Nosological classification (ICD-10)
- F09 Organic or symptomatic mental disorder, unspecified
- G12.2 Motor neuron disease
- G37.9 Demyelinating disease of the central nervous system, unspecified
- G58 Other mononeuropathies
- G61 Inflammatory polyneuropathy
- G62 Other polyneuropathies
- G62.9 Polyneuropathy, unspecified
- G70 Myasthenia gravis and other neuromuscular junction disorders
- G92 Toxic encephalopathy
- G96.8 Other specified disorders of the central nervous system
- G96.9 Damage to the central nervous system, unspecified
- K59.8.0* Intestinal atony
- M79.2 Neuralgia and neuritis, unspecified
Compound
Pills | 1 table |
active substance: | |
ipidacrine hydrochloride monohydrate | 20 mg |
(in terms of ipidacrine hydrochloride) | |
excipients: lactose monohydrate - 65 mg; potato starch - 14 mg; calcium stearate - 1 mg |
Solution for intramuscular and subcutaneous administration | 1 ml |
active substance: | |
ipidacrine hydrochloride monohydrate | 5 mg |
15 mg | |
(in terms of ipidacrine hydrochloride) | |
excipients: concentrated hydrochloric acid - up to pH 3; water for injection - up to 1 ml |
Pharmacodynamics
Neuromidin® has a direct stimulating effect on the conduction of impulses along nerve fibers, interneuronal and neuromuscular synapses of the central nervous system and the peripheral nervous system. The pharmacological action of Neuromidin® is based on a combination of two mechanisms of action: blockade of potassium channels in the membrane of neurons and muscle cells; reversible inhibition of cholinesterase at synapses.
Neuromidin® enhances the effect on smooth muscles of not only acetylcholine, but also adrenaline, serotonin, histamine and oxytocin.
Neuromidin® has the following pharmacological effects:
– improves and stimulates impulse conduction in the nervous system and neuromuscular transmission;
- enhances the contractility of smooth muscle organs under the influence of agonists of acetylcholine, adrenaline, serotonin, histamine and oxytocin receptors, with the exception of potassium chloride;
- improves memory, inhibits the progressive course of dementia.
In preclinical studies, Neuromidin® did not have teratogenic, embryotoxic, mutagenic, carcinogenic or immunotoxic effects, and did not affect the endocrine system.
Pharmacological properties of the drug Neuromidin
The action of ipidacrine (9 amino-2,3,5,6,7,8-hexahydro-1 H-cyclopentane (b) quinoline hydrochloride monohydrate) is due to a biologically beneficial combination of two molecular effects - blockade of potassium membrane permeability and reversible inhibition of cholinesterase activity. In this case, blockade of potassium permeability of the membrane plays a leading role. Blockade of potassium permeability of the membrane leads primarily to an increase in the repolarization phase of the action potential of the excited membrane and an increase in the activity of the presynaptic axon. This leads to an increase in the entry of calcium ions into the presynaptic terminal, which in turn leads to an increase in the release of transmitter into the synaptic cleft at all synapses. An increase in the concentration of the transmitter in the synaptic cleft promotes stronger stimulation of the postsynaptic cell due to the mediator-receptor interaction. In cholinergic synapses, inhibition of cholinesterase causes even greater accumulation of the neurotransmitter in the synaptic cleft and increased functional activity of the postsynaptic cell (contraction, conduction of excitation). Neuromidin enhances the effect of acetylcholine, adrenaline, serotonin, histamine and oxytocin on smooth muscles. The drug has the following pharmacological effects: stimulation and restoration of neuromuscular transmission; restoration of impulse conduction in the peripheral nervous system after its blockade by various agents (trauma, inflammation, exposure to local anesthetics, some antibiotics, potassium chloride and other factors); increased contractility of smooth muscle organs; specific moderate stimulation of the central nervous system with individual manifestations of sedation; improvement of memory and learning; analgesic and antiarrhythmic effect. The drug does not have teratogenic, embryotoxic, mutagenic and carcinogenic, as well as allergenic and immunotoxic effects, and does not affect the endocrine system. Rapidly absorbed after oral administration. The maximum concentration in blood plasma is observed 1 hour after oral administration and 25–30 minutes after subcutaneous or intramuscular administration. From the blood, the drug quickly enters the tissues and at the steady state stage, only 2% of the drug is detected in the blood serum. The half-life in the distribution phase is 40 minutes. The degree of binding to blood proteins is about 40–50%. Absorbed predominantly in the duodenum, to a lesser extent in the jejunum and ileum, only 3% of the dose is absorbed in the stomach. Elimination from the body is carried out through a combination of renal and extrarenal mechanisms (biotransformation, excretion in bile), with excretion in urine predominating. Only 3.7% of the drug is excreted unchanged in the urine, which indicates its rapid metabolism in the body.
Pharmacokinetics
After oral administration, intramuscular and subcutaneous administration, it is rapidly absorbed. Cmax in blood plasma is achieved 1 hour after oral administration and 25–30 minutes after intramuscular or subcutaneous administration. Binding to blood plasma proteins is 40–50% of the active substance. It quickly enters the tissues, the half-life of distribution is 40 minutes. Metabolized in the liver. It is excreted through the kidneys (mainly by tubular secretion and only 1/3 by glomerular filtration) and extrarenally (through the gastrointestinal tract). T1/2 of Neuromidin® when administered parenterally is 2–3 hours. After parenteral administration, 34.8% of the drug dose is excreted unchanged in the urine.
Arcoxia and Kagocel
Kagocel is an antiviral drug. Judging by the instructions for both Arcoxia and Kagocel, taking these drugs together is possible. Arcoxia can coexist with drugs of this pharmacological group, and Kagocel combines well with other antiviral drugs, immunomodulators, antibiotics and other drugs. But the combination of such means should be carried out by a qualified specialist. Independence in this matter and an arbitrary combination of medications can lead to negative consequences, poisoning and even death.
Contraindications
hypersensitivity to any of the components of the drug;
epilepsy;
extrapyramidal diseases with hyperkinesis;
angina pectoris;
severe bradycardia;
bronchial asthma;
mechanical obstruction of the intestine or urinary tract;
vestibular disorders;
peptic ulcer of the stomach or duodenum in the acute stage;
pregnancy (the drug increases the tone of the uterus);
lactation period;
children under 18 years of age (no systematic data on use).
With caution: for gastric and duodenal ulcers, thyrotoxicosis, cardiovascular diseases, as well as for patients with a history of obstructive diseases of the respiratory system or acute respiratory diseases.
Additionally for tablets
With caution: with lactase deficiency, lactose intolerance, lactose/isomaltose malabsorption syndrome, because the drug contains lactose.
Analogs
Analogues of the drug Arcoxia
To date, the drug Arcoxia has no analogues in the literal sense of the word, so if a replacement is necessary, you should consult your doctor.
Let us recall that Arcoxia is a selective nonsteroidal anti-inflammatory drug (NSAID) that suppresses the production of prostaglandins, which are mediators of inflammation. NSAIDs reduce fever, suppress pain and relieve inflammation and are used for symptomatic therapy. Although Arcoxia and the medications described below are part of the same pharmacological group, they have different active substances (to which the patient may have hypersensitivity), release forms, price, negative effects on the body, sometimes contraindications and side effects. Let's try to figure out what the pharmacy counter offers us. Remember that only a doctor can prescribe the appropriate drug!
Arcoxia or Movalis
Movalis is a drug whose active ingredient is meloxicam. Arcoxia and Movalis have similar indications and algorithm of action, but the release forms and negative effects on the body are different. Arcoxia is available in the form of tablets, and Movalis in the form of tablets, injection solution, suspension, and rectal suppositories. Thus, Arcoxia has a negative effect on the cardiovascular system, and Movalis has a negative effect on the gastric mucosa and gastrointestinal tract as a whole, causing perforations and possible bleeding. For endocrinological disorders (diabetes) and for elderly people, Arcoxia is indicated, since these parameters are on the list of contraindications for Movalis.
Arcoxia or Nimesil
The active substance Nimesil is nimesulide. It, like Arcoxia, blocks the activity of COX 2, which makes it possible to achieve an analgesic effect and be used for the treatment of inflammatory and degenerative diseases of the musculoskeletal system. But Nimesil has an additional area of application: it is used in the treatment of infectious and inflammatory processes of the respiratory system. Reduces temperature, relieves pain and inflammation.
Release form Nimesil is medicinal granules (powder), which are diluted in a glass of warm water.
Arcoxia or Aertal
Indications for use, contraindications and algorithm of action are identical to Arcoxia. The active ingredient in Aertal is aceclofenac. Release form: tablets, cream for external use and powder, from which a suspension is first prepared before use. The main negative effects that the patient encounters when taking Aertal are: nausea, vomiting, epigastric pain, intestinal colic, dyspepsia, flatulence, anorexia, constipation.
Arcoxia or Dexalgin
The active substance in Dexalgin is dexketoprofen, which, it should be noted right away, often causes allergies. It is sold in tablets and injections (administered intramuscularly) and taken throughout the day (tablets 2-6 times, injections 2-3 times). Otherwise, this is a NSAID with similar indications, action and contraindications.
Arcoxia or Diclofenac
Diclofenac is a very effective NSAID. It is not for nothing that doctors use it when they need to quickly relieve pain in the postoperative and post-traumatic period. Also, this remedy in the form of a suppository helps well with migraines. But, alas, the effect on the human body is negative. Long-term use of the drug affects not only the gastric mucosa, but also the cardiovascular system.
Arcoxia or Costarox
Kostarox is a generic, that is, a drug with the same active ingredient as the original (etoricoxib 90), however, it has not passed all stages of clinical trials. Generic status makes the drug cheaper, often without loss of pharmacological properties. Note that Kostarox, unlike Arcoxia, is available in only one dosage - 90 mg.
Arcoxia or Celebrex
Celebrex also belongs to the group of NSAIDs. It is sold on the market in the form of capsules containing 200 mg of the active substance - celecoxib. Celebrex is indicated for the following diseases:
- osteoarthritis;
- rheumatoid arthritis;
- primary dysmenorrhea;
- ankylosing spondylitis;
- pathologies of bone and muscle structures, accompanied by pain.
Since the indications and algorithm of action are the same, the prescription of Arcoxia or Celebrex will depend on the doctor, since only he, having carried out the necessary studies and taking an anamnesis, will be able to determine the need for a particular drug.
Eat right, move more, stay positive, and your mobility will stay with you!
Side effects
Caused by stimulation of m-cholinergic receptors: salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, bronchospasm, convulsions. Salivation and bradycardia can be reduced with m-anticholinergic drugs (atropine, etc.). Increased uterine tone, allergic skin reactions.
Rarely (after using higher doses), dizziness, headache, chest pain, vomiting, general weakness, drowsiness, and skin reactions (itching, rash) were observed. In these cases, reduce the dose or interrupt the drug for a short time (for 1–2 days). These side effects are observed in less than 10% of patients.
pharmachologic effect
Neuromidin belongs to the group of calcium channel blockers. Therefore, it helps reduce potassium levels in the body and, on the contrary, increases calcium in nerve endings. In addition, the drug prevents the effect of cholinesterase on neuromuscular fibers. Due to the occurrence of such processes, there is an increase in mediators in the body, namely adrenaline, serotonin, oxytocin and histamine.
The drug improves the transmission of nerve impulses in all areas of the muscles.
While taking this drug, there is a restoration of smooth muscle tone, synoptic connections and an improvement in mental activity, so new information is better and easier to remember.
The active component of the drug easily penetrates the bloodstream, and subsequently into the target organs.
Metabolism of drugs occurs in the liver. The highest concentration of the drug in the body occurs half an hour after use. The drug is excreted primarily through the excretory system.
Interaction
Neuromidin® enhances the sedative effect in combination with CNS depressants.
The action and side effects are enhanced when used together with other cholinesterase inhibitors and m-cholinomimetic drugs. In patients with myasthenia gravis, the risk of developing a cholinergic crisis increases if Neuromidin® is used simultaneously with other cholinergic drugs.
The risk of developing bradycardia increases if β-blockers were used before starting treatment with Neuromidin®.
Neuromidin® can be used in combination with nootropic drugs.
Alcohol increases the side effects of the drug.
Reduces the inhibitory effect on neuromuscular transmission and the conduction of excitation along peripheral nerves by local anesthetics, aminoglycosides, and potassium chloride.
Neuromidin, 10 pcs., 1 ml, 5 mg/ml, solution for intramuscular and subcutaneous administration
Approved by the Pharmacological Committee of the Russian Ministry of Health
INSTRUCTIONS (information for the patient) for the use of the drug NEIROMIDINUM
International nonproprietary name
Ipidacrine (9-Amino-2,3,5,6,7,8-hexahydro-1H-cyclopenta(b)quinoline hydrochloride monohydrate).
Dosage form
Pills.
Compound
Ipidacrine 20 mg.
Excipients: lactose, potato starch, calcium stearate.
Description
White tablets. In appearance they must comply with the requirements of the Global Fund XI, issue 2, p. 154.
Diameter - 6.0±0.2 mm.
Height - 2.7±0.3 mm.
Pharmacotherapeutic group
Cholinesterase inhibitor, neuromuscular conduction stimulator/ATS - N07AAOO.
Pharmacological properties
Neuromidin is a reversible cholinesterase inhibitor and also has a direct stimulating effect on impulse conduction at the neuromuscular synapse and in the central nervous system due to blockade of potassium channels in the excitable membrane.
Neuromidin enhances the effect on smooth muscles of not only acetylcholine, but also adrenaline, serotonin, histamine and oxytocin.
Neuromidin has the following pharmacological effects:
— restores and stimulates neuromuscular transmission;
- restores the conduction of impulses in the peripheral nervous system, disturbed due to the influence of various factors (trauma, inflammation, exposure to local anesthetics, some antibiotics, potassium chloride and other factors);
- enhances the contractility of smooth muscle organs under the influence of all agonists, with the exception of potassium chloride;
- moderately stimulates the central nervous system;
- improves memory and learning.
The drug does not have teratogenic, embryotoxic, mutagenic and carcinogenic, as well as allergenic or immunotoxic effects. The drug does not have a negative effect on the endocrine system.
After oral administration, Neuromidin is rapidly absorbed. The maximum concentration in the blood is observed after one hour. From the blood, Neuromidin quickly enters the tissues, and in the stabilization stage only 2% of the drug is found in the blood serum. Elimination of Neuromidin occurs through the kidneys, as well as extrarenally (biotransformation, secretion in bile). Only 3.7% of Neuromidin is excreted unchanged. This indicates the rapid metabolism of Neuromidin in the body.
Indications for use
Neuromidin is used in adults for diseases of the peripheral nervous system (neuritis, polyneuritis and polyneuropathy, polyradiculoneuropathies, myasthenia gravis and various myasthenic syndromes); bulbar paralysis and paresis, in the recovery period with organic lesions of the central nervous system, accompanied by motor disorders; in complex therapy of demyelinating diseases, with intestinal atony.
Contraindications
The use of Neuromidin is contraindicated in cases of epilepsy, extrapyramidal diseases, angina pectoris, severe bradycardia, bronchial asthma, individual hypersensitivity to the drug, vestibular disorders, peptic ulcer in the acute stage.
Use of the drug during pregnancy and lactation
Neuromidin penetrates well into all tissues of the body, increases the tone of the uterus and can cause premature birth, so it is not recommended to use the drug during pregnancy. The drug is used for weak labor. Contraindicated during breastfeeding.
Directions for use and doses
Neuromidin is used orally 1-3 times a day. A single dose of the drug is 10–20 mg (0.01–0.02 g) (0.5–1 tablets). For lesions of the peripheral nervous system, myasthenia gravis and myasthenic syndromes, the drug is prescribed orally at 10–20 mg (0.01–0.02 g) 1–3 times a day for 1–2 months. For short-term courses of treatment of patients with severe disorders of neuromuscular transmission, a single dose can be 20–40 mg (0.02–0.04 g) orally (1–2 tablets) 5–6 times a day.
For the treatment and prevention of intestinal atony, 20 mg (0.02 g) is prescribed 2-3 times a day for 1-2 weeks. If the next dose has not been taken, then continue the course of treatment at the previously prescribed doses. If necessary, you should consult your doctor.
special instructions
The drug increases the muscle tone of the uterus and can cause premature labor. Prescribe with caution for gastric ulcers, thyrotoxicosis, and diseases of the cardiovascular system.
Neuromidin penetrates well into tissues and organs, including the brain, and can have a sedative effect. Therefore, persons using Neuromidin should be careful when working with machinery. During treatment you should not drink alcohol.
Drug interactions
The drug enhances the sedative effect when interacting with central nervous system depressants. The action and side effects are enhanced when used together with other cholinesterase inhibitors and m-cholinomimetic drugs. In patients with myasthenia gravis, the risk of cholinergic crisis increases if Neuromidin is used simultaneously with other cholinergic drugs. Beta-blockers cause bradycardia if they were used before treatment with Neuromidin. When used simultaneously with alcohol, adverse side effects may increase.
Overdose
In case of Neuromidin poisoning or its relative overdose, m-anticholinergic blockers are used: atropine, cyclodol, etc.
Side effects
When using Neuromidin, hypersalivation, bradycardia, dizziness, nausea, vomiting, and allergic skin reactions (itching, rash) are possible. In these cases, reduce the dose or discontinue the drug. Hypersalivation and bradycardia can be reduced with m-anticholinergic blockers.
If during treatment with Neuromidin side effects are discovered that are not listed in the instructions, then it is necessary to inform the attending physician.
Manufacturer
JSC Olainsky Chemical-Pharmaceutical.
Address: st. Rupnicu 5, Olaine, LV-2114, Latvia.
Directions for use and doses
Inside, s/c or i/m. Doses and duration of treatment are determined individually, depending on the severity of the disease.
Pills
Diseases of the peripheral nervous system:
- mono- and polyneuropathy, polyradiculopathy, myasthenia gravis and myasthenic syndrome of various etiologies - 10-20 mg (0.5-1 tablet) 1-3 times a day. The course of treatment is from 1 to 2 months. If necessary, the course of treatment can be repeated several times with a break between courses of 1–2 months;
— to prevent myasthenic crises, in case of severe disorders of neuromuscular conduction, 1–2 ml (15–30 mg) Neuromidin® 1.5% solution for injection is administered parenterally for a short time, then treatment is continued with Neuromidin® tablets, the dose can be increased to 20–40 mg (1–2 tablets) 5 times a day.
Diseases of the central nervous system: bulbar paralysis and paresis, the recovery period of organic lesions of the central nervous system (traumatic, vascular and other origins), accompanied by motor and/or cognitive impairment - 10–20 mg (0.5–1 tablet) 2–3 times a day day. The course of treatment is from 2 to 6 months. If necessary, the course of treatment is repeated.
Treatment and prevention of intestinal atony - 20 mg (1 tablet) 2-3 times a day for 1-2 weeks.
Solution for intramuscular and subcutaneous administration
Diseases of the peripheral nervous system:
- mono- and polyneuropathy of various origins - subcutaneously or intramuscularly 5-15 mg 1-2 times a day, course - 10-15 days (in severe cases - up to 30 days); then treatment is continued with the tablet form of the drug;
- myasthenia gravis and myasthenic syndrome - subcutaneous or intramuscular 15-30 mg 1-3 times a day with further transition to the tablet form. The general course of treatment is 1–2 months. If necessary, treatment can be repeated several times with a break between courses of 1–2 months.
Diseases of the central nervous system:
— bulbar paralysis and paresis — subcutaneous or intramuscular 5–15 mg 1–2 times a day for 10–15 days; if possible, switch to tablet form;
- rehabilitation for organic lesions of the central nervous system - 10-15 mg intramuscularly 1-2 times a day, course - up to 15 days, then, if possible, switch to tablet form.
If the next dose was not taken on time, then it is not taken additionally.
The maximum daily dose is 200 mg.
Indications for use of the drug Neuromidin
Lesions of the peripheral nervous system - neuropathy, neuritis, polyneuritis, polyneuropathy, myelopolyradiculoneuritis, bulbar palsy and paresis; memory impairments of various origins (Alzheimer's disease and other forms of dementia in the elderly), mental retardation in children; lesions of the central nervous system of traumatic, vascular and other origins with impairments of memory, praxis, attention; myasthenia gravis and myasthenic syndromes; complex therapy of multiple sclerosis and other forms of demyelinating diseases of the nervous system; weakness of labor; intestinal atony.
Overdose
Symptoms: decreased appetite, bronchospasm, lacrimation, increased sweating, constriction of the pupils, nystagmus, increased gastrointestinal peristalsis, spontaneous bowel movements and urination, vomiting, jaundice, bradycardia, intracardiac conduction disturbances, arrhythmias, decreased blood pressure, restlessness, anxiety, agitation, feelings of fear, ataxia, convulsions, coma, speech impairment, drowsiness, general weakness.
Treatment: symptomatic therapy is used, m-anticholinergic blockers are prescribed (atropine, cyclodol, metacin, etc.).
Arcoxia and alcohol
Due to the fact that the instructions do not directly prohibit combination with alcohol, the question of their compatibility naturally arises. The simultaneous use of non-steroidal anti-inflammatory drugs in combination with alcohol is undesirable due to the possible occurrence and intensification of side effects. Migraine, weakness, nausea and vomiting, allergic reactions, diarrhea, disorientation in space, kidney failure, increased load on the liver, etc. Not the most pleasant set, right? Arcoxia in combination with alcohol leads to deterioration of the gastrointestinal tract and poisoning and internal bleeding. The risk of myocardial infarction, increased blood pressure, and cardiovascular failure cannot be excluded. But there are still a couple of tips. You can start drinking alcohol only after the drug has been completely eliminated from the body, which means 24 hours after taking the last pill. This also works the other way around: you should not drink alcohol the day before taking Arcoxia.
special instructions
There are no systematic data on the use of Neuromidin® in children.
Alcohol should be avoided during treatment (it increases the side effects of the drug).
Impact on the ability to drive a car or perform work that requires increased speed of physical and mental reactions. During treatment, you should refrain from driving a car, as well as engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Interaction with other drugs and alcohol
The use of Arcoxia does not replace the need to use other groups of medications, including antibiotics. But it's worth remembering the following:
- Before combining Arcoxia and other drugs, you should consult your doctor;
- Arcoxia enhances the effectiveness of anticoagulants and antiplatelet agents, lowering prothrombin time;
- reduces the effect of diuretics and antihypertensive drugs;
- if acetylsalicylic acid is used, then as a prevention of cardiovascular complications. But you should not get carried away, as gastric bleeding may be provoked;
- the compatibility of cyclosporines with Arcoxia enhances its nephrotoxic effect.
Release form
Tablets, 20 mg. 10 tablets each in blister packs made of PVC film and aluminum foil. 5 blister packs per cardboard pack.
Solution for intramuscular and subcutaneous administration, 5 mg/ml and 15 mg/ml. 1 ml of the drug in neutral glass ampoules (type I). 5 amp. in blister packs made of PVC film. 2 blister packs in a cardboard pack.
For the drug produced at SOPHARMA JSC, Bulgaria: 10 amp. in blister packs made of PVC film. 1 blister pack in a cardboard pack.