Pirenzepine-Ratiopharm

Pharmacological properties of the drug Pirenzepine

A specific inhibitor of gastric secretion, a selective blocker of M1-cholinergic receptors of parietal and main cells of the gastric mucosa. Inhibits the production of hydrochloric (hydrochloric) acid and pepsin without disturbing the physiological functions of the digestive tract. It has pronounced hydrophilic properties, and therefore does not penetrate the BBB in clinically significant quantities and, unlike most tricyclic compounds, does not have a central effect. It is characterized by a long half-life (10–12 hours), which explains its long-lasting therapeutic effect; It is characterized by rapid development of effect in hyperacid conditions (a few hours from the start of treatment) and good tolerability.

Side effects

Undesirable consequences of taking Pirenzepine can affect the following organ systems:

• Digestive system: dry mouth is bothersome, appetite increases, constipation occurs, or bowel movements become more frequent;
• Visual system: accommodation is impaired, mydriasis, the sensitivity of the visual organs to light increases;
• Excretory system: urinary retention, decreased sweating;
• Cardiovascular system: tachycardia;
• Immune system: allergic manifestations;
• Nervous system: headaches.

Overdose

Exceeding the dosage of the drug prescribed by a specialist or indicated in the instructions may cause deviations in the operation of some systems. The degree of intensity of side symptoms depends on the body’s sensitivity to the components of its composition and some individual characteristics of the patient’s health status.

Long-term overdoses lead to serious pathological processes, which require a visit to a specialist to eliminate them.

An overdose can provoke the following pathological conditions:

• tachycardia and other heart rhythm disorders;
• hallucinations, changes in consciousness and excessive weakness of the body;
• muscle weakness and convulsions of varying degrees of intensity;
• increased dryness of the mucous membranes in the mouth and sinuses (the symptom may be accompanied by discomfort in the eyes and sore throat);
• breathing problems (from difficulty breathing and shortness of breath to asthma-like attacks);
• increased body temperature;
• deterioration of vision (with regular overdose and hypersensitivity to the drug).

Contraindications

It is strictly forbidden for people with the following pathological conditions to take the drug:

• Individual hypersensitivity to individual components of the drug;
• Prostatic hyperplasia;
• Pyloric stenosis;
• Paralytic intestinal obstruction.

If these diseases are present, the medication is taken as prescribed and under the supervision of the attending physician:

• Glaucoma;
• Tachycardia;
• Kidney and liver failure (due to difficulty removing the drug);
• Intestinal atony (in elderly patients);
• Chronic lung diseases in children (plugs may form in the lumen of the bronchi due to the thicker consistency of the secretion);
• Chronic heart failure;
• Mitral stenosis;
• Atrial fibrillation;
• Arterial hypertension;
• Cardiac ischemia;
• Thyrotoxicosis;
• Acute bleeding.

During pregnancy

The product is not recommended for use by women in the 1st trimester of pregnancy.

In the second and third trimester, it can be used in pregnant women if the benefits of its use are higher than the likely risks for the unborn baby.

During the lactation period, Pirenzepine is also not recommended for use by young mothers , since it can pass into breast milk in small quantities. It is also necessary to take into account the fact that the medicine can worsen lactation.

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Use of the drug Pirenzepine

Orally, 50–150 mg per day is prescribed (usually at a dose of 50 mg) with a small amount of liquid in the morning and evening 30 minutes before meals. In rare cases, during the first 2–3 days of treatment, it may be necessary to take an additional dose during the day. Continuous oral therapy should be carried out (even in the case of rapid subjective improvement) for at least 4–6 weeks without dose reduction. 0.5% solution is usually administered intramuscularly or intravenously, 2 ml at an interval of 12 hours. For the prevention and treatment of “stress” ulcers of the upper gastrointestinal tract, it is recommended to administer 2 ml of solution 3 times a day at an interval of 8 h. For Zollinger-Ellison syndrome, the dose can be increased 2 times (4 ml of 0.5% solution 3 times a day). Parenteral administration for Zollinger-Ellison syndrome usually precedes surgery. Parenterally administered until clinical improvement (usually within 2-3 days), after which pirenzepine is prescribed orally. IV is administered as a slow bolus (over at least 3 minutes) or, preferably, as an IV drip. For intravenous infusion, pirenzepine can be diluted in isotonic sodium chloride solution, Ringer's solution, 5% levulose solution or 5% glucose solution.

special instructions

Impact on the ability to drive vehicles and operate machinery

Caution is advised. Pirenzepine can provoke increased sensitivity of the body to the drug and a slowdown in the speed of some mental reactions.

Pregnancy and lactation

It is not recommended to take Pirenzepine during pregnancy. Pirenzepine is not prescribed in the first trimester of pregnancy. At later stages, the decision to prescribe the drug should be made by the doctor (the potential benefit to the woman must outweigh the risk to the fetus). The ability of the drug to pass into breast milk causes a ban on its use during lactation.

Use in childhood

In pediatric practice, Pirenzepine is used only in case of emergency. The drug should not be taken by children with chronic diseases of the respiratory and nervous systems, as well as the brain. If a child has symptoms of body weakness, the medication should not be prescribed. The decision to use Pirenzepine in pediatric practice should be made by a pediatrician.

If kidney function is impaired

Pathologies associated with impaired renal function increase the risk of side effects (the drug is used with caution).

In case of liver dysfunction

The drug is used with caution in cases of serious pathological processes in the liver (liver failure).

Conditions for dispensing from pharmacies

Pirenzepine can be purchased at pharmacies only with a prescription.

Reviews

You can read patient reviews about the drug "Pirenzepine" at the end of this article.

According to the majority of patients who have personally tried to use Pirenzepine, the drug effectively eliminates heartburn and helps cope with pain in acute peptic ulcers of the stomach and duodenum, and gastritis.

Patients used the drug both in the acute period of the disease and as a prophylactic agent to consolidate the therapeutic effect. However, you should not abuse the drug, because it also has its side properties.

So, some of the most common side effects are: dry mouth , temporary digestive problems, headache. The average duration of the course of taking the drug is at least 30 calendar days.

Pirenzepine
International name of the medicinal substance:
Pirenzepine The list of drugs containing the active substance Pirenzepine is given after the description.
Pharmacological action:
M1-cholinergic receptor blocker.
Does not penetrate the BBB and has no effect on the central nervous system; the chronotropic effect is little expressed. In therapeutic doses there is no significant effect on the motility of the gastrointestinal tract, gallbladder and bladder. Inhibits the secretion of gastric juice, reduces the secretion of gastrin, reduces the production of HCl and pepsin. After stimulation with histamine, it blocks HCl secretion by 25%; after meals - by 53%; after insulin administration - by 58%. At 1 hour after a meal, pirenzepine reduces the secretion of HCl by 48% and by 30% at 2 hours. The secretion of pepsin stimulated by insulin is reduced by 49%, by histamine by 34%, and by gastrin by 24%. Inhibits the release of bicarbonate from the epithelium into the gastric cavity in patients with erosive lesions of the antrum and enhances the protection of the gastric mucosa; increases blood flow in the submucosal layer of the stomach and intestines, improves microcirculation. Pharmacokinetics:
Absorption - 40%, TCmax - 1.5-4 hours, T1/2 - 8-20 hours. Communication with plasma proteins - 10%. Metabolized to a small extent. Excreted in bile and kidneys.

Indications:
Peptic ulcer of the stomach and duodenum (treatment and prevention);
erosive and ulcerative lesions of the gastrointestinal tract, incl. caused by antirheumatic and anti-inflammatory drugs; stress ulcers of the gastrointestinal tract; chronic hyperacid reflux esophagitis; Zollinger-Ellison syndrome; bleeding from erosions and ulcerations in the upper gastrointestinal tract. Contraindications:
Hypersensitivity. Caution.
Diseases of the cardiovascular system in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, CHF, coronary artery disease, mitral stenosis, arterial hypertension, acute bleeding; thyrotoxicosis (possibly increased tachycardia); increased body temperature (may further increase due to suppression of the activity of the sweat glands); reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); gastrointestinal diseases accompanied by obstruction: achalasia of the esophagus, pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents); intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic intestinal obstruction (possible development of obstruction); diseases with increased intraocular pressure: closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; adjustment of therapy may be required); nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic ileus; in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); dry mouth (long-term use may further increase the severity of xerostomia); liver failure (decreased metabolism) and renal failure (risk of side effects due to decreased excretion); chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy); gestosis (possibly increased arterial hypertension); brain damage in children, cerebral palsy, Down's disease (response to anticholinergic drugs increases). Side effects:
Dry mouth, accommodation paresis, diarrhea, bulimia, allergic reactions.
Special instructions:
In a hyperacid state with a continuous type of secretion, it is advisable to combine it with H2-histamine receptor blockers.
During the treatment period, care must be taken when driving vehicles and engaging in potentially hazardous activities that require good vision. Preparations containing the active ingredient Pirenzepine:
Gastril, Gastrozem, Gastromen, Gastropin, Gastrocepin, Piregexal, Piren, Pirenzepin-Ratiopharm, Pirenzepin

The information provided in this section is intended for medical and pharmaceutical professionals and should not be used for self-medication. The information is provided for informational purposes only and cannot be considered official.

Storage conditions and periods

The storage location should be at room temperature and protected from moisture. The shelf life is 5 years.

All gastroenterology clinics and medical centers in your city. Tests and ultrasound. Consultation with a gastroenterologist. Diseases of the digestive system. Find out more: - In Kiev (Hertz, Ilaya, Euromed) - In St. Petersburg (SM-Clinic, Longevity, Allergomed, Doctor +, BaltZdrav, Professor) - In Moscow (SM-Clinic, Medlux, Onmed) - In Kharkov ( TsMEI, Olympic, Victoria, Fortis, Ecomed) - In Minsk (Belgirudo, Art-Med-Company, Sinlab, Mikosha, GrandMedica, MedClinic) - in Odessa (Medea, On Clinic, Into Sano, Venus) - In Razyan (Trust + , Polyclinic-Pesochnya, Evrikas +) - in Nizhny Novgorod (Only Clinic, Alpha Center, EuroClinic, SOLO, Altea) - gastroenterological clinics of Tyumen (Doctor A+, Clinic "Vera", Avicenna, Medis, Sibirina, Your Doctor)