Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
ONLS
АТХ:N.04.B.C.08 Piribedil
Pharmacodynamics:An antiparkinsonian remedy. The mechanism of action is associated with the stimulation of dopamine receptors mainly in the nuclei of the extrapyramidal system. Increases the blood supply of tissues and stimulates the transmission of nerve impulses, which helps improve brain metabolism.
Has a vasodilating effect due to the effect on the dopamine receptors located in the smooth muscles of peripheral vessels.
Pharmacokinetics:After oral administration piribedil quickly absorbed from the gastrointestinal tract, the maximum concentration achieved after 1 h. Binding to plasma proteins is low. Characterized by a high degree of metabolism with the formation of 2 major metabolites - hydroxylated and dehydroxylated. The concentration of pyribedil in the blood plasma is reduced biphasic - half-life from 1.7 h to 6.9 h. It is excreted mainly in the form of metabolites with urine: 68% in the kidneys, 25% in the bile.
Indications:Parkinson's disease (both in the form of monotherapy, and in combination with levodopa),chronic cognitive impairment, and neurosensory deficit (including disorders of attention and memory) with senile dementia (as an additional symptomatic treatment), intermittent claudication due to occlusive diseases of the arteries of the lower extremities (as adjuvant therapy), ischemic blood circulation eye.
VI.G20-G26.G21 Secondary Parkinsonism
VI.G20-G26.G20 Parkinson's disease
V.F00-F09.F01 Vascular dementia
V.F00-F09.F06.7 Mild cognitive impairment
VII.H53-H54.H53.4 Defects of the field of view
VII.H53-H54.H54.2 Low vision of both eyes
XVIII.R50-R69.R54 Old age
IX.I70-I79.I73.9 Peripheral vascular disease, unspecified
IX.I70-I79.I73.8 Other specified diseases of peripheral vessels
Contraindications:Acute myocardial infarction, acute vascular failure, hypotension, collapse, co-administration with a pronounced neuroleptic antipsychotic properties (except clozapine), pregnancy, breast-feeding. Hypersensitivity to pyribedil.
Carefully:When used in patients with hypertension must be simultaneous antihypertensive therapy.
Do not use simultaneously with dopamine receptor antagonists.
Pregnancy and lactation:Contraindicated in pregnancy and during lactation. Action category for the fetus by FDA - not defined. Adequate and well-controlled studies of the safety of piribedil in pregnancy have not been conducted.
Experimental studies have not established the teratogenic effect of pyribedil. The drug is used mainly in the elderly, when pregnancy is unlikely.
Dosing and Administration:Inside after eating 50 mg per day at a time, if necessary, 50 mg 2 times a day. Parkinson's disease: monotherapy - 150-250 mg per day in 3-5 sessions; in combination with levodopa - 100-150 mg in 2-3 doses.
The frequency and duration of use depend on the indications, the patient's response to treatment, the components of the combination therapy.
Side effects:From the side digestive system: rarely - nausea, vomiting, flatulence.
From the side CNS: rarely - anxiety, agitation, drowsiness.
From the side of cardio-vascular system: in some cases - orthostatic hypotension.
Mental disorders.
Overdose:Symptoms: vomiting. Treatment: gastric lavage, symptomatic therapy.
Interaction:With simultaneous use with antagonists of dopamine receptors, a possible decrease in efficacy is possible.
Special instructions:If it is necessary to use neuroleptics in patients with Parkinson's disease receiving piribedil, the dose of the latter should be reduced gradually until complete withdrawal. Sudden abolition of piribedil can cause malignant neuroleptic syndrome.
If there is a digestive disorder caused by taking piribedil, it is possible to prescribe antiemetic drugs acting on the peripheral receptors of dopamine (domperidone). Gastrointestinal side effects decrease with individual dose selection or taking the drug strictly after the main meal. Disturbance of digestion occurs more often with individual predisposition and in the case of eating in the intervals between use.
If there is a state of severe drowsiness (up to sudden falling asleep) on the background of taking piribedil, you should consider lowering the dose or canceling the drug.