administration of monoamine oxidase inhibitors such as A and B,selective inhibitors of reverse neuronal seizure of serotonin, adrenaline, noradrenaline, clonidine, digoxin, moclobemide, individual intolerance, children under 18 years of age.
Carefully:Epilepsy, hypersensitivity.
Pregnancy and lactation:Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.
Dosing and Administration:Inside to 50 mg 2 times a day, in the morning.
The highest daily dose: 250 mg.
The highest single dose: 50 mg.
Side effects:Central and peripheral nervous system: anxiety, dizziness, rarely - headache, tremor.
The cardiovascular system: palpitation, hot flashes.
Digestive system: dry mouth, constipation, nausea, vomiting.
Dermatological reactions: hyperhidrosis, rash.
Urinary system: delay urination.
Allergic reactions.
Overdose:Increased side effects, serotonin syndrome.
Treatment is symptomatic.
Interaction:When used simultaneously with nonselective inhibitors monoamine oxidase (iproniazide), selective inhibitors monoamine oxidase type B (selegiline), with sumatriptan, selective inhibitors monoamine oxidase type A (moclobemide, toloxaton), the risk of developing serotonin syndrome, arterial hypertension, coronary artery spasm increases.
Incompatible with alcohol.
With simultaneous use with adrenaline and norepinephrine, the risk of arrhythmia and arterial hypertension increases.
When used simultaneously with non-steroidal anti-inflammatory drugs and coagulants, the risk of gastrointestinal bleeding increases.
Reduces the hypotensive effect of clonidine and related compounds.
Special instructions:Milnacipran can be taken no earlier than two weeks after the withdrawal of monoamine oxidase inhibitors. Since the withdrawal of milnacipran before the initiation of therapy with monoamine oxidase inhibitors, at least one week must elapse.
In the treatment it is not recommended to drive vehicles and work with moving mechanisms.