Ceruglan - instructions for use, doses, side effects, contraindications

Composition:Active substance:
Metoclopramide hydrochloride (in terms of 100% anhydrous substance) - 10 mg
Excipients: potato starch, lactose, gelatin, calcium stearate.

Description:Tablets from white to white with a yellow or cream shade of color, flat-cylindrical, with a facet and a risk.

Pharmacotherapeutic group:Antiemetic means - dopamine receptors central antagonist.

ATX: & nbsp

A.03.F.A Motility stimulators GIT

A.03.F.A.01 Metoclopramide

Pharmacodynamics:The specific blocker of dopamine (D2) and serotonin (5-HTZ) receptors, depresses the chemoreceptors of the trigger zone of the brainstem, weakens the sensitivity of the visceral nerves that transmit pulses from the pyloric and duodenum to the vomiting center.Through the hypothalamus and the parasympathetic nervous system (innervation of the gastrointestinal tract) has a regulating and coordinating effect on the tone and motor activity of the upper gastrointestinal tract (including the tone of the lower sphincter of the esophagus). Increases the tone of the stomach and intestines, accelerates the emptying of the stomach, reduces the hyperacid stasis, prevents pyloric and esophageal reflux, stimulates intestinal peristalsis. Normalizes the separation of bile, reduces the spasm of the sphincter of Oddi. Without changing its tone, it eliminates dyskinesia of the gallbladder. Does not affect the tone of the blood vessels of the brain, blood pressure, respiratory function, as well as kidney and liver, on hematopoiesis, gastric and pancreatic secretion. Stimulates the secretion of prolactin. Increases the sensitivity of tissues to acetylcholine (the action does not depend on vagal innervation, but is eliminated by holinoblokatorami). Stimulating the secretion of aldosterone, enhances the retention of Na + and the excretion of K +.

Pharmacokinetics:Quickly absorbed from the gastrointestinal tract. In connection with partial destruction in the liver after absorption, bioavailability is -75%.The maximum concentrations in the blood are proportional to the dose taken, and are reached after 1-2 hours. Connection with plasma proteins - 13-30%. The half-life period is 2.5 to 6 hours, with renal dysfunction up to 14 hours. Removal of the drug occurs mainly through the kidneys for 24 hours in an unchanged form and in the form of conjugates. Passes through the placental and blood-brain barrier and penetrates into the mother's milk.

Indications:Vomiting, nausea, hiccough of various genesis (in some cases can be effective in vomiting caused by radiation therapy or the use of cytotoxic drugs). Atony and hypotension of the stomach and intestines (in particular, postoperative); biliary dyskinesia; reflux esophagitis; flatulence; in the complex therapy of exacerbations of gastric ulcer and duodenal ulcer. It is used to enhance peristalsis during radiocontrast studies of the gastrointestinal tract.

Contraindications:Hypersensitivity to the drug components, bleeding from the gastrointestinal tract, stenosis of the pylorus, mechanical intestinal obstruction, perforation of the stomach or intestine, pheochromocytoma, epilepsy,glaucoma, extrapyramidal disorders, Parkinson's disease, prolactin-dependent tumors, vomiting during treatment or overdose with antipsychotics and in breast cancer patients, pregnancy (I trimester), lactation period, early childhood (up to 2 years).
Do not appoint after operations on the digestive tract (like pyloroplasty or anastomosis of the intestine), because vigorous muscle contractions prevent healing.

Carefully:Childhood age, renal / hepatic insufficiency, bronchial asthma, arterial hypertension.

Dosing and Administration:Inside, 30 minutes before eating, squeezed a little water. Adults appoint 5-10 mg 3-4 times a day. The maximum single dose is 20 mg, the daily dose is 60 mg. Children over 6 years of age are prescribed 5 mg 1-3 times a day.

Side effects:From the nervous system: extrapyramidal disorders - spasm of facial musculature, trismus, rhythmic protrusion of the tongue, bulbar type of speech, spasm of extraocular muscles (including oculogic crisis), spastic torticollis, opisthotonus, muscular hypertonus; Parkinsonism (hyperkinesis, muscle rigidity is a manifestation of dopamine-blocking action,the risk of development in children and adolescents increases with exceeding the dose of 0.5 mg / kg / day); dyskinesia (in the elderly, with chronic renal failure); drowsiness, fatigue, anxiety, confusion, headache, tinnitus.
From the digestive system: constipation or diarrhea, rarely dry mouth.
Allergic reactions: hives.
From the endocrine system: rarely (with prolonged admission in high doses) - gynecomastia, galactorrhea, menstrual cycle.
Other: at the beginning of treatment, agranulocytosis is possible, rarely (when used in high doses) - hyperemia of the nasal mucosa.

Overdose:There may be hypersomnia, disorientation and extrapyramidal disorders. As a rule, the symptomatology disappears after stopping the drug within 24 hours. If necessary, treatment with holinoblokatorami and antiparkinsonian means.

Interaction:Strengthens the action of ethanol on the central nervous system, the sedative effect of hypnotics, increases the effectiveness of therapy H₂-gastamin blockers.
Increases the absorption of tetracycline, ampicillin, paracetamol, acetylsalicylic acid, levodopa,ethanol; slows the absorption of digoxin and cimetidine.
With simultaneous use with neuroleptics, the risk of developing extrapyramidal symptoms increases.
The action of metoclopramide may weaken the anticholinesterase drugs.

Special instructions:Children up to 6 years old metoclopramide prescribe in drops or parenterally.
It is not effective for vomiting of vestibular genesis.
Against the background of the use of metoclopramide, there are possible distortions of these laboratory parameters of liver function and determination of the concentration of aldosterone and prolactin in plasma.
Most side effects occur within 36 hours of the start of treatment and take place within 24 hours after cancellation. Treatment should be as short as possible
During the treatment with the drug, alcohol is not recommended.

Effect on the ability to drive transp. cf. and fur:When taking the drug should be avoided potentially dangerous activities that require increased concentration of attention, rapid mental and motor reaction (driving vehicles, etc.).

Form release / dosage:Pills.

Packaging:For 10 tablets in contour cell packs.
For 50 tablets in cans of light-protective glass, cans of polymeric or plastic bottles
1, 2, 3, 4, 5 cell packs, a can of light-protective glass, a can of polymer or plastic bottles along with instructions for use are placed in a pack of cardboard.

Storage conditions:List B. In a place protected from light, inaccessible to children, at a temperature of no higher than 25 ° C.

Shelf life:3 years. Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:P N001576 / 02-2003

Date of registration:29.10.2008

Expiration Date:Unlimited

The owner of the registration certificate:BRYNTSALOV-A, CJSC BRYNTSALOV-A, CJSC Russia

Manufacturer: & nbsp

BRYNTSALOV-A, CJSC Russia

Information update date: & nbsp2016-09-11

Illustrated instructions

Instructions

Cerulgan® (Ceruglan)