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

Pharmacodynamics:An antiparkinsonian remedy. Has central and peripheral anticholinergic, as well as miorelaksiruyuschee effect. The mechanism of action is based on competition with acetylcholine on the postsynaptic membrane. Reduces tremor, to a lesser extent affects the rigidity and hypokinesia. Has a peripheral M-anticholinergic action: reduces salivation, less sweating and secretion of the sebaceous glands.

Pharmacokinetics:When administered orally trihexyphenidyl quickly and completely absorbed from the digestive tract. The half-life is 5-10 hours. Trihexyphenidyl has a high lipotropy, passes well through the blood-brain and placental barriers. Excreted in breast milk. Hydrolyzed in tissues under the action of nonspecific esterases. It is excreted by the kidneys: a small amount in unchanged form, and the main part - in the form of metabolites. Do not cumulate.

Indications:Parkinsonism of various etiologies; motor disorders associated with the lesion of the extrapyramidal system.

Contraindications:Hypersensitivity to any of the components of the drug, mechanical stenosis of the gastrointestinal tract, megacolon, zakratougolnaya glaucoma, urinary retention, prostatic hyperplasia (with the presence of residual urine), pulmonary edema, dementia, children's age (under 12 years), pregnancy, lactation.

Carefully:Decompensated diseases of the heart, kidney or liver, tachycardia, tachyarrhythmia, hypertension, psychosis, acute myocardial infarction, advanced age.

Dosing and Administration:

Inside, before meals or during meals.

The initial dose is -0.5-1 mg / day.The dose is increased gradually by 1-2 mg every 3-5 days. The usual maintenance dose is 6-10 mg per day, divided into 3-4 doses. In severe cases, it may be necessary to increase the dose to 12-16 mg, divided into 3-4 doses. The maximum single dose is -10 mg, daily -16 mg.

Side effects:

From the nervous system: headache, dizziness, irritability, delirium, hallucinations, increased fatigue, decreased concentration, psychosis. Effects caused by anticholinergic activity: dryness of the oral mucosa, paresis of accommodation, increased intraocular pressure, constipation, urinary retention (including prostate adenoma), tachycardia, decreased sweating.

From the digestive system: nausea, vomiting. Allergic reactions: skin rash.

Other: purulent parotitis (due to xerostomia), skin hyperemia, decreased muscle tone, it is possible to develop drug dependence.

Overdose:

Large doses of trihexyphenidyl cause blockade of postganglionic endings of the parasympathetic nervous system, the poisoning pattern corresponds to atropine poisoning (mydriasis, dryness of the oral mucosa, tachycardia, intestinal and biliary tractions, fever, etc.).Disturbances from the central nervous system are expressed by the symptoms of mental and motor excitement, coma or paralysis of the respiratory center may develop.

Treatment: there is no specific antidote. First aid: gastric lavage, activated charcoal, symptomatic treatment.

Interaction:

When combined with HI-histaminoblockers derivatives of phenothiazine, tricyclic antidepressants, the intensity of peripheral cholinoblocking effects increases, with chlorpromazine - it is possible to reduce its concentration in the plasma.

Under the influence of reserpine, the antiparkinsonian action of trihexyphenidyl decreases (depletion of dopamine reserves in the central nervous system, activation of cholinergic neurons).

Levodopa increases the antiparkinsonian activity of trihexyphenidyl. When used together with levodopa, the dosage of both drugs should be reduced. Usually in this case, enough 3-6 mg of trihexyphenidyl per day, divided into two doses.

Under the influence of MAO inhibitors, it is possible to enhance the anticholinergic effect of cholinoblockers used in parkinsonism.

With the simultaneous use of trihexyphenidyl, the effect of sublingual nitrates (due to dry mouth) is reduced.

The depressive effects of alcohol and drugs that affect the central nervous system may be exacerbated when used with trihexyphenidyl.

Special instructions: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. Treatment can not be stopped suddenly. If there is dryness in the mouth when taking the drug, it is advisable to take it before meals, tk. otherwise, nausea may occur.

At the end of treatment or in the case of initiating an alternative treatment, the dose of trihexyphenidyl should be reduced gradually.

Patients over 60 years of age are prescribed with extreme caution because of hypersensitivity to the drug, the possibility of memory impairment and thinking. When using large doses of the drug or in the treatment of patients with predisposing factors (atherosclerosis, advanced age or patients,who previously appeared idiosyncrasy for a drug) may develop mental disorders (unnatural increase in mood, agitation, increased irritability), vomiting, or nausea. In these cases, it is necessary to stop treatment. In the course of long-term treatment, the severity of side effects due to anticholinergic action decreases. Periodically monitor the intraocular pressure.

Form release / dosage:

Tablets 2 mg.

Packaging:

10 or 20 tablets in a planar cell package.

1, 2, 3 or 5 contour packagings with instructions for use in a pack of cardboard

Storage conditions:

List of potent substances. Store at a temperature not exceeding 25 ° C. Keep out of the reach of children.

Shelf life:5 years. Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:LSR-002952/08

Date of registration:21.04.2008

The owner of the registration certificate:PHARMSTANDART-FORESTRY, OJSC PHARMSTANDART-FORESTRY, OJSC Russia

Manufacturer: & nbsp

PHARMSTANDART-FORESTRY, OJSC Russia

Information update date: & nbsp25.09.2015

Illustrated instructions

Instructions

Cyclodol® (Cyclodol®)