Buy Neuromidin solution intravenously and intramuscularly 15 mg/ml 1 ml No. 10 in pharmacies
Instructions for use Neuromidin solution IV and IM 15 mg/ml 1 ml No. 10
Dosage forms injection solution 15 mg/ml 1 ml Synonyms Axamon Ipigrix Group Cholinesterase inhibitors International nonproprietary name Ipidacrine Composition Active substance: Ipidacrine. Manufacturers: Olainfarm JSC (Latvia), Olainfarm JSC, packaged Sopharma JSC (Latvia), Olainfarm Olainsky HFZ (Latvia) Pharmacological action Reversibly inhibits cholinesterase, stimulates impulse conduction in neuromuscular synapses and in the central nervous system due to blockade of potassium channels of the excitable membrane. Restores and stimulates neuromuscular transmission (including in the peripheral nervous system), enhances the contractility of smooth muscle organs, moderately stimulates the central nervous system, improves memory and learning. Does not have teratogenic, embryotoxic, mutagenic, carcinogenic, allergenic, or immunotoxic effects. Does not affect the endocrine system. The drug penetrates well into all tissues of the body, increases the tone of the uterus and can cause premature birth. The drug can be used for weak labor. After oral administration, it is quickly absorbed. It is excreted through the kidneys and through the gastrointestinal tract, mainly in the form of metabolites. Side effects: Dizziness, bradycardia (can be eliminated with m-anticholinergic blockers), hypersalivation (can be eliminated with m-anticholinergic blockers), nausea, vomiting, itching, rash. Indications for use Diseases of the peripheral nervous system in adults (neuritis, polyneuritis, polyneuropathy, polyradiculoneuropathy, myasthenia gravis); bulbar palsy and paresis, organic lesions of the central nervous system, accompanied by nervous disorders (recovery period); demyelinating diseases (complex therapy), intestinal atony. Contraindications Hypersensitivity, epilepsy, extrapyramidal disorders, severe bradycardia, angina pectoris, bronchial asthma, vestibular disorders, gastric ulcer in the acute stage, pregnancy, breastfeeding. Overdose Treatment: prescription of m-anticholinergics, incl. atropine, cyclodol, etc. Interaction Strengthens the sedative effect of central nervous system depressants. M-cholinomimetics and other cholinesterase inhibitors increase the effect and side effects (the risk of a cholinergic crisis increases, especially in patients with myasthenia gravis). Beta-blockers cause bradycardia if they were used before treatment with Neuromidin. When used simultaneously with alcohol, adverse side effects may increase. Special instructions The drug increases the muscle tone of the uterus and can cause premature labor. Caution should be used for stomach ulcers, thyrotoxicosis, and diseases of the cardiovascular system. The drug penetrates well into tissues and organs, incl. brain and may have a sedative effect. Care should be taken when working with machinery. During treatment you should not drink alcohol. Storage conditions List A. In a place protected from light, at a temperature not exceeding 25 °C.
Neuromidin injection solution 15 mg/ml 1 ml n10 amp
Indications for use of the drug NEUROMIDIN® are diseases of the peripheral nervous system (including neuritis, polyneuritis, polyneuropathy, polyradiculopathy, myasthenia gravis, myasthenic syndrome of various etiologies);
- bulbar paralysis and paresis;
— recovery period of organic lesions of the central nervous system, accompanied by motor disorders;
— complex therapy of demyelinating diseases;
- intestinal atony.
pharmachologic effect
A reversible cholinesterase inhibitor, directly stimulates impulse transmission at the neuromuscular synapse and in the central nervous system due to blockade of membrane potassium channels. Enhances the effect of acetylcholine, adrenaline, serotonin, histamine and oxytocin on smooth muscles.
Neuromidin ® improves and stimulates neuromuscular transmission; improves conductivity in the peripheral nervous system, impaired due to injury, inflammation, exposure to local anesthetics, some antibiotics, potassium chloride; 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.
Pharmacokinetics
Suction
After oral administration, the drug is quickly absorbed from the gastrointestinal tract. Cmax in blood plasma is reached after 1 hour.
After parenteral administration, the drug is rapidly absorbed. Cmax in blood plasma is achieved 25-30 minutes after administration.
Distribution
Plasma protein binding is 40-55%.
Ipidacrine quickly enters the tissues; at equilibrium, only 2% of the active substance is found in the blood plasma.
Metabolism
Ipidacrine is metabolized in the liver.
Removal
It is excreted by the kidneys and also extrarenally (through the gastrointestinal tract). The half-life of distribution is 40 minutes. Excretion by the kidneys occurs mainly by tubular secretion and only 1/3 of the active substance is excreted by glomerular filtration. After parenteral administration, 34.8% is excreted unchanged in the urine.
Dosage regimen
Doses and duration of treatment with Neuromidin are determined individually depending on the severity of the disease.
Diseases of the peripheral nervous system, myasthenia gravis and myasthenic syndrome
The drug is prescribed orally at a dose of 10-20 mg (0.5-1 tablets) 1-3 times a day. Parenterally, the drug is used intramuscularly or subcutaneously at a dose of 5-15 mg 1-2 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.
Prevention of myasthenic crises in severe disorders of neuromuscular conduction
1-2 ml (15-30 mg) of a 1.5% solution of Neuromidin for injection are administered parenterally for a short time, then treatment is continued with tablets - the dose can be increased to 20-40 mg (1-2 tablets) 5 times a day.
Treatment and prevention of intestinal atony
The drug is prescribed orally at a dose of 20 mg (1 tablet) 2-3 times a day. within 1-2 weeks. If the next dose was not taken on time, you should not take it additionally.
The maximum daily dose is 200 mg.
When administered parenterally, the initial dose of the drug is 10-15 mg/day. within 1-2 weeks. The dose of the drug can be increased to 30 mg/day.
Side effect
Reactions caused by stimulation of m-cholinergic receptors:
<10%
—
salivation, increased sweating, palpitations, nausea, diarrhea, jaundice, bradycardia, epigastric pain, increased secretion of bronchial secretions, convulsions. Salivation and bradycardia can be reduced with m-anticholinergic drugs (including atropine).
When using the drug in high doses:
<10%
-
dizziness, headache, vomiting, general weakness, drowsiness, allergic skin reactions (itching, rash).
In these cases, reduce the dose or interrupt the drug for a short time (for 1-2 days). Contraindications to the use of the drug NEUROMIDIN®
- epilepsy;
- vestibular disorders;
- extrapyramidal diseases with hyperkinesis;
- angina pectoris;
- severe bradycardia;
- bronchial asthma;
- peptic ulcer of the stomach or duodenum in the acute phase;
- obstruction of the intestines or urinary tract;
- pregnancy;
- lactation period (breastfeeding);
- childhood;
- hypersensitivity to the components of the drug.
Carefully _
used for gastric and duodenal ulcers, thyrotoxicosis, diseases of the cardiovascular system, as well as in patients with a history of obstructive diseases of the respiratory system or acute respiratory diseases.
Use of the drug NEUROMIDIN® during pregnancy and breastfeeding
The use of the drug during pregnancy and lactation (breastfeeding) is contraindicated.
The drug does not have a teratogenic or embryotoxic effect.
special instructions
The drug does not have mutagenic, carcinogenic or immunotoxic effects. Does not affect the endocrine system.
The patient should inform the doctor about taking other medications and the occurrence of side effects during treatment with Neuromidin .
Use in pediatrics
The use of the drug in childhood is contraindicated.
Impact on the ability to drive vehicles and operate machinery
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.
Overdose
In case of poisoning with Neuromidin, you should immediately call a doctor.
Symptoms:
decreased appetite, bronchospasm, lacrimation, increased sweating, constriction of the pupils, nystagmus, increased gastrointestinal peristalsis, spontaneous defecation and urination, vomiting, jaundice, bradycardia, intracardiac conduction disturbances, arrhythmias, decreased blood pressure, restlessness, anxiety, agitation, feelings of fear, ataxia, convulsions, coma, speech disorders, drowsiness, general weakness.
Treatment:
gastric lavage, use of m-anticholinergic drugs (including atropine, cyclodol, metacin), symptomatic therapy.
Drug interactions
Neuromidin ® enhances the sedative effect in combination with CNS depressants.
The effect of the drug 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 when Neuromidin with other cholinergic drugs.
The risk of developing bradycardia increases if beta-blockers were used before starting treatment with Neuromidin .
The drug can be used in combination with Cerebrolysin.
Ethanol increases the side effects of the drug.
Neuromidin ® weakens the inhibitory effect on neuromuscular transmission and conduction of excitation through peripheral nerves of local anesthetics, aminoglycosides, and potassium chloride.
Conditions for dispensing from pharmacies
The drug is available with a prescription.
Storage conditions and periods
The drug in tablet form should be stored out of the reach of children, in a dry place, protected from light, at a temperature not exceeding 25°C. Shelf life: 3 years.
The drug in the form of a solution for intramuscular and subcutaneous administration (list A) should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life: 2 years.
Neuromidin 15 mg/ml 1 ml n10 solution for intramuscular and subcutaneous administration amp.
Release form
Solution for intramuscular and subcutaneous administration
Package
10 ampoules of 1 ml.
pharmachologic effect
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.
Pharmacokinetics
After oral, 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.
Indications
- diseases of the peripheral nervous system (mono- and polyneuropathy, polyradiculopathy, myasthenia gravis and myasthenic syndrome of various etiologies);
— diseases of the central nervous system (bulbar paralysis and paresis; recovery period of organic lesions of the central nervous system, accompanied by motor and/or cognitive impairment)
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 (there is no systematic data on use).
Carefully:
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.
Use during pregnancy and breastfeeding
Contraindicated during pregnancy. Breastfeeding should be stopped during treatment.
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.
Compound
1 ml solution contains:
active substance: ipidacrine hydrochloride monohydrate 15 mg (in terms of ipidacrine hydrochloride)
excipients: concentrated hydrochloric acid - up to pH 3; water for injection - up to 1 ml
Directions for use and doses
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.
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.
Drug interactions
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.
Overdose
Symptoms:
decreased appetite, bronchospasm, lacrimation, increased sweating, constriction of the pupils, nystagmus, increased gastrointestinal motility, spontaneous defecation and urination, vomiting, jaundice, bradycardia, intracardiac conduction disorders, arrhythmias, decreased blood pressure, restlessness, anxiety, agitation, fear, ataxia, convulsions, coma, speech disorders, drowsiness, general weakness.
Treatment:
in case of an overdose of tablets, gastric lavage. Prescription of m-anticholinergics, incl. atropine, cyclodol, metacin, etc.; symptomatic therapy.
Storage conditions
5 years.
